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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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