An Outbreak of Escherichia coli 0157:H7 Colitis Associated with Consumption of Precooked Meat Patties

Abstract
An outbreak of Escherichia coli 0157:H7 hemorrhagic colitis at a Minnesota junior high school in October 1988 comprised 32 cases among 1562 students (attack rate, 2.0%). Four children were hospitalized; none developed hemolytic-uremic syndrome. Case children were more likely than controls to have eaten heat-processed meat patties (odds ratio, 6.2; 95% confidence interval, 2.0–20.1; P < .001) in the school cafeteria on a specific day. The minimum estimated attack rate among students who ate these patties was 8%. The patties should have been sufficientlycooked by the manufacturer to destroy enteric pathogens before they were frozen and distributed. E. coli were cultured from frozen patties that were manufactured at the same plant on the same dates as the implicated patties, but serotype 0157:H7 was not isolated. Heat-processed meat patties may serve as vehicles for E. coli 0157:H7 infection, and currently there are no federal or state regulatory standards to ensure the safety of these products.