The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.
An Outbreak of Diarrhea and Hemolytic Uremic Syndrome From Escherichia coli O157:H7 in Fresh-Pressed Apple Cider
Abstract
OBJECTIVE: Escherichia coli O157:H7 causes hemorrhagic colitis and the hemolytic uremic syndrome. In the fall of 1991, an outbreak of E coli O157:H7 infections in southeastern Massachusetts provided an opportunity to identify transmission by a seemingly unlikely vehicle. DESIGN: Case-control study to determine the vehicle of infection. New England cider producers were surveyed to assess production practices and determined the survival time of E coli O157:H7 organisms in apple cider. RESULTS: Illness was significantly associated with drinking one brand of apple cider. Thirteen (72%) of 18 patients but only 16 (33%) of 49 controls reported drinking apple cider in the week before illness began (odds ratio [OR], 8.3; 95% confidence interval [CI], 1.8 to 39.7). Among those who drank cider, 12 (92%) of 13 patients compared with two (13%) of 16 controls drank cider from cider mill A (lower 95% CI, 2.9; P < .01). This mill pressed cider in a manner similar to that used by other small cider producers: apples were not washed, cider was not pasteurized, and no preservatives were added. In the laboratory, E coli O157:H7 organisms survived for 20 days in unpreserved refrigerated apple cider. Addition of sodium benzoate 0.1% reduced survival to less than 7 days. CONCLUSIONS: Fresh-pressed, unpreserved apple cider can transmit E coli O157:H7 organisms, which cause severe infections. Risk of transmission can be reduced by washing and brushing apples before pressing, and preserving cider with sodium benzoate. Consumers can reduce their risk by only drinking cider made from apples that have been washed and brushed.
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Cites
A rapid alkaline extraction procedure for screening recombinant plasmid DNA
Birnboim, H. C., & Doly, J. (1979) · Nucleic Acids Research · doi:10.1093/nar/7.6.1513 · Cited by 14,686
Hemorrhagic Colitis Associated with a Rare Escherichia coli Serotype
Riley, L. W., Remis, R. S., Helgerson, S. D., McGee, H. B., Wells, J. G., Davis, B. R., Hebert, R. J., Olcott, E. S., Johnson, L. M., Hargrett, N. T., et al. (1983) · New England Journal of Medicine · doi:10.1056/nejm198303243081203 · Cited by 2,668
Griffin, P. M., & Tauxe, R. V. (1991) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a036079 · Cited by 1,807
Meyers, J. A., Sanchez, D., Elwell, L. P., & Falkow, S. (1976) · Journal of Bacteriology · doi:10.1128/jb.127.3.1529-1537.1976 · Cited by 1,098
Wells, J. G., Davis, B. R., Wachsmuth, I. K., Riley, L. W., Remis, R. S., Sokolow, R., & Morris, G. K. (1983) · Journal of Clinical Microbiology · doi:10.1128/jcm.18.3.512-520.1983 · Cited by 584
March, S. B., & Ratnam, S. (1986) · Journal of Clinical Microbiology · doi:10.1128/jcm.23.5.869-872.1986 · Cited by 570
Illnesses Associated with Escherichia coli 0157:H7 Infections: A Broad Clinical Spectrum
Griffin, P. M., Ostroff, S. M., Tauxe, R. V., Greene, K. D., Wells, J. G., Lewis, J. H., & Blake, P. A. (1988) · Annals of Internal Medicine · doi:10.7326/0003-4819-109-9-705 · Cited by 503
A GENERAL ESTIMATOR FOR THE VARIANCE OF THE MANTEL HAENSZEL ODDS RATIO
ROBINS, J., GREENLAND, S., & BRESLOW, N. E. (1986) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114447 · Cited by 330
Tarr, P. I., Neill, M. A., Clausen, C. R., Watkins, S. L., Christie, D. L., & Hickman, R. O. (1990) · Journal of Infectious Diseases · doi:10.1093/infdis/162.2.553 · Cited by 242
An outbreak of hemolytic uremic syndrome associated with ingestion of fresh apple juice
Steele, B. T., Murphy, N., Arbus, G. S., & Rance, C. P. (1982) · The Journal of Pediatrics · doi:10.1016/s0022-3476(82)80021-8 · Cited by 134
Cited by
Epidemiology of Escherichia coli O157:H7 Outbreaks, United States, 1982–2002
Rangel, J. M., Sparling, P. H., Crowe, C., Griffin, P. M., & Swerdlow, D. L. (2005) · Emerging Infectious Diseases · doi:10.3201/eid1104.040739 · Cited by 1,263
Ecological factors influencing survival and growth of human pathogens on raw fruits and vegetables
Beuchat, L. R. (2002) · Microbes and Infection · doi:10.1016/s1286-4579(02)01555-1 · Cited by 934
Fresh fruit and vegetables as vehicles for the transmission of human pathogens
Berger, C. N., Sodha, S. V., Shaw, R. K., Griffin, P. M., Pink, D., Hand, P., & Frankel, G. (2010) · Environmental Microbiology · doi:10.1111/j.1462-2920.2010.02297.x · Cited by 889
Armstrong, G. L., Hollingsworth, J., & Morris, J. G. (1996) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a017914 · Cited by 678
Metadata
- Authors
- Besser, R. E.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1993-05-05
- Volume
- 269
- Issue
- 17
- Pages
- 2217
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2041929026
- Cited by
- 851
- References
- 12
- FWCI
- 11.84
- Type
- journal article
- Language
- en
- Open access
- closed
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