Outbreak of Escherichia coli O157:H7 Infections Associated With Drinking Unpasteurized Commercial Apple Juice—British Columbia, California, Colorado, and Washington, October 1996

ON OCTOBER 30,1996, the Seattle-King County Department of Public Health and the Washington State Department of Health reported an outbreak ofEscherichia coli0157:H7 infections epidemiologically associated with drinking Odwalla brand unpasteurized apple juice or Odwalla juice mixtures containing apple juice from a coffee shop chain, grocery stores, or other locations. A case was defined as hemolytic uremic syndrome (HUS) or a stool culture yieldingE. coli0157:H7 in a person who became ill after September 30,1996, and drank Odwalla juice within 10 days before illness onset. As of November 6, British Columbia, California, Colorado, and Washington had reported a total of 45 cases. The median age of the 28 case-patients for whom information was reported was 5.0 years (range: 1-41 years); 15 (54%) were male. HUS was diagnosed in 12 persons; none have died. One case ofE. coli0157:H7 infection occurred in a child who had