A new study published this week concludes that young children and females have an increased risk of developing life-threatening HUS, or hemolytic uremic syndrome, once infected with E. coli O157:H7.

The study by 11 microbiologists from a range of state and federal public health agencies, including the Centers for Disease Control and Prevention (CDC) and the Minnesota Department of Health, also found that with or without E. coli HUS, elderly patients had the highest proportion of deaths associated with infection from Shiga-toxin producing E. coli O157:H7. 

As a rule of thumb, scientists have estimated in the past that five to 10 percent of people who contract E. coli O157:H7 develop HUS, a disease that attacks the body’s red blood cells in ways that can result in various health problems that are potentially fatal.

The study led by Dr. L. Hannah Gould of CDC’s Enteric Diseases Epidemiology Branch reviewed 3,464 E. coli O157:H7 infections recorded  from 2000 to 2006. Overall, 218 of the patients, or 6.3 percent, developed HUS, the leading cause of kidney failure in children.

The highest proportion of E. coli HUS cases — 15.3 percent — occurred in children less than five years old. In all cases, death occurred .6 percent of the time when a person was infected with E. coli 0157:H7. In all HUS cases, death occurred 4.6 percent of the time.

With or without HUS, victims older than 60 had the highest rate of death due to E. coli O157:H7 infection. The study said 12 of 390, or 3.1 percent, of patients older than 60 died. In the same population, five of 15, or 33 percent, of patients died after their infection developed into HUS, which can lead to hemorrhaging, brain damage, spinal cord injury and heart problems.

Among children less than 5 years old, death occurred in 3 percent of those who developed E. coli  HUS. In young children who are infected, but don’t develop HUS, the death rate was .3 percent.

E. coli O157:H7 infections are preventable. They occur from ingesting the bacteria, mostly from contaminated ground beef, leafy green vegetables, raw milk, raw cider, cantaloupe and  other fresh produce. National food safety law firm Pritzker Olsen Attorneys has years of experience representing victims of these foodborne E. coli  HUS cases, including  E. coli wrongful death lawsuits.  To receive a free case consultation, call 1-888-377-8900 (Toll Free), or complete an online contact and information form. If we agree to accept your case, we don’t get paid unless you win compensation for the injuries and suffering in your family.

Today, June 30, 2009, the CDC reported additional illnesses associated with consumption of Nestle refrigerated cookie dough.  Also, FDA found E. coli in an unopened package of Nestle Toll House cookie dough that was in Nestle’s Danville, Virginia, plant.

The following is information from the CDC:

CDC is collaborating with public health officials in many states, the United States Food and Drug Administration (FDA), and the United States Department of Agriculture Food Safety and Inspection Service (FSIS) to investigate an outbreak of E. coli O157:H7 infections.

As of Tuesday, June 30, 2009, 72 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 30 states. Of these, 51 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (6), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Ill persons range in age from 2 to 65 years; however, 65% are less than 19 years old; 71% are female. Thirty-four persons have been hospitalized, 10 developed hemolytic uremic syndrome (HUS); none have died. Reports of these infections increased above the expected baseline in May and continue into June.
Investigation of the Outbreak

In an epidemiologic study, ill persons answered questions about foods consumed during the days before becoming ill and investigators compared their responses to those of persons of similar age and gender previously reported to State Health Departments with other illnesses. Preliminary results of this investigation indicate a strong association with eating raw prepackaged cookie dough. Most patients reported eating refrigerated prepackaged Nestle Toll House cookie dough products raw.

On June 29, 2009, the U.S. Food and Drug Administration announced that a culture of a sample of prepackaged Nestle Toll House refrigerated cookie dough currently under recall yielded E. coli O157:H7. The contaminated sample was collected at the firm on June 25, 2009. Further laboratory testing is underway to determine whether the E. coli strain in the product matched the strain causing the outbreak.

E. coli O157:H7 has not been previously associated with eating raw cookie dough. CDC, the state health departments, and federal regulatory partners are working together in this ongoing investigation.
Clinical Features

Most people infected with E. coli O157:H7 develop diarrhea (often bloody) and abdominal cramps 2-8 days (average of 3-4 days) after swallowing the organism, but some illnesses last longer and are more severe. Infection is usually diagnosed by culture of a stool sample. Most people recover within a week, but some develop a severe infection. A type of kidney failure called hemolytic uremic syndrome (HUS) can begin as the diarrhea is improving; this can occur in people of any age but is most common in children under 5 years old and the elderly.

The FDA has found E. coli O157:H7  in an unopened package of Nestle Toll House cookie dough. According to a Nestle news release:

Nestlé USA’s Baking Division was informed today by the Food and Drug Administration (FDA) that it has found and confirmed evidence of E. coli 0157:H7 in a retained production sample of 16.5 oz. Nestlé Toll House refrigerated chocolate chip cookie dough bar. The product has a day code of 9041 and a “Best before 10 JUN 2009” notation.

Nestle Toll House refrigerated cookie dough has been associated with an E. coli outbreak that has sickened at least 69 people in 29 states, according to the CDC:

69 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 29 states. Of these, 46 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (5), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (3), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (2), Virginia (2), Washington (6), and Wisconsin (1).

We are receiving hundreds of calls and emails from people concerned about E. coli O157:H7 exposure from Nestlé® TOLL HOUSE® refrigerated cookie dough products.  Here are some important facts to keep in mind:

1) The symptoms of E. coli O157:H7 infections vary for each person but often include severe stomach cramps, diarrhea (often bloody), and vomiting. If there is fever, it usually is not very high (less than 101˚F/less than 38.5˚C).
2) These symptoms may represent a life threatening infection. If you have symptoms, especially bloody diarrhea, you should get immediate medical attention.
3) The only practical way to diagnose E. coli O157:H7 is by stool sample. Without a stool sample confirming the presence of E. coli O157:H7, it is difficult to prove you are part of this outbreak. Therefore, if you believe you have symptoms related to E. coli O157:H7, you need to receive medical attention and get a stool test.
4) You need to get a stool test as soon as possible after your symptoms commence. If you wait too long, the E. coli O157:H7 bacteria may be shed from your body and the test will be negative even though you had an E. coli O157:H7 infection. Also, if you are prescribed antibiotics, the medication may kill off the E. coli O157:H7 in which case your test will be negative.
5) This is important: Non-specific supportive therapy, including hydration, is important. Antibiotics should not be used to treat this infection. There is no evidence that treatment with antibiotics is helpful, and taking antibiotics may increase the risk of HUS. Antidiarrheal agents like Imodium® may also increase that risk. Thus, if you receive antibiotics, it may cause you harm and  make it impossible to detect the E. coli O157:H7.
6) If you have remaining Nestlé® TOLL HOUSE® refrigerated cookie dough products that have been recalled in this outbreak, do not throw them out or return them to the grocery store. Here’s why: lab testing of the product may confirm the presence of E. coli O157:H7. Thus, if your stool is not tested or if the test is negative, it still may be possible to link your symptoms to the outbreak if the product tests positive for E. coli O157:H7. Therefore, seal the unused Nestlé® TOLL HOUSE® refrigerated cookie dough products in a plastic bag, mark the bag so it is not used or consumed accidentally, and continue to store it in your refrigerator until it is tested.
7) Call us right away if you have E. coli O157:H7 symptoms and you test positive for E. coli O157:H7 or if you have strong reason to believe a negative test does not rule out E. coli O157:H7 (i.e. you were put on antibiotics before stool testing was done)

PritzkerOlsen, P.A. is one of the most experienced and trusted food safety law firms in the United States and has represented foodborne illness survivors in virtually every major E. coli O157:H7 outbreak.

The Solano County Public Health Department in California has closed its investigation into the E. coli death of a 15-year-old boy with no finding of what caused the infection.

Dr. Ronald Chapman, deputy director of the department, told The Reporter newspaper the case was isolated and not caused by municipal drinking water in the boy’s town of Dixon. Nor could his illness be tracked to any food source, Chapman said.

The boy died last week. Parts of Dixon were under a boil water advisory in early December after a utility pipe broke and E coli was detected. But Chapman told the newspaper that recent tests on the city’s water supply came back negative for E. coli bacteria.

In addition, E. coli tests were negative in stool samples taken from a Dixon girl who was treated for diarrhea last week in a hospital emergency room. Health officials were concered that the diarrhea was a symptom of  an E. coli infection.

“We do not know how or why this child (the 15-year-old boy) became infected with E. coli, but we do know that it was an isolated case and there is no threat to the public’s safety,” Chapman said in a press release. ”We are deeply saddened by this loss and our hearts go out to the child’s family and friends.”

Chapman said the county is waiting for state lab test results to determine what strain of E. coli was responsible for the fatal infection in the boy.