In August 2008, a large outbreak of Shiga toxin-producing Escherichia coli (STEC) O111:NM infections associated with a buffet-style restaurant in rural Oklahoma was identified. A case-control study of restaurant patrons and a retrospective cohort study of catered event attendees were conducted coupled with an environmental investigation to determine the outbreak's source and mode of transmission. Of 1823 persons interviewed, 341 (18.7%) met the outbreak case definition; 70 (20.5%) were hospitalized, 25 (7.3%) developed haemolytic uraemic syndrome, and one died. Multiple food items were significantly associated with illness by both bivariate and multivariate analyses, but none stood out as a predominant transmission vehicle. All water, food, and restaurant surface swabs, and stool cultures from nine ill employees were negative for the presence of Shiga toxin and E. coli O111:NM although epidemiological evidence suggested the outbreak resulted from cross-contamination of restaurant food from food preparation equipment or surfaces, or from an unidentified infected food handler. © 2011 Cambridge University Press.
CITATION STYLE
Bradley, K. K., Williams, J. M., Burnsed, L. J., Lytle, M. B., McDermott, M. D., Mody, R. K., … Smithee, L. K. (2012). Epidemiology of a large restaurant-associated outbreak of Shiga toxin-producing Escherichia coli O111:NM. Epidemiology and Infection, 140(9), 1644–1654. https://doi.org/10.1017/S0950268811002329
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