- A ProMED-mail post ProMED-mail is a program of the International
Society for Infectious Diseases www.isid.org
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- Source - ABC News
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- At least 19 people who had gone to a county fair in Ohio
in 2001 fell ill with _E. coli_ after the bacteria apparently spread through
sawdust in the air at an exhibition hall, the first time researchers have
connected an outbreak to a contaminated building. Testing at the building
in Lorain County found _E. coli_ O157 in the rafters, the walls, and the
sawdust in some cases 10 months after the fair.
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- "This is an entirely new mode of transmission,"
said Dr. Michael S. Donnenberg, professor of medicine and head of infectious
diseases at the University of Maryland, who was not involved in the study.
The study was conducted by the Centers for Disease Control and Prevention
and published in Wed, 26 Nov 2003 Journal of the American Medical Association.
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- Tainted food is the most common source of _E. coli_ outbreaks,
which cause an average of 61 deaths and 73 000 illnesses a year in the
USA. People can also become infected from animal or human feces.
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- Altogether, 23 people who had attended the fair became
sick with _E. coli_. 19 of them had gone to a dance at the hall or had
otherwise visited the building, which contained exhibits involving cattle,
sheep, horses, and dogs. The building had a clay floor covered with sawdust,
and some of those at the dance complained the air was dusty.
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- "We do not have any proof that persons were infected
because the _E. coli_ O157 landed directly in their mouth, but our study
suggests this is possible," said Dr. Jay K. Varma of the CDC, who
led the study. Researchers were also surprised at how long _E. coli_ remained
in the building.
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- "It is possible that the _E. coli_ that live for
that long are not abundant enough or virulent enough to cause infection,"
Varma said, but the study "raises this as a dangerous possibility."
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- Researchers said the few precautions available for reducing
the risk of outbreaks at fairs include not using sawdust, providing soap
and water, and disallowing eating at places where animals are on display.
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- Since the study, the CDC has learned of 2 other outbreaks
that might have been caused by building contamination, Varma said. One
happened at the University of Wisconsin, the other at the Lane County Fair
in Oregon.
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- http://abcnews.go.com/wire/Living/ap20031125_1157.html
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- ProMED-mail <promed@promedmail.org>
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- [This outbreak occurred 2 years ago, but the data suggesting
aerosol transmission of the bacterium has prompted ProMED-mail to post
the description published in JAMA at this time. The abstract of the article
follows:
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- Varma JK, Greene KD, Reller ME, et al. An Outbreak of
_Escherichia coli_ O157 Infection Following Exposure to a Contaminated
Building. JAMA. 2003; 290:2709-12.
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- Context: Infection with _Escherichia coli_ O157 causes
an estimated 70 000 diarrheal illnesses per year in the USA and can result
in hemolytic-uremic syndrome and death. Environmental contamination with
_E. coli_ O157 may be a public health problem.
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- Objectives: To determine risk factors for _E. coli_ O157
infection during an outbreak investigation at a county fair and to evaluate
environmental contamination as a possible cause of the outbreak.
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- Design, Setting, and Participants: Case-control study
of 23 patients (median age, 15 years) and 53 age-matched controls who had
attended the Lorain County, Ohio, fair between 20 and 26 Aug 2001. Case-patients
had laboratory-confirmed _E. coli_ O157 infection, hemolytic-uremic syndrome,
or bloody diarrhea within 7 days of attending the fair; controls attended
the fair and did not have diarrhea.
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- Main Outcome: Measures Risk factors for infection and
isolates of _E. coli_ O157 from environmental specimens.
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- Results: 6 (26 percent) case-patients were hospitalized
and 2 (9 percent) developed hemolytic-uremic syndrome. Case-patients were
more likely than controls to have visited building A (a multipurpose community
facility on the fairgrounds; matched odds ratio [MOR], 21.4 [95 percent
confidence interval {CI}, 2.7-170.7]). Among visitors to building A, illness
was independently associated with attending a dance in the building (MOR,
7.5; 95 percent CI, 1.4-41.2), handling sawdust from the floor (MOR, 4.6;
95 percent CI, 1.1-20.0), or eating and/or drinking in the building (MOR,
4.5; 95 percent CI, 1.2-16.6).
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- 24 (44 percent) of 54 specimens collected from building
A 6 weeks after the fair grew Shiga toxin-producing _E. coli_ O157. Isolates
from sawdust, the rafters, and other surfaces were identical by molecular
fingerprinting to patient isolates. Sawdust specimens collected 42 weeks
after the fair also grew the same _E. coli_ O157 strain.
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- Conclusions: Absence of evidence implicating specific
food or beverage sources and the recovery of _E. coli_ O157 from the rafters
suggest that airborne dispersion of bacteria contributed to the contamination.
Because _E. coli_ O157 can survive in the environment for more than 10
months, humans may be at risk of infection long after an environment is
initially contaminated. - Mod.LL]
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- Patricia A. Doyle, PhD Please visit my "Emerging
Diseases" message board at: http://www.clickitnews.com/ubbthreads/postlist.php?Cat=&Board=emergingdiseases
Zhan le Devlesa tai sastimasa Go with God and in Good Health
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