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.
Peppa’s South King Restaurant E coli Cases Prompt Closure
In Hawaii, a Notice of Permit Suspension and Order to Cease and Desist has been issued to Peppa’s South King restaurant, a Korean BBQ restaurant cited for food handling violations as part of an E. coli O157:H7 outbreak investigation.
Media outlets in Honolulu are reporting that of seven victims in the Hawaii E. coli outbreak, four ate at Peppa’s Korean BBQ on South King Street in Pawaa. Hawaii Department of Health investigators found problems at the restaurant, which is now working with the agency on an intensive mitigation plan to correct permit violations.
The Honolulu Advertiser reported that the restaurant’s management will be required to attend the Sanitation Branch’s Food Safety Certification Workshop to receive training on proper food-handling practices.
Hawaii Department of Health said the seven E. coli cases were diagnosed between March 2-23 and it has reminded doctors to report any additional cases to the state. One of four victims who were hospitalized remains in serious condition.
In 5 to 15 percent of E. coli O157:H7 infections, patients develop HUS, or hemolytic uremia – a life-threatening disease that is the leading cause of kidney failure in children. But HUS is more than a kidney disease. Powerful toxins emitted by E. coli O157:H7 microbes wreak havoc in other parts of the body, too, altering brain function and sometimes leading to stroke, convulsion, coma and paralysis. A related condition, often in older adults, is known as thrombotic thrombocytopenic purpura, or TTP.
Health officials have not pinpointed a cause for the outbreak, but consumption of contaminated meat — often undercooked ground beef — is the leading form of transmission. E. coli O157:H7 outbreaks also have been caused by contaminated raw milk, unpasteurized cider, sprouts, leafy green vegetables, other vegetables and fruits, including pineapple.
High Season for E. coli is Near
E. coli outbreaks happen all year round, but studies have shown that the high season for E. coli O157:H7 infections starts in April and runs through September.
In this season of long days,E. coli microbes cluster in greater concentrations inside the guts of cattle — making it more likely for some of the pathogens to slip through the defenses set up to stop them at slaughterhouses. A chronic source of contamination, still not solved by the meatpacking industry, is fecal matter from hides cross-contaminating meat surfaces.
When primal cuts containingE. coli O157:H7 are ground up for hamburger, the pathogens get mixed in and survive cooking temperatures if they are lodged in the center of under-cooked patties or meat.
Warmer air temperatures are not thought to cause the high concentrations, but summer temps do support colonizing of the organisms when they are outside the refrigerator.
There is a very close association between E. coli O157:H7 infection and E. coli HUS, or hemolytic uremic syndrome. There also is a close association in older adults with thrombotic thrombocytopenic purpura, or TTP.
The life-threatening seriousness of HUS, TTP and hemorrhagic colitis and the relatively small number of cells that it takes to make a person sick make E. coli O157:H7 one of the most dangerous of human pathogens, causing an estimated 60 deaths each year in the United States and thousands of hospitalizations.
Meat products — particularly ground beef — are still the leading source of infection. But unpasteurized milk or apple cider, leafy green vegetables, other vegetables, fruits and other raw foods can carry E. coli O157:H7. Last year, for example, a nationwide outbreak was caused by uncooked Nestle Toll House cookie dough.
As we enter spring and summer, it’s also important for parents to realize that E. coli O157:H7 infections can result from contact with animals at livestock exhibits, petting zoos, county fairs and state fairs. Children, the group most prone to developing HUS from an infection, are especially at risk in these situations.
Once ingested, E. coli O157:H7 cells line the gut and reproduce. While reproducing, the bacteria produce a powerful toxin called shiga-toxin. The shiga-toxin eats away at the cells of the intestinal wall and blood vessels running through the walls. These blood vessels can bleed into the bowel, which is why many people with E.coli O157:H7 have bloody diarrhea. Other symptoms include stabbing pains in the stomach, severe cramping, possible fever and possible vomiting.
HUS occurs in five to 15 percent of patients infected byE. coli. The disease sets in about a week to 10 days after the diarrhea starts. By then, the shiga-toxin has entered the blood stream and starts to destroy and misshape red blood cells, often leading to kidney failure.
But our experience representing HUS E. coli clients is that the disease is capable of much more than renal failure. HUS can lead to multi-organ failure, including damage of the heart, and many problems with the central nervous system and altering of the brain. Stroke, convulsions, brain stem injury, paralysis and coma are all problems associated with HUS.
For a complete list of E. coli prevention methods to protect your family this spring, summer and fall, click here.
Three of Largest Meat Recalls in History Tied to Beef E coli
A new study of the largest recall of meat in U.S. history shows that three of the top six meat recalls ever were caused by E. coli O157:H7 in beef.
The information was compiled by The Food Industry Center at the University of Minnesota in an in-depth case study of the 2008 recall of 143 million pounds of beef from Westland/Hallmark Meat Packing Co. in Chino, California.
In that case, the massive recall was spurred by Humane Society of the United States video of inhumane treatment of cows at the plant and USDA’s admission that meat produced at the plant was unfit for human consumption because it was processed without lawful inspection.
The Westland/Hallmark recall on February 17, 2008, was by far the largest ever. The two next largest were caused by Listeria contamination — one in Michigan in 1999 for 35 million pounds and a poultry recall in Pennsylvania in 2002 for 27 million pounds.
Numbers four, five and six were beef E. coli recalls related to E. coli O157:H7 outbreaks that included cases of life-threatening hemolytic uremic syndrome (HUS), the leading cause of kidney failure in children.
Fourth Largest: 1977 Hudson Foods Co. of Nebraska/ 25 million pounds of ground beef sold to quick-service retailers. Tied to an E. coli O157:H7 outbreak of about 20 illnesses.
Fifth Largest: 2007 Topps Meats Co. of New Jersey/ 21.7 million pounds of frozen ground beef patties. Tied to more than 30 E. coli O157:H7 illnesses in eight states.
Sixth Largest: 2002 ConAgra Foods of Colorado/ 18.6 million pounds of beef. Tied to an E. coli O157:H7 outbreak in 10 states that sickened at least 34 people.
USDA E. coli Beef Recall at West Missouri Beef
The third beef E. coli recall of 2010 hails from West Missouri Beef of Rockville, Missouri.
The West Missouri beef recall applies to 14,000 pounds of fresh boneless beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced. It was distributed to Chicago area wholesalers in 2000-pound “combo bins”
The following products are subject to recall:
- One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “75 1-M,” produced on October 26, 2009.
- One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “90 3-D,” produced on November 25, 2009.
- One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “90 5-D,” produced on November 27, 2009.
- Combo bins containing approximately 2,000 pounds of fresh boneless beef identified as “90 2-P,” “90 2-R” or “90 2-V,” produced on December 8, 2009.
- One combo bin containing approximately 2,000 pounds of fresh boneless beef identified as “90 3-E,” produced on January 13, 2010.
The problem was discovered by FSIS during a verification review performed at the establishment. The product bears the USDA establishment number 5821. FSIS said it is not aware of illnesses associated with the recall.
In January, beef E. coli recalls were announced by Adams Farm Slaughterhouse of Massachusetts and Huntington Meat Packing Inc. of California. Total poundage for the year so far is 880,500 pounds.
