Published Date: 2002-06-01 23:50:00
Subject: PRO/EDR> E. coli O157 - USA (New York)
Archive Number: 20020601.4377
E. COLI O157 - USA (NEW YORK)
A ProMED-mail post
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International Society for Infectious Diseases
Date: 31 May 2002
From: ProMED-mail <firstname.lastname@example.org>
Source: Rockland Journal News (edited)
Two more reports of E. coli in Rockland
2 more suspected cases of _Escherichia coli_ O157:H7 infection were
reported to the Rockland Department of Health (New York) on 30 May 2002 as
officials kept searching for the source of the bacteria they believe has
now stricken 15 local residents. Only 2 cases of the infection were
reported in Rockland in 2001.
For the first time since the outbreak started, the illness was diagnosed in
a resident outside Monsey, where the 14 other victims, mostly children,
live, county commissioner of health Dr Joan Facelle said. Most of the cases
have been reported since 26 May 2002.
A 6 year old Orangetown girl with a diagnosis of _E. coli_ infection was in
stable condition yesterday at Westchester Medical Center, Facelle said. The
other case was reported in Monsey, but the Orangetown case has no obvious
connections to the Monsey area, the apparent epicenter of the outbreak.
Tests to determine whether the girl has the same strain of the bacteria as
the Monsey victims will not be complete for about a week.
"What is encouraging at this point is that no large public food or water
supply appears to be involved," Facelle said. "If that was the case, there
would be more incidents."
Investigators from the New York State Department of Health arrived in
Rockland to assist local officials searching for the bacteria's source.
"The county Health Department is in charge of the investigation," said
Claire Pospisil, spokeswoman for the state Health Department. "We are
providing technical assistance and will continue to do so until we find the
cause." Inspectors from the New York Department of Agriculture and Markets
are visiting stores and food-processing companies in the Monsey area to
look for signs of the bacteria. Nothing has been found to link any of the
establishments to the outbreak, department spokeswoman Jessica Chittenden said.
So far 4 children, including the girl from Orangetown, have been admitted
to hospital for treatment of hemolytic uremic syndrome. The condition, in
which the bacteria attack blood cells and damage the kidneys, sometimes
accompanies _E. coli_ O157:H7 infection. All but 2 of the victims are
younger than 18, with the highest frequency among youngsters 4 and younger.
Both of the two adult cases occurred in members of a household with an
The biggest outbreak of the disease in New York State history occurred in
1999, when a young girl and an elderly man died and nearly 1000 more became
ill after drinking water contaminated with _E. coli_ at the Washington
County, NY, fair.
[Byline: Jane Lerner]
[Monsey, New York, is the home of a large orthodox religious population
whose children attend religious schools. It is possible that the school may
represent the site of spread of the infection from an index case, perhaps
relating to inadequate handwashing after bathroom use. Such transmission
has occurred in the past in this population, resulting in a significant
outbreak of shigellosis (1,2). That outbreak ended when the schools were
closed for a religious observance.
1. CDC. Multistate outbreak of Shigella sonnei gastroenteritis. MMWR Morb
Mortal Wkly Rep 1987; 36: 440-2.
2. Sobel J, Cameron DN, Ismail J, et al. A prolonged outbreak of Shigella
sonnei infections in traditionally observant Jewish communities in North
America caused by a molecularly distinct bacterial subtype. J Infect Dis
1998; 177: 1405-9. - Mod.LL]