HUS E coli in Wisconsin Possibly Connected to Petting Zoo
A young child with E. coli-related hemolytic uremic syndrome (HUS) in Wisconsin may have been sickened at a petting zoo. The child, an 18-month-old girl from Lomira, Wisconsin, is battling HUS complications, including HUS kidney failure. She is expected to remain hospitalized for several weeks at Children’s Hospital of Wisconsin in Milwaukee.
The toddler’s father, told The Northwestern that his family wants all parents to know what can happen with E. coli and the signs to watch out for. HUS develops in five to 15 percent of people who contract shiga toxin-producing E. coli — mostly E. coli 0157:H7 — and children under 5 are the most susceptible of any age group.
The sick child developed a low-grade fever about five days after visiting the petting zoo on July 25. When she developed bloody diarrhea, they rushed her to the emergency room at St. Agnes Hospital. The next day they brough her to see her pediatrician and she was admitted to the hospital because she was dehydrated. When her kidneys failed, she was transported to the hospital in Milwaukee. She remains on dialysis and has been receiving blood transfusions.
CDC E. coli Outbreak Surveillance Report for 2007
E. coli 0157:H7 and other foodborne agents cause an estimated 76 million illnesses annually in the United States.
The Centers for Disease Control and Prevention has published its latest set of data on foodborne disease outbreaks submitted from all states and territories. The CDC Surveillance for Foodborne Diseases Outbreaks Report summarizes epidemiologic data for the 1,097 reported outbreaks occurring during 2007 (the most recent finalized data), which resulted in 21,244 cases of foodborne illness and 18 deaths.
Among the 497 foodborne outbreaks with a laboratory-confirmed single etiologic agent reported, 40 were shiga toxin-producing E. coli outbreaks, primarily E. coli O157:H7. Coupled with two more suspected E. coli outbreaks, the E. coli classification accounted for 6 percent of 2007 outbreaks.
The 2007 surveillance number was much higher than the mean established from 2002-2006. In that period, the mean number of shiga toxin-producing E. coli outbreaks was 28 per year, or 2 percent of the total outbreaks.
In terms of illnesses, the 2007 report also was higher. In 2007, CDC and state health departments tracked 603 confirmed and suspected shiga-toxin E. coli illnesses. That was up from the 2002-2006 mean number of 375 E. coli illnesses per year.
It is important to note when reviewing the foodborne disease surveillance report that the actual numbers of outbreaks and illnesses in the U.S. is much higher than those confirmed by public health scientists and laboratories.
Clark County, WA Warns of Possible E coli O157 Risk
A child who recently tested positive for E. coli O157:H7 attended a supervised play area at Lake Shore Athletic Club near Vancouver, Washington while possibly contagious. Clark County Public Health and Lake Shore managers are asking parents to watch for symptoms among children who visited the play area between July 10 and August 4.
Clark county health officials continue to work with Lake Shore management to contain the situation and eliminate any risk of additional exposures. The child’s positive test for E. coli was reported to Public Health by a clinical laboratory. The original source of the infection is not known. In a continuing investigation, Public Health is contacting people who may have been exposed at the athletic club or at other locations visited by the infected child or others who have reported symptoms possibly related to the incident.
To date, there are 30 probable cases of E coli O157 in the area that are associated with Lake Shore Athletic Club. Four of the probable cases are staff members of the athletic club and 28 are children who attended the supervised child care center.
Children who contract E coli O157:H7 infections are at risk for developing hemolytic uremic syndrome (HUS-E coli), a severe illness that causes kidney failure, brain damage and death. Clark county officials recommend that children with symptoms of an E coli infection should see a health care provider immediately. In addition, their parents should contact Public Health at (360) 397-8022. The initial symptoms of an E coli O157:H7 infection include nausea, vomiting and diarrhea that may be bloody.
Fecal Shedding Underestimates E. coli 0157:H7 Volume in Cattle
New research published this week shows that testing for E. coli O157:H7 in cow feces underestimates the prevalance of the pathogen in the animals’ gastrointestinal tract.
The research, published August 1 by the journal Applied and Environmental Microbiology, was conducted by the USDA’s Agricultural Research Service.
E. coli 0157:H7 is a dangerous foodborne pathogen in humans that grows benignly in cattle.
It is common to test cattle feces to determine if any individual animal is shedding the bacteria, but scientists are seeking more information about where in the cattle gastrintestinal tract the E. coli can be found. The information is needed for the purpose of fighting the bug.
The research team found E. coli O157:H7 in samples from the mouth, pharynx, tonsils, lymph nodes, esophagus, all four sections of the stomach, and the small and large intestines, though the specific locations of positive cultures varied between animals.
“Although 31 percent of the animals were culture positive for E. coli O157:H7 somewhere along the intestinal tract, only 26 percent of those were fecal-culture positive. These data suggest that fecal shedding underestimated E. coli O157:H7 prevalence in the beef cattle gut and identified potential intervention sites,” the researchers concluded.
In short, fecal shedding underestimated E. coli O157:H7.
Better Non-0157:H7 E. coli Test is in the Works
USDA is collaborating with DuPont Qualicon to develop a more effective test for the six most common non-0157:H7 shiga toxin-producing E. coli (STEC)
The U.S. Centers for Disease Control and Prevention (CDC) estimate that non-O157 STEC bacteria are responsible for 36,000 illnesses, 1,000 hospitalizations and 30 deaths annually.
In recent years, they have become a growing concern as agents of foodborne illness. In fact, USDA has been studying the possibility of expanding its definition of “adulterated meat” to include meat that is contaminated with non-O157 STEC E. coli.
According to the CDC, about 70 percent of non-O157 STEC isolated from humans fall into six serogroups, which are (in order of frequency): O26, O103, O111, O121, O45, and O145. STEC that are known to cause human illness are sometimes called enterohemorrhagic E. coli (EHEC).
Whatever the serotype, if a bacterium is making Shiga toxins in the gastrointestinal tract of an infected individual, that person is at risk for developing hemorrhagic colitis and life-threatening HUS, or hemolytic uremic syndrome.
“The USDA continually looks for opportunities to collaborate in ways that will expedite research to assist regulatory agencies and move technologies into the marketplace. This collaborative project to develop a discriminating STEC test is a good fit with our mission,” Pina Fratamico, USDA research microbiologist said in a press release.
