A UNIVERSITY OUTBREAK OF ESCHERICHIA-COLI O157/H7 INFECTIONS ASSOCIATED WITH ROAST BEEF AND AN UNUSUALLY BENIGN CLINICAL COURSE

An outbreak of Escherichia coli O157:H7 infections occurred after a graduation banquet at a university in Wisconsin. Sixty-one (32%) of 193 banquet attendees developed a gastrointestinal illness; 2 were hospitalized, none developed hemolytic-uremic syndrome or thrombotic thrombocytopenic purpura, and none died. The spectrum of illness was unusually mild, with 61% of ill persons reporting nonbloody diarrhea. A strain of E. coli O157:H7, indistinguishable from the outbreak strain by toxin type, plasmid profile, and pulsed-field gel electrophoresis, was isolated from an unopened package of an uncooked round of beef from the original shipment of meat. An investigation suggested that both undercooked roast beef and salad cross-contaminated with beef were vehicles of transmission. These findings demonstrate that meat from beef cattle may transmit E. coli O157:H7, and such infections among young to middle-aged adults may be mild and may often go undetected.