ENVIRONMENTAL RISK-FACTORS FOR SPORADIC ESCHERICHIA-COLI-O157 INFECTION IN SCOTLAND - RESULTS OF A DESCRIPTIVE EPIDEMIOLOGY STUDY

The objective of the study was to obtain detailed descriptive epidemio logical information on sporadic verocytotoxin-producing Escherichia co il 0157 infection in Scotland in relation to transmission routes and h ost-related risk factors. Using a standardized questionnaire, the stud y was carried out throughout Scotland over an Is-month period from Jul y 1992 and co-ordinated at the Communicable Diseases and Environmental Health (Scotland) Unit, Glasgow (CDEH(S)U). The subjects were laborat ory-confirmed cases of Escherichia coli 0157 infection, of whom 138 me t the criteria for inclusion in the study. The most important findings were the high proportion of cases who had been exposed to environment al factors such as farm animals and/or their by-products; or who had p articipated in gardening or garden-play; or who had suspected or confi rmed household water supply problems, prior to the onset of illness. T he frequency and relative importance of environmental risk factors req uires further quantification and study in order to assess where contro l measures can be directed most effectively. The implications for the NHS in preventing this crippling, life-threatening infection are consi derable, not least in relation to hospitalization, dialysis and renal transplantation costs.