National patterns of Escherichia coli O157 infections, USA, 1996–2011

SUMMARY US public health laboratories began reporting Escherichia coli O157 isolates to CDC in 1996. We describe temporal and geographical patterns of isolates reported from 1996 to 2011 and demographics of persons whose specimens yielded isolates. We calculated annual E. coli O157 isolation rates/100 000 persons by patient's state of residence, county of residence, age, and sex using census data. The average annual isolation rate was 0·84. The average isolation rate in northern states (1·52) was higher than in southern states (0·43). Counties with ⩾76% rural population had a lower isolation rate (0·67) than counties with ⩽25%, 26–50%, and 51–75% rural populations (0·81, 0·92, and 0·81, respectively). The highest isolation rate (3·19) was in children aged 1–4 years. Infections were seasonal with 49% of isolates collected during July to September. Research into reasons for higher incidence in northern states and for seasonality could guide strategies to prevent illnesses.

[1]  W. Levine,et al.  Factors contributing to the emergence of Escherichia coli O157 in Africa. , 2001, Emerging infectious diseases.

[2]  T. Besser,et al.  A longitudinal study of Escherichia coli O157 in fourteen cattle herds , 1997, Epidemiology and Infection.

[3]  M. Widdowson,et al.  Foodborne Illness Acquired in the United States—Major Pathogens , 2011, Emerging infectious diseases.

[4]  S. Martin,et al.  Temporal and geographical distributions of reported cases of Escherichia coli O157[ratio ]H7 infection in Ontario , 1999, Epidemiology and Infection.

[5]  C. Hedberg,et al.  Factors affecting surveillance data on Escherichia coli O157 infections collected from FoodNet sites, 1996-1999. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[6]  Preliminary FoodNet data on the incidence of infection with pathogens transmitted commonly through food--10 states, 2007. , 2008, MMWR. Morbidity and mortality weekly report.

[7]  A. Naugle,et al.  Food safety and inspection service regulatory testing program for Escherichia coli O157:H7 in raw ground beef. , 2005, Journal of food protection.

[8]  J. Wells,et al.  Escherichia coli 0157 : H 7 Diarrhea in the United States : Clinical and Epidemiologic Features , 2009 .

[9]  M. Kibel,et al.  The haemolytic-uraemic syndrome: a survey in Southern Africa. , 1968, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[10]  James L. Withee,et al.  Determining relationships between the seasonal occurrence of Escherichia coli O157:H7 in live cattle, ground beef, and humans. , 2010, Foodborne pathogens and disease.

[11]  S. Ostroff,et al.  Infections with Escherichia coli O157:H7 in Washington State. The first year of statewide disease surveillance. , 1989, JAMA.

[12]  J. Hilbe.  Negative Binomial Regression: Preface , 2007 .

[13]  T. Ayers,et al.  Ground beef consumption patterns in the United States, FoodNet, 2006 through 2007. , 2012, Journal of food protection.

[14]  P. Mead,et al.  Risk Factors for Sporadic Shiga Toxin–producing Escherichia coli Infections in Children, Argentina , 2008, Emerging infectious diseases.

[15]  J. P. Davis,et al.  Multistate outbreak of Escherichia coli O157:H7 infection associated with consumption of packaged spinach, August-September 2006: the Wisconsin investigation. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  J. H. Green,et al.  Isolation of Escherichia coli serotype O157:H7 and other Shiga-like-toxin-producing E. coli from dairy cattle , 1991, Journal of clinical microbiology.

[17]  P. Griffin,et al.  Characterization and epidemiologic subtyping of Shiga toxin-producing Escherichia coli strains isolated from hemolytic uremic syndrome and diarrhea cases in Argentina. , 2006, Foodborne pathogens and disease.

[18]  L. Held,et al.  Cattle density and Shiga toxin-producing Escherichia coli infection in Germany: increased risk for most but not all serogroups. , 2008, Vector borne and zoonotic diseases.

[19]  Robin C. Anderson,et al.  Seasonal shedding of Escherichia coli O157:H7 in ruminants: a new hypothesis. , 2006, Foodborne pathogens and disease.

[20]  A. Naugle,et al.  Sustained decrease in the rate of Escherichia coli O157:H7-positive raw ground beef samples tested by the food safety and inspection service. , 2005, Journal of food protection.

[21]  J. Wells,et al.  Laboratory practices for stool-specimen culture for bacterial pathogens, including Escherichia coli O157:H7, in the FoodNet sites, 1995-2000. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[22]  David L. Swerdlow,et al.  Epidemiology of Escherichia coli O157:H7 Outbreaks, United States, 1982–2002 , 2005, Emerging infectious diseases.

[23]  Ongoing multistate outbreak of Escherichia coli serotype O157:H7 infections associated with consumption of fresh spinach--United States, September 2006. , 2006, MMWR. Morbidity and mortality weekly report.

[24]  J. Waters,et al.  Infection caused by Escherichia coli O157:H7 in Alberta, Canada, and in Scotland: a five-year review, 1987-1991. , 1994, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[25]  D. Swerdlow,et al.  Escherichia coli O157:H7 and the hemolytic-uremic syndrome. , 1995, The New England journal of medicine.

[26]  M. Woolhouse,et al.  Edinburgh Research Explorer Spatial and temporal epidemiology of sporadic human cases of Escherichia coli O157 in Scotland, 1996-1999 Spatial and temporal epidemiology of sporadic human cases of Escherichia coli O157 in Scotland, 1996–1999 , 2022 .

[27]  Kibel Ma,et al.  The haemolytic-uraemic syndrome: a survey in Southern Africa. , 1968 .

[28]  D. Swerdlow,et al.  2008 outbreak of Salmonella Saintpaul infections associated with raw produce. , 2011, The New England journal of medicine.