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A 10-Year Review of Outbreaks in the United States

Rachel C. Wood, MD, MPH; Kristine L. MacDonald, MD, MPH; Michael T. Osterholm, PhD, MPH

JAMA. 1992;268(22):3228-3230.

Abstract
Objective.
—To determine the incidence of recognized outbreaks of Campylobacter enteritis associated with drinking raw milk during youth activities.

Design.
—Retrospective survey of 51 state and territorial health departments.

Setting.
—The 50 United States and the Territory of Puerto Rico.

Populations.
—Persons in preschool through college.

Measurement.
—Information was obtained for all Campylobacteroutbreaks associated with consumption of raw milk during youth activities from 1981 through 1990 that were investigated by state and territorial health departments. Results.—Twenty outbreaks were identified in 11 states. Four hundred fifty-eight outbreak-associated cases occurred among 1013 persons who drank raw milk, with an overall attack rate of 45%. At least one outbreak was reported for each year of the 10-year period. Fourteen outbreaks (70%) occurred among children in kindergarten through third grade, compared with one outbreak (5%) among fourth through sixth graders. The remaining five outbreaks (25%) occurred in mixed groups of children and teenagers. Only nine (60%) of 15 outbreaks identified from 1981 through 1988 were reported to the Campylobacter national surveillance system maintained by the Centers for Disease Control and Prevention.

Conclusion.
—Drinking raw milk on school field trips or other youth activities continues despite the occurrence of multiple Campylobacter outbreaks documented from this practice. Such illnesses can be prevented by educating dairy farmers and officials of schools and youth organizations about the hazards of drinking raw milk. Public health organizations need to develop and implement such educational programs.

(JAMA. 1992;268:3228-3230)

Author Affiliations
From the Acute Disease Epidemiology Section, Division of Disease Prevention and Control, Minnesota Department of Health, Minneapolis. Dr Wood was assigned to the Minnesota Department of Health from the Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, Ga.

Footnotes
Reprint requests to the Acute Disease Epidemiology Section, Minnesota Department of Health, 717 Delaware St SE, PO Box 9441, Minneapolis, MN 55440-9441 (Dr Osterholm).

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