IN OCTOBER 1996, unpasteurized apple cider or juice was associated with three outbreaks of gastrointestinal illness. In the Western United States, an outbreak of Escherichia coli 0157:H7 infections associated with unpasteurized commercial apple juice caused illness in 66 persons and one death.1 In addition, one outbreak of apple cider—related E. coli O157:H7 infections and another of cider-related Cryptosporidium parvum infections occurred in the Northeast. Apple cider is a traditional beverage produced and consumed in the fall. Cider often is manufactured locally at small cider mills where apples are crushed in presses, and the cider frequently is not pasteurized before sale. This report summarizes the clinical and epidemiologic features of the two apple cider—related outbreaks, which suggest that current practices for producing apple cider may not be adequate to prevent microbial contamination.
On October 11, the Connecticut Department of Public Health (DPH) was notified by staff of
Outbreaks of Escherichia coli O157:H7 Infection and Cryptosporidiosis Associated With Drinking Unpasteurized Apple Cider—Connecticut and New York, October 1996. JAMA. 1997;277(10):781-782. doi:10.1001/jama.1997.03540340015008