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. 2001 Sep-Oct;7(5):812–819. doi: 10.3201/eid0705.017507

Factors contributing to the emergence of Escherichia coli O157 in Africa.

E Effler 1, M Isaäcson 1, L Arntzen 1, R Heenan 1, P Canter 1, T Barrett 1, L Lee 1, C Mambo 1, W Levine 1, A Zaidi 1, P M Griffin 1
PMCID: PMC2631888  PMID: 11747693

Abstract

In 1992, a large outbreak of bloody diarrhea caused by Escherichia coli O157 infections occurred in southern Africa. In Swaziland, 40,912 physician visits for diarrhea in persons ages >5 years were reported during October through November 1992. This was a sevenfold increase over the same period during 1990-91. The attack rate was 42% among 778 residents we surveyed. Female gender and consuming beef and untreated water were significant risks for illness. E. coli O157:NM was recovered from seven affected foci in Swaziland and South Africa; 27 of 31 patient and environmental isolates had indistinguishable pulsed-field gel electrophoresis patterns. Compared with previous years, a fivefold increase in cattle deaths occurred in October 1992. The first heavy rains fell that same month (36 mm), following 3 months of drought. Drought, carriage of E. coli O157 by cattle, and heavy rains with contamination of surface water appear to be important factors contributing to this outbreak.

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Selected References

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