E. coli Blog

E. coli Outbreak Linked to Spartanburg South Carolina Mexican Restaurant

marler@marlerclark.com (E. coli Lawyer) — Fri, 11 May 2012 22:45:54 -0800

A few months ago the CDC refused to name Taco Bell as the source of a Salmonella outbreak that sickened many. Now it seems like South Carolina is learning that bad behavior.

The South Carolina Department of Health and Environmental Control (DHEC) is requesting heightened surveillance for persons presenting with symptoms consistent with Shiga toxin producing E. coli (i.e., enterohemorrhagic E. coli), including diarrhea that is often bloody, hemolytic uremic syndrome (HUS) in children or thrombocytopenia purpura in adults.

DHEC is investigating an outbreak of Shiga toxin-producing Escherichia coli (STEC) related to dining at a Spartanburg-area Mexican restaurant during the last week of April, 2012. Preliminary lab results indicate the E. coli serotype being O157:H7. Of the 3 cases interviewed thus far, two reported the infection has progressed to hemolytic uremic syndrome (HUS), a severe condition associated with STEC infection that can lead to kidney failure. Interviews with an additional 8 cases are in progress.

Multistate Outbreak of Shiga Toxin-producing Escherichia coli O26 Infections Linked to Raw Clover Sprouts at Jimmy John's Restaurants

marler@marlerclark.com (E. coli Lawyer) — Wed, 09 May 2012 21:21:45 -0800

Those damn sprouts

Yesterday, Cleveland Beansprouts Co., Cleveland, recalled alfalfa sprouts because of possible listeria contamination. No lot codes or any other identifier are on the sprouts, which were distributed in Ohio, according to a company news release posted on the Food and Drug Administration’s website.

And a few months, a total of 29 persons infected with the outbreak strain of STEC O26 were reported from 11 states linked to sprouts.

The number of ill persons identified in each state is as follows: Alabama (1), Arkansas (1), Iowa (5), Kansas (2), Michigan (10), Missouri (3), Ohio (3), Pennsylvania (1), Washington (1), Wisconsin (1), and West Virginia (1).
Seven ill persons have been hospitalized.

Stanford Kindergartener, Ramsey King, one of three hit with E. coli

marler@marlerclark.com (E. coli Attorney) — Fri, 27 Apr 2012 03:43:52 -0800

WKYT TV reports that so far at least three central Kentucky children are now recovering after investigators suspect they were exposed to E. coli.

6-year-old Ramsey King is one of three kindergarten students at Stanford Elementary recovering from suspected E. coli exposure. King is one of two children still at UK Hospital where doctors have already confirmed at least one of the cases as E. coli.

School officials insist Stanford Elementary followed all safety procedures, prompting health investigators to continue looking for the source of the problem.

As many as three at Kentucky's Stanford Elementary School sick with E. coli

marler@marlerclark.com (E. coli Lawyer) — Thu, 26 Apr 2012 16:27:52 -0800

According to Kentucky news media, as many as three Stanford Elementary School kindergarten students may have contracted E. coli according to Ronnie Deatherage, director of operations for the Lincoln County Public Schools. State and local health officials are investigating the case and have examined the elementary school cafeteria without finding a cause. Two of the 5-year-olds became ill within the last few days, Deatheridge said. They are being treated at University of Kentucky Children's Hospital.

Prior School Outbreaks:

Finley Elementary School E. coli Outbreak - Washington

Robeson Schools E. coli Outbreak - North Carolina

Prior Daycare/School Settings:

Kid’s Korner Daycare E. coli Outbreak - Missouri

Kindercare E. coli Outbreak - California

CCC Alternative Learning Daycare E. coli Outbreak - Texas

Newport Tennessee E. coli Outbreak Sickens Three

marler@marlerclark.com (E. coli Attorney) — Tue, 24 Apr 2012 17:44:05 -0800

KBIR reports, three children are in the hospital following an E. coli outbreak at a Cocke County daycare facility.

According to the Tennessee Department of Health, three juveniles, all of whom attend the same daycare facility in Newport, were diagnosed with E. coli symptoms.

The source of the bacteria is currently unknown, but managers of the facility are working with investigators, and the families of all children who attend the daycare have been contacted.

State health department officials have not closed the facility, but are continuing to investigate the situation.

There have been a few other Day Care E. coli O157:H7 Outbreaks some with severe consequences - hemolytic uremic syndrome (HUS):

CCC Alternative Learning Daycare E. coli Outbreak - Texas

Kid’s Korner Daycare E. coli Outbreak - Missouri

Kindercare E. coli Outbreak - California

Raw Milk Sickens Over Two Dozen in Oregon and Missouri with E. coli O157:H7

marler@marlerclark.com (E. coli Attorney) — Fri, 20 Apr 2012 21:13:26 -0800

Nineteen people in Oregon are ill with E. coli O157:H7 infections in an outbreak traced to raw milk from Foundation Farm near Wilsonville according to the Public Health Division of the state's Health Authority. Of the 19 people, 11 have culture-confirmed E. coli O157:H7 infections. Fifteen of the 19 cases are children 19 or younger. Four of the children have been hospitalized with kidney failure. On April 19, a Portland hospital confirmed that one of the hospitalized children, a 13-year-old girl, was in critical condition.

Illnesses in the ongoing E. coli O157:H7 outbreak in central Missouri rose to 15 on Friday, while information on the individual infections suggests they may come from multiple sources. Of the 15 cases, seven individuals have reported that they consumed raw milk products from a single dairy in Howard County. As a result, the dairy has been under investigation and has halted sales of its raw milk products. The E. coli infections in six of those seven raw milk drinkers have shown to match by their identifiable genetic pattern known as a pulsed-field gel electrophoresis (PFGE).

The infection of the seventh raw milk drinker, the newest addition to the total number ill, has a different PFGE pattern, though one that is very similar to the other six, according to epidemiologist Sarah Rainey at Missouri's Columbia-Boone County Health Department. Of the other eight illnesses, the ones who did not report consuming raw milk products, only one individual has a PFGE pattern matching the raw milk drinkers. The other seven infections vary genetically or have not returned a PFGE reading.

The newest case in the outbreak is a child under 18 from Boone County who was hospitalized from the infection but has since been released. A 2-year-old from Boone County has been hospitalized for more than two weeks after developing symptoms of hemolytic uremic syndrome (HUS), a kidney disease associated with severe E. coli infections.

Schnuck's and Vaughn's E. coli Romaine Outbreak - a Long History

marler@marlerclark.com (E. coli Lawyer) — Fri, 20 Apr 2012 07:23:41 -0800

E. coli outbreaks associated with lettuce or spinach, specifically the “pre-washed” and “ready-to-eat” varieties, are by no means a new phenomenon. In fact, the frequency with which this country’s fresh produce consuming public has been hit by outbreaks of pathogenic bacteria is astonishing. By way of illustration, in October 2003, thirteen residents of a California retirement home were sickened, and two people died, after eating E. coli-contaminated, pre-washed spinach; in September 2003, nearly forty patrons of a California restaurant chain fell ill after eating salads prepared with bagged, pre-washed lettuce; and in July 2002, over fifty young women fell ill with E. coli O157:H7 at a dance camp after eating “pre-washed” lettuce, leaving several hospitalized and one with life-long kidney damage. And this is just a small sampling of the twenty or more E. coli outbreaks since 1995 in which spinach or lettuce was the source. Several more, including the September 2005 Dole lettuce outbreak, and the infamous September 2006 Dole baby spinach outbreak, appear in the chart below, which is based on information gathered by the Center for Science in the Public Interest:

Date	Vehicle	Etiology	Confirmed Cases	States/Provinces
Aug. 1993	Salad Bar	E. coli O157:H7	53	1:WA
July 1995	Lettuce (leafy green; red; romaine)	E. coli O157:H7	70	1:MT
Sept. 1995	Lettuce (romaine)	E. coli O157:H7	20	1:ID
Sept. 1995	Lettuce (iceberg)	E. coli O157:H7	30	1:ME
Oct. 1995	Lettuce (iceberg; unconfirmed)	E. coli O157:H7	11	1:OH
May-June 1996	Lettuce (mesclun; red leaf)	E. coli O157:H7	61	3:CT, IL, NY
May 1998	Salad	E. coli O157:H7	2	1:CA
Feb.-Mar. 1999	Lettuce (iceberg)	E. coli O157:H7	72	1:NE
July-Aug. 2002	Lettuce (romaine)	E. coli O157:H7	29	2:WA, ID
Oct. 2003-May 2004	Lettuce (mixed salad)	E. coli O157:H7	57	1:CA
Apr. 2004	Spinach	E. coli O157:H7	16	1:CA
Sept. 2005	Lettuce (romaine)	E. coli O157:H7	32	3:MN, WI, OR
Sept. 2006	Spinach (baby)	E. coli O157:H7 and other serotypes	204	Many States
Nov/Dec 2006	Lettuce	E. coli O157:H7	71	NY, NJ, PA, DE
Nov/Dec 2006	Lettuce	E. coli O157:H7	81	IA, MN, WI
May 2008	Romaine	E. coli O157:H7	9	WA
April	Romaine	E. coli O145	33	MI, NY, OH, PA, TN

As of December 4, 2011, 60 persons infected with the outbreak strain of E. coli O157:H7 have been reported from10 states. The number of ill persons identified in each state is as follows: Arizona (1), Arkansas (2), Georgia (1), Illinois (9), Indiana (2), Kansas (3), Kentucky (1), Minnesota (3), Missouri (37), and Nebraska (1).

Among persons for whom information is available, illnesses began from October 10, 2011 to November 4, 2011. Ill persons ranged in age from 1 to 94 years, with a median age of 29 years old. Sixty-three percent were female. Among the 45 ill persons with available information, 30 (67%) were hospitalized, and 2 developed hemolytic uremic syndrome (HUS). No deaths have been reported.

Collaborative investigative efforts of state, local, and federal public health agencies indicate that romaine lettuce sold primarily at several locations of a single grocery store chain (Chain A) was the likely source of illnesses in this outbreak. Contamination likely occurred before the product reached grocery store Chain A locations.

During October 10 to November 4, 2011, public health officials in several states and CDC conducted an epidemiologic study by comparing foods eaten by 22 ill and 82 well persons, including 45 well persons who shopped at grocery store Chain A during the week of October 17, 2011. Analysis of this study indicates that eating romaine lettuce was associated with illness. Ill persons (85%) were significantly more likely than well persons (46%) to report eating romaine lettuce in the week before illness. Ill persons (86%) were also significantly more likely than well persons (55%) to report shopping at grocery store Chain A. Among ill and well persons who shopped at grocery store Chain A, ill persons (89%) were significantly more likely than well persons (9%) to report eating a salad from the salad bar at grocery store Chain A. Several different types of lettuce were offered on the salad bar at grocery store Chain A. Of 18 ill persons who reported the type of lettuce eaten, 94% reported eating romaine lettuce. No other type of lettuce or other item offered on the salad bar was reported to be eaten by more than 55% of ill persons.

Ill persons reported purchasing salads from salad bars at grocery store Chain A between October 5 and October 24, 2011. A total of 9 locations of grocery store Chain A were identified where more than one ill person reported purchasing a salad from the salad bar in the week before becoming ill. This included 2 separate locations where 4 ill persons reported purchasing a salad at each location. For locations where more than one ill person reported purchasing a salad from the salad bar and the date of purchase was known, dates of purchase were all within 4 days of other ill persons purchasing a salad at that same location. Chain A fully cooperated with the investigation and voluntarily removed suspected food items from the salad bar on October 26, 2011, out of an abundance of caution. Romaine lettuce served on salad bars at all locations of grocery store Chain A had come from a single lettuce processing facility via a single distributor. This indicates that contamination of romaine lettuce likely occurred before the product reached grocery store Chain A locations.

The FDA and several state agencies conducted traceback investigations for romaine lettuce to try to identify the source of contamination. Traceback investigations focused on ill persons who had eaten at salad bars at several locations of grocery store Chain A and ill persons at university campuses in Minnesota (1 ill person) and Missouri (2 ill persons). Traceback analysis determined that a single common lot of romaine lettuce harvested from Farm A was used to supply the grocery store Chain A locations as well as the university campus in Minnesota during the time of the illnesses. This lot was also provided to a distributor that supplied lettuce to the university campus in Missouri, but records were not sufficient to determine if this lot was sent to this university campus. Preliminary findings of investigation at Farm A did not identify the source of the contamination. Farm A was no longer in production during the time of the investigation.

Oregon Foundation Farm raw milk, cows, surfaces test positive for E. coli O157:H7

marler@marlerclark.com (E. coli Lawyer) — Tue, 17 Apr 2012 14:17:43 -0800

Four children are hospitalized; a total of five confirmed with E. coli - as many as seventeen sick

Oregon Public Health officials today report test results of samples taken from Foundation Farm cows, manure and surfaces as well as raw milk from a farm customer are positive for E. coli O157.

The samples came from leftover milk recovered from one household, rectal swabs from two of four cows, and multiple manure and other environmental samples collected at the farm.

“We continue to warn people to not drink the raw milk or any products made from the raw milk that came from this farm or any other source. Pasteurized milk is the only safe milk because it kills harmful bacteria such as E. coli O157,” said Oregon Public Health State Epidemiologist Katrina Hedberg, M.D., M.P.H.

Four children have been hospitalized. Three have hemolytic uremic syndrome, a type of kidney failure. The fourth child is waiting lab-confirmation. A total of five people, ages 1 to 14, have laboratory-confirmed cases of E. coli. Thirteen people have reported having diarrhea, but their cases have not been lab-confirmed. All drank raw milk from Foundation Farm.

Milk from Foundation Farm and raw cow’s milk in general cannot be sold in retail stores in Oregon. The dairy only distributed to 48 households that were part of a herd-share, in which people contract to take ownership of a portion of a herd or individual animals.

Besides the state, health officials in Clackamas, Washington and Multnomah counties and the Oregon Department of Agriculture are investigating these cases, including interviewing customers and family members of those infected.

E. coli O157 infections are characterized by diarrhea — sometimes bloody — and abdominal pain. Kidney failure and related complications may occur, especially among young children and the elderly. Symptoms usually develop within two to eight days of eating contaminated food. Antibiotics have not been shown to reduce the duration or severity of symptoms, and may increase the risk of kidney failure.

Raw Milk Outbreaks in Oregon and Missouri add to Recent Toll

marler@marlerclark.com (E. coli Attorney) — Fri, 13 Apr 2012 14:42:33 -0800

Today the Oregon Public Health Division, Department of Agriculture and several local Oregon health departments are investigating an outbreak of Escherichia coli O157:H7 - E. coli infections that have left three Portland-area children hospitalized, two with kidney failure (hemolytic uremic syndrome – HUS) – all of whom drank raw milk from the same small farm.

Three children with laboratory-confirmed infections have been hospitalized. A fourth child has lab-confirmed E. coli but has not been hospitalized. All of the children consumed raw unpasteurized milk obtained from Foundation Farm in Clackamas County. The farm has voluntarily ceased its milk distribution.

According to news reports over the last week, Missouri state health officials have confirmed nine cases of E. coli in Missouri. Missouri Department of Health and Senior Services confirmed cases in Boone, Cooper, Howard, Camden and Jackson counties.

Health officials say a 2-year-old girl a 17-month-old child have developed symptoms of a condition that can cause kidney damage (Hemolytic Uremic Syndrome)

Investigators say consumption of raw dairy products is a "possible" factor in some (actually only four at this time) of the cases.

Raw Milk and Raw Milk Cheese Outbreaks since 2010 (Not including Missouri and Oregon:

Outbreaks

- 24 raw dairy outbreaks with 309 illnesses, no deaths (22 fluid raw milk, 2 aged raw milk cheese)

Recalls (no illnesses reported)

- 14 raw dairy (7 fluid raw milk, 7 aged raw milk cheese)

For more information on the real risks of raw milk, see www.realrawmilkfacts.com.

Town and Country Foods, Inc recall beef for E. coli risk

marler@marlerclark.com (E. coli Lawyer) — Wed, 11 Apr 2012 18:00:29 -0800

On April 11, 2012, the USDA announced a recall of 2,057 pounds of ground and tenderized beef products from Town and Country Foods, Inc., after the company confirmed a positive E. coli O157:H7 lab test result. The following products are subject to the recall:

5- and 10- lb. boxes of 2-, 2.6-, 3-, and 4- oz. “Town & Country Foods XL Hamburg Patties”
5- and 10- lb. boxes of 2-, 2.6-, 3-, and 4- oz. “Town & Country Foods Hamburg Patties”
10- lb. box containing variously weighted bags of “Town & Country Beef for Stewing”
6-, 8-, and 10- oz. “Town & Country Beef Sirloin Filets”
5- and 10- lb. boxes containing variously weighted bags of “Town and Country Hamburg”
5- and 10- lb. boxes containing variously weighted bags of “Town and Country XL Hamburg”

Each case bears a label with the establishment number “EST. 9710” inside the USDA mark of inspection. Additionally, the products contain the following packaging codes: 10952, 10962, 10972, 11002, and 11012. The products subject to recall were produced between April 4, 2012 and April 10, 2012 and were shipped to wholesale and retail establishments in Maine. When available, the retail distribution list(s) will be posted on FSIS' website at www.fsis.usda.gov/FSIS_Recalls/ Open_Federal_Cases/index.asp.

The problem was discovered through company lab testing which confirmed a positive result for E.coli O157:H7. The company did not hold product pending test results, resulting in this recall. FSIS and the company have received no reports of illnesses associated with consumption of these products. Individuals concerned about an illness should contact a health care provider.