TY - JOUR AU - Effler, Paul AU - IsaƤcson, Margaretha AU - Arntzen, Lorraine AU - Heenan, Rosemary AU - Canter, Paul AU - Barrett, Timothy AU - Lee, Lisa AU - Mambo, Clifford AU - Levine, William AU - Zaidi, Akbar AU - Griffin, Patricia T1 - Factors Contributing to the Emergence of Escherichia coli O157 in Africa T2 - Emerging Infectious Disease journal PY - 2001 VL - 7 IS - 5 SP - 812 SN - 1080-6059 AB - In 1992, a large outbreak of bloody diarrhea caused by Escherichia coli O157 infections occurred in southern Africa. In Swaziland, 40,912 physician visits for diarrhea in persons ages >5 years were reported during October through November 1992. This was a sevenfold increase over the same period during 1990-91. The attack rate was 42% among 778 residents we surveyed. Female gender and consuming beef and untreated water were significant risks for illness. E. coli O157:NM was recovered from seven affected foci in Swaziland and South Africa; 27 of 31 patient and environmental isolates had indistinguishable pulsed-field gel electrophoresis patterns. Compared with previous years, a fivefold increase in cattle deaths occurred in October 1992. The first heavy rains fell that same month (36 mm), following 3 months of drought. Drought, carriage of E. coli O157 by cattle, and heavy rains with contamination of surface water appear to be important factors contributing to this outbreak. KW - Escherichia coli O157 KW - Africa KW - epidemiology KW - surveillance KW - outbreaks KW - drought KW - floods KW - Swaziland DO - 10.3201/eid0705.017507 UR - https://wwwnc.cdc.gov/eid/article/7/5/01-7507_article ER - End of Reference