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21 August 2001 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.

Seeds of Doubt: Raw Sprouts Cause Illnesses in California -Contaminated Clover and Alfalfa Seeds the Culprit

Six outbreaks of salmonellosis and E. coli 0157 in California between 1996 and 1998 were investigated and found to be associated with eating raw (uncooked), contaminated alfalfa and clover sprouts, a study found (Article, p. 239). Researchers studied 600 people with laboratory-confirmed diagnoses in these outbreaks and estimated that 22,800 others may have had unreported or unconfirmed illnesses from sprouts during the outbreaks. The contamination probably came from the seeds, which are usually grown by farmers for agricultural uses. Seed contamination can come from irrigation water, fertilizing crops with animal manure or allowing livestock to graze on crops. Sprout growers or processors can perpetuate or amplify the contamination by not disinfecting seeds prior to growing the sprouts or not thoroughly cleaning and disinfecting facilities and equipment. Researchers traced the six outbreaks to three sprout growers in California and infected seed to farms in several states.

Since there is currently no reliable way to eliminate all pathogens from the seeds or the growing procedures, the researchers say that children, people with damaged immune systems and the elderly should not eat raw sprouts and, further, that consumers who want to decrease their risk for foodborne illness "should avoid eating raw sprouts."

Hormone Replacement May Keep Blood Pressure from Rising as Women Age

Systolic blood pressure, which is a strong precursor of heart attacks, heart failure, strokes, and kidney failure, tends to rise with advancing age. Women taking hormone replacement therapy (HRT) had a smaller increase in systolic blood pressure as they aged than women not taking the hormones, a study found (Article, p. 229). If confirmed, the finding is a benefit of hormone replacement therapy to be weighed against risks when considering the complex HRT decision.

Study Finds Use of Alternative Medicine Widespread and Growing in the U.S.

(Academia and Clinic, p. 262.)

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