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Peer reviewedOpen access

Factors Contributing to the Emergence of Escherichia coli O157 in Africa

Emerging Infectious Diseases·

Paul Effler, Margaretha Isaäcson, Lorraine Arntzen, Rosemary Heenan, Paul Canter, Timothy Barrett, Lisa Lee, Clifford Mambo, William Levine, Akbar Zaidi, Patricia M. Griffin

DOI
10.3201/eid0705.017507
PMID
11747693
PMCID
PMC2631888
OpenAlex
W2123437427
Study type
Journal article
Publisher
Centers for Disease Control and Prevention (CDC)
Article type
journal-article
Integrity
current

Why this research matters now

The findings highlight potential roles for drought, cattle carriage of E. coli O157, and heavy rainfall in facilitating water contamination and disease emergence in this region.

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Structured evidence summary

Research question

This study investigated factors contributing to the emergence of Escherichia coli O157 infections in southern Africa during a 1992 outbreak.

Study design

The investigation included a retrospective survey of 778 residents, environmental sampling from affected areas, and analysis of patient and environmental bacterial isolates using pulsed-field gel electrophoresis.

Population and setting

The outbreak affected persons over 5 years of age in Swaziland and South Africa during October through November 1992, following drought conditions and heavy rainfall.

Main findings

Among surveyed residents, the attack rate was 42%, with significant risk factors including female gender, consumption of beef, and untreated water. Molecular typing showed indistinguishable patterns in 27 of 31 isolates from patients and the environment. The outbreak coincided with a fivefold increase in cattle deaths, first heavy rains after three months of drought, and contamination of surface water.

Public-health relevance

The findings highlight potential roles for drought, cattle carriage of E. coli O157, and heavy rainfall in facilitating water contamination and disease emergence in this region.

Important limitations

This summary is limited to the supplied single-article abstract and metadata; full interpretation requires access to the original paper for assessment of study limitations, potential confounders, and generalizability of findings.

GIDS interpretation

This study documents a specific outbreak in 1992 and provides descriptive evidence of environmental and behavioral risk factors. The findings are contextual to this event and should not be extrapolated to current surveillance signals without supporting contemporary data.

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Evidence relationships

This article has 7 auditable classifier relationships to diseases, places, topics, and study design.

addresses topicaddresses topicaddresses topicstudied population settingstudies populationstudies populationuses study design