American Journal of Epidemiology Vol. 150, No. 8: 787-796
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Massive Outbreak of Escherichia coli O157: H7 Infection In Schoolchildren in Sakai City, Japan, Associated with Consumption of White Radish Sprouts
1Environmental Health Bureau, Ministry of Health and Welfare Tokyo, Japan
2Department of Hygiene and Preventive Medicine, School of Medicine, Fukuoka University Fukuoka, Japan
3Department of Public Health, Jichi Medical School Tochigi, Japan
4Present address: Saitama Prefectural University, Saitama, Japan.
Reprint requests to Dr. Hideshi Michino, Food Sanitation Division, Environmental Health Bureau, Ministry of Health and Welfare, Tokyo 100-8045, Japan.
In July 1996, an outbreak of Escherichia coli O157: H7 infection occurred among schoolchildren in Sakai City, Osaka, Japan. This outbreak developed in 13 North-East District and 34 Middle-South District elementary schools in the city. All children hospitalized on July 17–19 had presented on July 8 (North-East District) and July 9 (Middle-South District). School lunches served on July 1 and 8 in the North-East District and on July 1, 4, 8, and 9 in the Middle-South District were proposed by a food consumption study to be associated with infection. White radish sprouts from a single farm were the only uncooked food common to the most highly implicated meals on the involved days in two school districts (sweet and sour chicken with lettuce on July 8 in the North-East District and chilled Japanese noodles on July 9 in the Middle-South District). Two incidents of E. coli O157: H7 in neighboring areas were also related to white radish sprouts from the farm. The pulse-field gel electrophoresis patterns of isolates from patients in these two districts and the neighboring areas were identical. Thus, it was concluded that the cause of the outbreak was the white radish sprouts shipped on July 7–9 from one particular farm. Am J Epidemiol 1999;150:787-96.
disease outbreaks; enterocolitis; Escherichia coli infections; Escherichia coli O157; food handling; food inspection
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