Outbreaks of Escherichia coli O157:H7 Infection and Cryptosporidiosis Associated With Drinking Unpasteurized Apple Cider—Connecticut and New York, October 1996

Mshar, P.; Dembek, Zygmunt F.; Cartter, Matthew L.; Hadler, James L.; Fiorentino, Terry; Marcus, Ruthanne; McGuire, Jacqueline; Shiffrin, M. A.; Lewis, Ann M.; Feuss, J.; Dyke, Julia Van; Toly, M.; Cambridge, Michael; Guzewich, John J.; Keithly, Jan S.; Dziewulski, David M.; Braun-Howland, Ellen B.; Ackman, D.; Smith, P.J.; Coates, Jennifer; Ferrara, James F.

doi:10.1001/jama.1997.03540340015008

Cited by 31 publications

(2 citation statements)

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“…Because this is the third reported Cryptosporidium outbreak related to unpasteurized apple cider ( 1 , 2 ), whatever sterilization procedure is used must be effective against Cryptosporidium . Although pasteurization kills Cryptosporidium oocysts ( 12 ), no data exist on the use of ozonation against Cryptosporidium in food or juice products, where turbidity and low temperature render ozonation less effective ( 13 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…are protozoan parasites transmitted by the fecal-oral route that cause prolonged diarrhea. Only 2 reports describe outbreaks associated with apple cider ( 1 , 2 ), and none have been associated with ozonated cider. In October 2003, a northeast Ohio health department identified 12 local residents with laboratory-confirmed cryptosporidiosis; 11 had drunk a locally produced, ozonated apple cider (cider A) in the 2 weeks before illness.…”

mentioning

confidence: 99%

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Cryptosporidiosis Associated with Ozonated Apple Cider

Blackburn

Mazurek

Hlavsa

et al. 2006

Emerg. Infect. Dis.

116

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Cryptosporidiosis Associated with Ozonated Apple Cider

Blackburn

Mazurek

Hlavsa

et al. 2006

Emerg. Infect. Dis.

116

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A Multistate Outbreak of Escherichia coli O157:H7 Infections Associated With Consumption of Mesclun Lettuce

Hilborn

Mermin²,

Mshar³

et al. 1999

Arch Intern Med

319

169

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This multistate outbreak of E. coli O157:H7 infections was associated with consumption of mesclun lettuce from a single producer. Molecular subtyping facilitated the epidemiological investigation. This investigation increased the knowledge about current production practices that may contribute to the contamination of lettuce by microbial pathogens. Lettuce production practices should be monitored for microbiological safety.

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Does Organic Gardening Foster Foodborne Pathogens?-Reply

Tauxe¹

1997

JAMA

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destroy microbes. Even in conventional agricultural prac¬ tices, which use animal manure as well as chemical fertilizers, there are states that restrict the use of manure. For example, Florida has a 120-day restriction on crops grown for human consumption.It is my understanding that the recent cases of E coli 0157:H7 did not stem from organic food. Therefore, specifi¬ cally indicating organic production as a contributor to the in¬ creasing outbreaks of foodborne infections is unjustified. Or¬ ganic farmers and processors follow food safety regulations and safe sanitation practices. The basis for organic certifica¬ tion is on-site inspections and production plans that require farmers and processors to detail how their operations provide for soil fertilization, pest and weed control, storage, sanita¬ tion, and product handling within the framework of organic standards. This system is compatible with surveillance and quality control systems such as Hazard Analysis Critical Control Points, which will be an important part of the solu¬ tion for eliminating further outbreaks of foodborne diseases. Pasteurization is allowed in organic production; requiring pasteurization would not necessarily be a burden to the or¬ ganic industry.In Repl y.\p=m-\ The public health hazard of fresh fruits and vegetables contaminated with feces used as fertilizer is a longstanding concern. Early in this century, Creel1 called attention to transmission of typhoid fever bacillus via fresh produce contaminated with human sewage. In W. Somerset Maugham's 1925 novel The Painted Veil, a despondent microbiologist committed suicide during a cholera epidemic by eating a fresh garden salad that was understood to be grown with human sewage fertilizer. More recently, foodborne outbreaks of E coli 0157:H7 infection and of cryptosporidiosis in apple cider, juice, and lettuce have highlighted concern that foodborne pathogens present in animal manures might also find their way into fresh produce.2 This could happen directly, via use of insufficiently composted manure as fertilizer, or indirectly, through irrigation water or untreated wash waters that are contaminated with animal manures. A small outbreak of E coli 0157:H7 infection attributed to homegrown produce fertilized with fresh bovine manure shows how this could happen on a small scale.3Ms DiMatteo is quite correct that adequate composting of manure should in principle eliminate pathogens from manure.Unfortunately, knowledge of the critical times and tempera¬ tures needed to make composted animal manures microbiologically safe is incomplete, and the regulatory approach to agricultural use of animal manures is patchy at best. Al¬ though the Organic Foods Production Act of 1990 specifies that raw manures should not be applied within 60 days of harvest, this is not entirely reassuring; Wang and colleagues4 have shown that E coli 0157:H7 can survive in bovine feces for 70 days depending on the temperature.Although important foodborne pathogens are present both in human sewage and in animal manure, there...

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Outbreaks of Escherichia coli O157:H7 Infection and Cryptosporidiosis Associated With Drinking Unpasteurized Apple Cider—Connecticut and New York, October 1996

Cited by 31 publications

References 2 publications

Cryptosporidiosis Associated with Ozonated Apple Cider

Cryptosporidiosis Associated with Ozonated Apple Cider

A Multistate Outbreak of Escherichia coli O157:H7 Infections Associated With Consumption of Mesclun Lettuce

Does Organic Gardening Foster Foodborne Pathogens?-Reply

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