Epidemiologic Notes and Reports Gastrointestinal Illness
Associated with Imported Brie Cheese --
District of Columbia
Between September 19 and September 27, 1983, three outbreaks of
a
gastrointestinal illness affecting 45 people were reported to the
District of Columbia Department of Human Services. All three
outbreaks followed office parties that occurred on September 13 (11
of
16 persons ill), September 16 (27/71), and September 22 (7/7).
Four
people sought medical attention, but none required hospitalization.
The mean incubation period was 44 hours, and the mean duration of
symptoms was 4.4 days. Illness was characterized by watery
diarrhea
(91%), abdominal cramps (80%), nausea (38%), and fever (20%).
Vomiting and blood in the stool were each reported by one patient.
Analysis of data from a questionnaire administered to 70 of the
71
people who attended the largest party showed a strong association
between eating imported French brie cheese and becoming ill (p
0.001). The same brand of cheese was also served at the other two
parties.
The cheese was purchased at two stores in the Washington, D.C.,
area, which were supplied by the same distributor. The cheese bore
the brand name Marcillat and the lot number 20208 and was produced
in
France on July 21, 1983. No evidence of mishandling or improper
refrigeration could be determined. No information is yet available
about the manufacturing plant in France.
Washington, D.C., area retailers of the cheese were notified of
possible contamination and advised by health officials not to sell
cheese of the implicated lot. Retailers in Washington, D.C.,
voluntarily relinquished the remaining quantities of lot 20208 to
health officials. Since the shelf-life of brie cheese is short,
none
of that lot should be available now. However, health departments
in
other states in which the cheese was distributed have been
contacted--Colorado, Connecticut, Florida, Georgia, Illinois,
Louisiana, Massachusetts, Minnesota, New Jersey, New York, North
Carolina, Pennsylvania, and Texas.
Cultures performed in the laboratory of the District of
Columbia
Department of Human Services on one cheese sample and four stool
samples did not detect any routine enteric pathogens but did detect
Citrobacter freundii in the cheese and in three of the stools. C.
freundii is not generally recognized as an enteric pathogen, and
its
role in these outbreaks is uncertain. Specimens of stool and blood
from ill and well persons who attended the parties have been
obtained
for further evaluation at CDC. The U.S. Food and Drug
Administration
is testing cheese from the implicated lot and from other lots
produced
by the same manufacturer.
Reported by ME Levy, MD, District Epidemiologist, District of
Columbia
Dept of Human Svcs; Emergency and Epidemiology Operations Br, US
Food
and Drug Administration; Enteric Diseases Br, Div of Bacterial
Diseases, Center for Infectious Diseases, CDC.
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