An Outbreak of Diarrhea and Hemolytic Uremic Syndrome From Escherichia coli O157:H7 in Fresh-Pressed Apple Cider

Objective.

—Esherichia coliO157:H7 causes hemorrhagic colitis and the hemolytic uremic syndrome. In the fall of 1991, an outbreak ofE coliO157: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...