A Swimming-Associated Outbreak of Hemorrhagic Colitis Caused by Escherichia coli O157:H7 and Shigella Sonnei

Escherichia coli O157:H7 is increasingly recognized as a common cause of both epidemic and sporadic disease, notably bloody diarrhea and hemolytic-uremic syndrome. Common-source outbreaks have been traced to the consumption of contaminated hamburger, 1 – 6 other foods, 7 – 10 and drinking water 11 , 12 . Person-to-person transmission is also well documented 4 , 13 – 17 . In 1987, Washington became the first state to mandate public health reporting of E. coli O157:H7 infections by physicians and diagnostic laboratories. Oregon instituted a similar requirement in August 1990, and all case reports are now followed with in-depth standardized interviews of patients that include questions about possible sources . . .