TY - JOUR AU - Olsen, Sonja J. AU - Miller, Gayle AU - Breuer, Thomas AU - Kennedy, Malinda AU - Higgins, Charles AU - Walford, Jim AU - McKee, Gary AU - Fox, Kim AU - Bibb, William AU - Mead, Paul T1 - A Waterborne Outbreak of Escherichia coli O157:H7 Infections and Hemolytic Uremic Syndrome: Implications for Rural Water Systems T2 - Emerging Infectious Disease journal PY - 2002 VL - 8 IS - 4 SP - 370 SN - 1080-6059 AB - In the summer of 1998, a large outbreak of Escherichia coli O157:H7 infections occurred in Alpine, Wyoming. We identified 157 ill persons; stool from 71 (45%) yielded E. coli O157:H7. In two cohort studies, illness was significantly associated with drinking municipal water (town residents: adjusted odds ratio=10.1, 95% confidence intervals [CI]=1.8-56.4; visitors attending family reunion: relative risk=9.0, 95% CI=1.3-63.3). The unchlorinated water supply had microbiologic evidence of fecal organisms and the potential for chronic contamination with surface water. Among persons exposed to water, the attack rate was significantly lower in town residents than in visitors (23% vs. 50%, p<0.01) and decreased with increasing age. The lower attack rate among exposed residents, especially adults, is consistent with the acquisition of partial immunity following long-term exposure. Serologic data, although limited, may support this finding. Contamination of small, unprotected water systems may be an increasing public health risk. KW - Escherichia coli O157:H7 KW - waterborne transmission KW - epidemiology KW - drinking water KW - antibody KW - United States DO - 10.3201/eid0804.000218 UR - https://wwwnc.cdc.gov/eid/article/8/4/00-0218_article ER - End of Reference