E coli O145 Outbreak in MI, OH and NY Investigated by CDC and FDA
Both the CDC and the FDA have become involved in a multistate E coli O145 outbreak that has sickened people in Michigan, Ohio and New York. The CDC became involved early in the outbreak investigation when local health officials requested help identifying the strain of E coli involved in the outbreak.
Most E coli outbreaks are caused by E coli O157, but health officials in Washtenaw County, Michigan, where the outbreak began, ruled out O157 and made a preliminary finding that O145 was the E coli serotype involved in the outbreak. Because neither the county nor the state had a lab capable of definitively determining that it was O145, samples were sent to the CDC for testing.
The FDA was asked to help with the outbreak investigation when a product regulated by the FDA was suspected as the source of the outbreak. Early in the investigation, ground beef, which is regulated by USDA-FSIS, was ruled out as the source of the outbreak, or as one health official put it, “ground beef was not high on the list of suspects.”
State and county health officials, the CDC and the FDA are still investigating the E coli O145 outbreak and have not yet reported their findings.
Three university campuses are involved in this outbreak, suggesting that the campuses food service companies may be involved in this outbreak. To date, there have been 18 lab-confirmed illnesses and 32 potential E. coli O145 infections around Ohio State University (Columbus, Ohio), the University of Michigan (Ann Arbor, Michigan) and Daemen College (Amherst, New York).
E coli can cause death and serious illness, including hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP) and hemorrhagic colitis with severe dehydration.
Four Mile Prison E. coli Outbreak
The Colorado Department of Public Health and Environment is investigating the Four Mile Prison E. coli outbreak, a situation where at least 13 of 500 incarcerated offenders are believed to be infected with E. coli O157:H7.
The Colorado Department of Corrections issued a statement saying the prison’s kitchens have been checked off as sanitary. So far, no one has been able to identify what food source is causing the outbreak, but the investigation is continuing.
Extra precautions are being exercised to prevent the spread of bacteria, the DOC said.
Three offenders have tested positive for E. coli and eight more in the prison population are suspected of having infections. Four Mile Correctional Facility is located in Canon City, Colorado.
Estimates are imprecise, but microbiologists guess that more than 70,000 Americans fall ill every year from E. coli bacterial infections, the largest source of which is contaminated ground beef. Of those infected, 5 to 15 percent develop life-threatening HUS E. coli orthrombotic thrombocytopenic purpura (TTP).
Both of those illnesses commonly shut down a person’s kidneys, but also attack other parts of the body, including the brain and central nervous system.
E. coli O157 Cases Decrease in 2009
The Foodborne Diseases Active Surveillance Network (FoodNet) of CDC’s Emerging Infections Program surveillance data for 2009 found a decline in reported incidences of infection from “Shiga toxin-producting Escherichia coli (STEC) O157,” commonly referred to as E. coli O157. In 2009, a total of 459 laboratory-confirmed cases of E. coli O157 were reported. That is 41% fewer cases of E. coli O157 in 2009 than in the years from 2006 through 2008.
FoodNet also conductes surveillance for hemolytic uremic syndrome (HUS), a complication of an E. coli O157 infection that causes renal failure and hemolytic anemia. In 2008 (2009 data is not yet available), FoodNet identified 64 cases of postdiarrheal HUS in persons under 18 years old. Among those, 42 occurred in children under five years old.
Daycare E. coli Outbreak in Portland Area Prompts Shut Down
According to the Centers for Disease Control and Prevention, person-to-person outbreaks of E. coli O157:H7 occur most frequently in child daycare centers.
That appears to be the case in the greater Portland-Vancouver area where public health officials have shut down a daycare center in Clark County (Washington) where four children were hospitalized with E. coli O157:H7 infections. The Portland Oregonian reports that one child remains hospitalized, possibly with HUS, or hemolytic uremic syndrome, which can be life-threatening.
The Clark County health department first learned of a child from the daycare center being hospitalized on March 19. The state-licensed daycare center, which was not named by the newspaper, was closed April 2 and won’t reopen until tests prove that staff and children are free of the pathogen.
According to the Oregonian, investigators tested stool samples from 22 children and four adult caregivers at the day care and found six carrying the O157:H7 strain but not showing symptoms. It can take up to 10 days for symptoms to appear after initial exposure.
E. coli prevention efforts in daycare settings should be focused on strict hygiene, especially if diapers are being changed. The transmission is fecal-oral. That is why public health agencies emphasize the importance of educating caretakers to avoid direct contact with fecal matter and to apply stringent handwashing rules.
Honolulu E. coli Outbreak Prompts Safety Training
A worker from the Hawaii Department of Health put in extra hours this week to give E. coli prevention training to workers at Peppa’s South King restaurant as part of the agency’s response to the Honolulu E. coli outbreak that has sickened seven people.
Health officials have said four of the seven victims reported eating at Peppa’s before they became ill last month. And of the seven, four were hospitalized, including one who remained in serious condition.
In outbreaks of E. coli O157:H7, five to 15 percent of those infected develop life-threatening HUS TTP conditions that often produce long-term health injuries beyond kidney failure. Children are particularly prone to developing HUS from E. coli.
In the Hawaii Department of Health review of Peppa’s, investigators noticed food handling violations, which prompted an immediate shutdown of the restaurant on Thursday. The Honolulu Star Bulletin reported that a state worker involved in the training was on site with employees until midnight.
A cause of the outbreak has not yet been determined. Most often in E. coli outbreaks, the pathogens travel in meat, especially ground beef. Inside a ground beef patty or meatball, the organisms can survive cooking if internal temperators don’t reach 160 degrees. When cooking, color is not an indicator of whether meat has been heated to a safe temperature. Only a thermometer can effectively measure meat temps.
E. coli outbreaks also have been attributed to uncooked vegetables, especially leafy greens. Fruits, raw milk, unpasteurized cider, sprouts and some processed foods that aren’t cooked also have caused E. coli outbreaks.
