Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109158

Michelle R. Torok, MPH¹, Pia D.M. MacDonald, PhD, MPH¹, Andrew C. Voetsch, MPH¹, Amy L. Nelson, PhD, MPH², Martha Salyers, MD, MPH³, and Leslie A. Wolf, PhD⁴. (1) Department of Epidemiology / North Carolina Center for Public Health Preparedness, The University of North Carolina at Chapel Hill, Campus Box 8165, Chapel Hill, NC 27599-8165, (2) North Carolina Center for Public Health Preparedness, The University of North Carolina at Chapel Hill, Campus Box 8165, Chapel Hill, NC 27599-8165, 919-843-5561, apickard@email.unc.edu, (3) Public Health Regional Surveillance Team Six, 35 Woodfin St, Asheville, NC 28801, (4) North Carolina State Laboratory of Public Health, P.O. Box 28047, Raleigh, NC 27611-8047

Background: Foodborne disease surveillance identifies outbreaks and monitors disease trends. In North Carolina, surveillance is performed by clinicians and laboratories. Shiga toxin-producing Escherichia coli (STEC) is a pathogen of special concern due to its potential for severe morbidity or mortality and tendency to affect vulnerable populations. Last year 108 cases of diarrheal illness and 15 cases of hemolytic uremic syndrome were associated with an outbreak of E. coli O157:H7 in North Carolina. Methods: In 2004, 108 clinical microbiology laboratories in North Carolina were queried using an online survey to assess foodborne pathogen testing and reporting practices. Results: The response rate was 39% (42/108). Ninety-three percent (39/42) of laboratories reported testing fecal specimens for E. coli O157/STEC; 60% (22/37) do so routinely. Of the 15 laboratories that do not routinely test, all test upon physician request, 93% (13/14) test when a specimen appears bloody, 21% (3/14) test when the patient has a history of bloody stools, and 29% (4/14) test when the patient has a history of hemolytic uremic syndrome. Sixty-five percent (22/34) of laboratories forward isolates to the North Carolina State Laboratory of Public Health for testing, 65% (13/20) forward all isolates. Among laboratories that screen fecal specimens for E. coli O157/STEC, 11% (4/36) use non-culture methods; 263 fecal specimens were tested using non-culture methods in 2003. Conclusion: CDC recommends all stool specimens submitted for microbiologic culture be tested for this pathogen. These results indicate a need to promote routine laboratory testing of E. coli O157/STEC in North Carolina.

Learning Objectives: Learning objectives

• Describe laboratory testing practices for Escherichia coli 0157/STEC in North Carolina
• Identify what testing practices need to be promoted in laboratories in concordance with CDC recommendations
• Discuss why testing for E. coli O157
  H7 is important for foodborne disease prevention

  Keywords: Surveillance, Practice

  Presenting author's disclosure statement:
  

  I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

  Infectious Disease Epidemiology: Poster Session

  The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA