In the summer of 1991 a large outbreak of Escherichia coli O157:H7 associated diarrhea occurred in 6 Inuit communities in the Canadian Northwest Territories. The total population of these communities is 5,292. Of the 521 individuals who developed diarrhea, 152 (29%) were positive for E. coli O157:H7 on stool culture or positive by verotoxin analysis. Median age was 6 years. The attack rate for children < 1 year was 43% in the major affected community of Arviat. Hemolytic-uremic syndrome (HUS) developed in 22 cases, and 2 patients died. Asymptomatic stool carriage of verotoxin-producing E. coli (VTEC) 2-5 weeks after diarrheal illness was noted in 4/28 persons followed prospectively. Epidemic curves, case-control studies and phage type testing suggested person-to-person transmission. The original source of infection was not identified, though a food source was suspected. VTEC were detected in 6 food samples (minced beef and caribou) taken from retail outlets and homes. Primary prevention of infection through health education and promotion activities, as well as long-term follow-up of HUS survivors, are indicated in this population.

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The seroprevalence of H. pylori in the study group was higher than rates in southern Canadian populations, but lower than the seroprevalence previously documented in a Canadian subarctic Indian (First Nations) community. The detection of H. pylori in local water supplies may indicate a natural reservoir for the organism or possible contamination from human sewage.

IBook 1Revtew. Aids to Bacteriology. Fourth Edition, 264 pages. By XV. Partridge. Published by Balliere, Tindall and Cox, London.. This small book is intended, presumably, for the few whose interest in bacteriology is confined to remembering a number of superficial facts long enough to pass an examination. The correctness of the title may therefore be questioned. The table of contents includes sections on apparatus, media, technique, and individual pathogenic bacteria, spirilla, higher bacteria, protozoa, metabolism of bacteria; bacterial diseases of plants, filterable viruses, bacteriology of water, milk, sewage, etc., disinfection and disinfectants. The size of the book has necessarily limited the treatmentof all subjects to outlines and mere statements of fact, so that the presentation lacks completeness, is of little value for the student, and, in many places, for want of discussion, fails to give a present day view point. It cannot be recommended. H. B. M.