Community outbreak of XXXX : epidemiology, immunogenetic characteristics, and long-term outcome.

@entity1 @entity2743 @entity16414 @entity1955 @entity5651 @entity158 @entity1576 @entity291 @entity1954 @entity1374
Between January and March 1984, the first community outbreak of transient @entity2743 in the United States was documented in a seven-county area of southeastern Nebraska; 36 of the total 49 @entity1 resided in York County (2.4 cases per 1,000 population). The median age of @entity1 was 36 years, range six to 82 years; 51 percent were @entity1 . By definition, all @entity1 were symptomatic, visited a physician, and had a newly identified elevated serum concentration of @entity1955 or @entity1954 of unknown cause. None had a @entity5651 or a @entity158 . Low 131I uptake measurements were found in all nine @entity1 studied. Six @entity1 were hospitalized; none died. Investigation of all 12 household contacts of eight selected @entity1 revealed five additional @entity1 with @entity2743 and four with asymptomatic @entity16414 . A case-control study revealed that illness was associated with a significantly higher frequency of a @entity1576 . In another case-control study, the HLA-DR3 antigen was present in more case subjects (39 percent) than control subjects (14 percent). In addition, a significantly higher proportion of @entity1 than control subjects purchased beef from one of the three supermarkets in York Country. Concomitant with the outbreak, the supermarket implicated in the outbreak purchased an unusually large quantity of beef (7,000 pounds) from a nonregular supplier in Nebraska, which had reportedly instituted the practice of trimming gullets (a procedure that removes the muscles from @entity291 larynx for beef) about three months earlier. Thus, it is concluded that the Nebraska outbreak, like one in Minnesota that occurred 18 months later, probably resulted from @entity1 having eaten ground beef that was contaminated with @entity291 thyroid gland. This form of @entity2743 , perhaps misdiagnosed as @entity1374 in the past, probably represents a previously under-recognized public health problem.
