Authors: Klumb C, Saunders S, Smith K

Journal of Agromedicine. Minneapolis, Minnesota. June 9, 2014

ABSTRACT:
Escherichia coli O157:H7 (O157) is an important cause of enteric illness, causing an estimated 96,000 infections and 31 deaths annually in the United States. O157 infections are primarily foodborne but can also occur from contact with infected animals (especially cattle and other ruminants) or their environment. Population-based surveillance data for O157 infections in agricultural populations are sparse, and the extent to which animal agriculture exposures contribute to O157 disease burden is unknown. All O157 cases in Minnesota were interviewed about illness characteristics and potential exposures. Retrospective surveillance data from 1996-2011 were collated from electronic databases and surveillance interview forms. Prospective surveillance for O157 in 2012 included detailed follow-up of agricultural exposures. Descriptive analyses were performed using SAS version 9.2 (SAS Institute, Cary, N.C.). During 1996–2011, 358 (14%) of the 2,623 O157 cases in Minnesota had a documented animal agriculture exposure in the week before illness onset. Of these 358 cases, 52% were female, 93% were white, 91% were non-Hispanic, and the median age was 11 years (range, 5 months–89 years). Eighty-seven percent of the 358 cases had bloody diarrhea, and 36% were hospitalized (median stay, 4 days). Prior to their illness, 143 (40%) of the 358 cases with animal agricultural exposures lived on a farm, 61 (17%) worked on a farm, 142 (39%) visited a farm; 127 (35%) reported direct animal contact, and 198 (55%) reported contact with an animal’s environment. In 2012, 23 (19%) of 124 E. coliO157 cases had an animal agriculture exposure before illness onset. Of these 23 cases, 7 (30%) lived on a farm, 1 (4%) worked on a farm, 11 (48%) visited a farm or petting zoo, and 4 (17%) had multiple exposures. Agricultural exposures can account for a substantial proportion of O157 infections in Minnesota. We will develop practical interventions through awareness campaigns, personal protective equipment recommendations, and job duty modifications. Industry leaders can be valuable collaborators in promoting these initiatives with agricultural populations. In the future we will use social media outlets (Twitter and Facebook) and publications in trade journals to promote interventions.

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