An Outbreak of Shigellosis at an Outdoor Music Festival
In August 1988, an estimated 3,175 women who attended a 5-day outdoor music festival in Michigan became ill with gastroenteritis caused by Shigella sonnei. Onset of illness peaked 2 days after the festival ended, and patients were spread throughout the United States by the time the outbreak was reco...
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| Veröffentlicht in: | American journal of epidemiology 1991-03, Vol.133 (6), p.608-615 |
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| container_title | American journal of epidemiology |
| container_volume | 133 |
| creator | Lee, Lisa A. Ostroff, Stephen M. McGee, Harry B. Johnson, David R. Downes, Frances P. Cameron, Daniel N. Bean, Nancy H. Griffin, Patricia M. |
| description | In August 1988, an estimated 3,175 women who attended a 5-day outdoor music festival in Michigan became ill with gastroenteritis caused by Shigella sonnei. Onset of illness peaked 2 days after the festival ended, and patients were spread throughout the United States by the time the outbreak was recognized. An uncooked tofu salad served on the last day was implicated as the outbreak vehicle (odds ratio = 3.4, p |
| doi_str_mv | 10.1093/oxfordjournals.aje.a115933 |
| format | Article |
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Onset of illness peaked 2 days after the festival ended, and patients were spread throughout the United States by the time the outbreak was recognized. An uncooked tofu salad served on the last day was implicated as the outbreak vehicle (odds ratio = 3.4, p <0.0001). Over 2,000 volunteer food handlers prepared the communal meals served during the festival. This large foodborne outbreak had been heralded by a smaller outbreak of shigellosis among staff shortly before the festival began and by continued transmission of shigellosis from staff to attendees during the festival. S. sonnei isolated from women who became ill before, during, and after the festival had identical antimicrobial susceptibility patterns and plasmid profiles, limited access to soap and running water for handwashing was one of the few sanitary deficits noted at this gathering. This investigation demonstrates the need for surveillance and prompt public health intervention when Shigella infections are recognized in persons attending mass outdoor gatherings, the singular importance of handwashing in reducing secondary transmission of shigellosis, and the potential for explosive outbreaks when communal meals are prepared by large numbers of food handlers.</description><identifier>ISSN: 0002-9262</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/oxfordjournals.aje.a115933</identifier><identifier>PMID: 2006648</identifier><identifier>CODEN: AJEPAS</identifier><language>eng</language><publisher>Cary, NC: Oxford University Press</publisher><subject>Adult ; Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Biological and medical sciences ; Camping ; Child ; Child, Preschool ; Disease Outbreaks - statistics & numerical data ; Dysentery, Bacillary - epidemiology ; Dysentery, Bacillary - etiology ; Dysentery, Bacillary - prevention & control ; Female ; food handling ; Food Handling - standards ; Food Microbiology ; gastroenterities ; Hand Disinfection - standards ; handwashing ; Holidays ; Human bacterial diseases ; Humans ; Infant ; Infectious diseases ; Medical sciences ; Michigan - epidemiology ; Music ; Risk Factors ; Rural Population ; Shigella sonnei ; Surveys and Questionnaires ; Toilet Facilities - standards ; Water Microbiology</subject><ispartof>American journal of epidemiology, 1991-03, Vol.133 (6), p.608-615</ispartof><rights>1991 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-270cd364e3464790552940a1e1db336a8cc098fcb3829ad02389b4c1ff44c6a13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27868,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19632495$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2006648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Lisa A.</creatorcontrib><creatorcontrib>Ostroff, Stephen M.</creatorcontrib><creatorcontrib>McGee, Harry B.</creatorcontrib><creatorcontrib>Johnson, David R.</creatorcontrib><creatorcontrib>Downes, Frances P.</creatorcontrib><creatorcontrib>Cameron, Daniel N.</creatorcontrib><creatorcontrib>Bean, Nancy H.</creatorcontrib><creatorcontrib>Griffin, Patricia M.</creatorcontrib><title>An Outbreak of Shigellosis at an Outdoor Music Festival</title><title>American journal of epidemiology</title><addtitle>Am J Epidemiol</addtitle><description>In August 1988, an estimated 3,175 women who attended a 5-day outdoor music festival in Michigan became ill with gastroenteritis caused by Shigella sonnei. Onset of illness peaked 2 days after the festival ended, and patients were spread throughout the United States by the time the outbreak was recognized. An uncooked tofu salad served on the last day was implicated as the outbreak vehicle (odds ratio = 3.4, p <0.0001). Over 2,000 volunteer food handlers prepared the communal meals served during the festival. This large foodborne outbreak had been heralded by a smaller outbreak of shigellosis among staff shortly before the festival began and by continued transmission of shigellosis from staff to attendees during the festival. S. sonnei isolated from women who became ill before, during, and after the festival had identical antimicrobial susceptibility patterns and plasmid profiles, limited access to soap and running water for handwashing was one of the few sanitary deficits noted at this gathering. This investigation demonstrates the need for surveillance and prompt public health intervention when Shigella infections are recognized in persons attending mass outdoor gatherings, the singular importance of handwashing in reducing secondary transmission of shigellosis, and the potential for explosive outbreaks when communal meals are prepared by large numbers of food handlers.</description><subject>Adult</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Camping</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Disease Outbreaks - statistics & numerical data</subject><subject>Dysentery, Bacillary - epidemiology</subject><subject>Dysentery, Bacillary - etiology</subject><subject>Dysentery, Bacillary - prevention & control</subject><subject>Female</subject><subject>food handling</subject><subject>Food Handling - standards</subject><subject>Food Microbiology</subject><subject>gastroenterities</subject><subject>Hand Disinfection - standards</subject><subject>handwashing</subject><subject>Holidays</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Michigan - epidemiology</subject><subject>Music</subject><subject>Risk Factors</subject><subject>Rural Population</subject><subject>Shigella sonnei</subject><subject>Surveys and Questionnaires</subject><subject>Toilet Facilities - standards</subject><subject>Water Microbiology</subject><issn>0002-9262</issn><issn>1476-6256</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><recordid>eNpdkE1P3DAQhq0KRBfan4AUgegty_gzMTeECosA0aqtqHqxJo5TsmTXYCcI_n0NG0D05MP7jN-Zh5AdClMKmu_7h8aHeu6HsMQuTnHupkip1Jx_IBMqCpUrJtUamQAAyzVT7CPZjHEOQKmWsEE2GIBSopyQ4nCZXQ59FRzeZL7Jfly3f13X-djGDPsMn9Pa-5BdDLG12bGLfXuP3Sey3qRu93l8t8iv468_j2b5-eXJ6dHheW6FoH3OCrA1V8JxoUShQUqmBSB1tK44V1haC7psbMVLprEGxktdCUubRgirkPIt8mX1723wd0MqN4s22rQhLp0foqGyLEqqdAJ3_wNf_BjK07FSypIl6mBF2eBjDK4xt6FdYHg0FMyTW_PerUluzeg2DW-PFUO1cPXr6Cgz5XtjjtFi1wRc2ja-NWjFmdAycfmKa2PvHl5zDDdGFbyQZvb7jxGz79-uruAsbf8P8iuVVg</recordid><startdate>19910315</startdate><enddate>19910315</enddate><creator>Lee, Lisa A.</creator><creator>Ostroff, Stephen M.</creator><creator>McGee, Harry B.</creator><creator>Johnson, David R.</creator><creator>Downes, Frances P.</creator><creator>Cameron, Daniel N.</creator><creator>Bean, Nancy H.</creator><creator>Griffin, Patricia M.</creator><general>Oxford University Press</general><general>School of Hygiene and Public Health of the Johns Hopkins University</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>HVZBN</scope><scope>K30</scope><scope>PAAUG</scope><scope>PAWHS</scope><scope>PAWZZ</scope><scope>PAXOH</scope><scope>PBHAV</scope><scope>PBQSW</scope><scope>PBYQZ</scope><scope>PCIWU</scope><scope>PCMID</scope><scope>PCZJX</scope><scope>PDGRG</scope><scope>PDWWI</scope><scope>PETMR</scope><scope>PFVGT</scope><scope>PGXDX</scope><scope>PIHIL</scope><scope>PISVA</scope><scope>PJCTQ</scope><scope>PJTMS</scope><scope>PLCHJ</scope><scope>PMHAD</scope><scope>PNQDJ</scope><scope>POUND</scope><scope>PPLAD</scope><scope>PQAPC</scope><scope>PQCAN</scope><scope>PQCMW</scope><scope>PQEME</scope><scope>PQHKH</scope><scope>PQMID</scope><scope>PQNCT</scope><scope>PQNET</scope><scope>PQSCT</scope><scope>PQSET</scope><scope>PSVJG</scope><scope>PVMQY</scope><scope>PZGFC</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>19910315</creationdate><title>An Outbreak of Shigellosis at an Outdoor Music Festival</title><author>Lee, Lisa A. ; Ostroff, Stephen M. ; McGee, Harry B. ; Johnson, David R. ; Downes, Frances P. ; Cameron, Daniel N. ; Bean, Nancy H. ; Griffin, Patricia M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-270cd364e3464790552940a1e1db336a8cc098fcb3829ad02389b4c1ff44c6a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Adult</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the digestive system and abdomen</topic><topic>Biological and medical sciences</topic><topic>Camping</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Disease Outbreaks - 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Onset of illness peaked 2 days after the festival ended, and patients were spread throughout the United States by the time the outbreak was recognized. An uncooked tofu salad served on the last day was implicated as the outbreak vehicle (odds ratio = 3.4, p <0.0001). Over 2,000 volunteer food handlers prepared the communal meals served during the festival. This large foodborne outbreak had been heralded by a smaller outbreak of shigellosis among staff shortly before the festival began and by continued transmission of shigellosis from staff to attendees during the festival. S. sonnei isolated from women who became ill before, during, and after the festival had identical antimicrobial susceptibility patterns and plasmid profiles, limited access to soap and running water for handwashing was one of the few sanitary deficits noted at this gathering. This investigation demonstrates the need for surveillance and prompt public health intervention when Shigella infections are recognized in persons attending mass outdoor gatherings, the singular importance of handwashing in reducing secondary transmission of shigellosis, and the potential for explosive outbreaks when communal meals are prepared by large numbers of food handlers.</abstract><cop>Cary, NC</cop><pub>Oxford University Press</pub><pmid>2006648</pmid><doi>10.1093/oxfordjournals.aje.a115933</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0002-9262 |
| ispartof | American journal of epidemiology, 1991-03, Vol.133 (6), p.608-615 |
| issn | 0002-9262 1476-6256 |
| language | eng |
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| source | Oxford University Press Journals Digital Archive legacy; MEDLINE; Periodicals Index Online |
| subjects | Adult Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Camping Child Child, Preschool Disease Outbreaks - statistics & numerical data Dysentery, Bacillary - epidemiology Dysentery, Bacillary - etiology Dysentery, Bacillary - prevention & control Female food handling Food Handling - standards Food Microbiology gastroenterities Hand Disinfection - standards handwashing Holidays Human bacterial diseases Humans Infant Infectious diseases Medical sciences Michigan - epidemiology Music Risk Factors Rural Population Shigella sonnei Surveys and Questionnaires Toilet Facilities - standards Water Microbiology |
| title | An Outbreak of Shigellosis at an Outdoor Music Festival |
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