Escherichia coli 0157:H7 diarrhea in a nursing home: Clinical, epidemiological, and pathological findings

Caroline A. Ryan, Robert V. Tauxe, Gary W. Hosek, Joy G. Wells, Paul A. Stoesz, Harry W. McFadden, Philip W. Smith, Gregg F. Wright, Paul A. Blake, Caroline A. Ryan, Robert V. Tauxe, Gary W. Hosek, Joy G. Wells, Paul A. Stoesz, Harry W. McFadden, Philip W. Smith, Gregg F. Wright, Paul A. Blake

Research output: Contribution to journalArticle

204 Scopus citations

Abstract

In September 1984, an outbreak of Escherichia coli 0157:H7 infection occurred in a nursing home. It was the first recognized outbreak of this organism in the United States since 1982, when two outbreaks led to its recognition as a pathogen. Thirty-four of 101 residents developed a diarrheal illness; 14 were hospitalized with a severe illness characterized by crampy abdominal pain, marked abdominal distention, and grossly bloody diarrhea, and four died. The spectrum of illness associated with the infection was broad and included the following: asymptomatic infection, nonbloody diarrhea, hemorrhagic colitis, hemolytic uremic syndrome, and death. Clinical, radiographic, and postmortem pathological findings suggested involvement of the cecum and right colon. No evidence of response to antimicrobial agents could be documented, and antidiarrheal agents may have aggravated the disease. This investigation implicated hamburger as the vehicle of transmission. Seventeen of 19 residents with hemorrhagic colitis, but only 28 of 67 healthy residents, had eaten hamburger on 13 September (P<.001, Fisher’s two-tailed exact test; relative risk [RR] = 7.7). Infection with E. coli 0157:H7 can cause a wide range of manifestations. In the elderly these can be particularly severe and may resemble ischemic colitis.

Original languageEnglish (US)
Pages (from-to)631-638
Number of pages8
JournalJournal of Infectious Diseases
Volume154
Issue number4
DOIs
StatePublished - Oct 1986
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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  • Cite this

    Ryan, C. A., Tauxe, R. V., Hosek, G. W., Wells, J. G., Stoesz, P. A., McFadden, H. W., Smith, P. W., Wright, G. F., Blake, P. A., Ryan, C. A., Tauxe, R. V., Hosek, G. W., Wells, J. G., Stoesz, P. A., McFadden, H. W., Smith, P. W., Wright, G. F., & Blake, P. A. (1986). Escherichia coli 0157:H7 diarrhea in a nursing home: Clinical, epidemiological, and pathological findings. Journal of Infectious Diseases, 154(4), 631-638. https://doi.org/10.1093/infdis/154.4.631