The Kentucky Department for Public Health is warning consumers about the dangers of consuming unpasteurized milk as well as other products that could lead to disease-producing E. coli infection, following a recent outbreak in North Central Kentucky and the hospitalization of four children.
DPH has been working with local health departments, hospital and the provider community to investigate the outbreak. Four of the five children associated with the cluster developed Hemolytic Uremic Syndrome (HUS), a disease caused by the most severe E. coli infections which may result in life-threatening kidney failure.
“At this time, we know that all of the children consumed unpasteurized milk, which is different from the milk and dairy products you purchase at the grocery store,” said DPH Commissioner Stephanie Mayfield, M.D. “Unpasteurized milk is dangerous and has not undergone a process to kill bacteria before it is consumed, meaning it could contain disease-causing agents such as E. coli. The health of anyone who drinks unpasteurized milk can be affected if they are exposed to E. coli or other bacteria that can cause very serious illness, but the risk is even greater for children.”
Five Kentucky children were being treated at Kosair Children’s Hospital on Friday for a potentially life-threatening syndrome usually caused by E. coli O157:H7 infection, and the state health department has launched an investigation into how they got sick.
“There is a cluster of children with” hemolytic uremic syndrome,” said Beth Fisher, a spokeswoman for the Kentucky Department for Public Health. “We don’t know the source at this point.”
Three of the sick children are from Hardin County, one is from Oldham County and one is from Boone County. Fisher did not know their ages, but said they are very young. All remained hospitalized Friday September 12..
As of Tuesday, four Kentucky children remain hospitalized after suffering E. coli O157:H7 infections. The cluster of cases is being investigated by the Lincoln Trail District Health Department based in Elizabethtown and the Kentucky State Department of Health.
According to news reports, the first illness was reported in mid-August. Health Department Public Information Officer Wendy Keown says investigators are trying to determine if there is a common cause. There is a possibility of a sixth case as well.
“We thoroughly investigate activities such as recent travel, exposure to animals, food histories. You know, have they been swimming anywhere? And try to find any commonality between those to determine a source. As of right now, there has not been a confirmed source of infection identified,” said Keown.
The children have developed hemolytic uremic syndrome (HUS), a rare and potentially fatal blood disorder. The children range in age from 18 months to six years.
Keown says they are suffering kidney related problems. She says three of the children are from Hardin County and one each from Oldham and Boone Counties.
It’s possible they are not tied together, but Keown says that’s not likely.
According to the Kentucky Health Department, five Kentucky children have been diagnosed with Hemolytic-uremic syndrome, or HUS, likely caused by E. coli O157:H7.
The Department for Public Health said there are three cases in Hardin County and one each in Nelson and Oldham Counties. All the children are currently hospitalized.
Kosair Children’s Hospital released this statement at noon on September 13:
Several children from several different counties in Kentucky are being treated for hemolytic uremic syndrome at Kosair Children’s Hospital. In children, this syndrome is most often caused by E. coli O157:H7 infection. We have notified the state health department, which has begun an investigation.
Minnesota State health officials have identified green whole head cabbage as the likely source of an E. coli O111 outbreak that sickened 15 people in Minnesota in July. The cabbage was likely contaminated at some point prior to distribution to restaurants.
Routine monitoring by the Minnesota Department of Health (MDH) identified the 15 cases of illness associated with Shiga toxin-producing E. coli O111. Bacterial isolates from all of the cases had the same DNA fingerprint. This genetic strain of E. coli O111 had not been seen in the United States previously.
MDH investigators were able to interview 14 of the cases: 13 of them ate at 9 different Applebee’s restaurants in Minnesota, and one ate at Yard House.
Many cases had reported eating the Oriental Chicken Salad at Applebee’s, leading Applebee’s to voluntarily and out of an abundance of caution pull the menu item and specific ingredients from the salad from their menu for a time. It was returned to the menu after Applebee’s obtained different sources for the ingredients.
The common food item across all foods consumed by cases was green whole head cabbage.
Minnesota officials traced the cabbage to a common supplier outside of Minnesota and continue to work with the United States Food and Drug Administration (FDA) to investigate its source. The FDA examination of the potentially involved farms is still ongoing.
Single cases of illness that match the outbreak strain have occurred in three other states.
The illnesses occurred between June 25 and July 3. Four of the people who became ill were hospitalized and all have recovered. No new cases connected with this outbreak have been identified in Minnesota since July 10.
SW Wisc Dairy Goat Products Coop of Mt Sterling, Wisc is recalling Raw Milk Mild Cheddar Cheese Lot Code 103-114 because it may be contaminated with Shiga toxin producing Escherichia coli (STEC) O111:H8 bacteria. This is one of the 6 STEC strains that have been deemed to be of serious health concern as it can cause diarrheal illness, often with bloody stools, and may lead to more severe complications like Hemolytic Uremic Syndrome (HUS). HUS is most likely to occur in young children, the elderly and immunocompromised individuals and can lead to severe kidney damage and even death.
This product was distributed in the Midwest and Southwest regions of the US. This product was sent through distributorship in Wisconsin and Georgia. From these two states this product was then sent to retail stores in the Midwest and Southwest.
This product was packed as an 8oz cryovac retail size piece with the code 103-114 on a sticker attached to the side of the cheese. This product is all white in appearance and has a front and back separate label. The back label is a black and white nutrition and ingredient label and the front label is a yellow and blue colored label with the Mt Sterling Coop Creamery brand name. “No illnesses have been reported to date.”
The recall was initiated after a case of two five pound loafs in the original packaging was collected on 7-8—14 from an offsite warehouse. The product sample tested positive for Shiga toxin 1and was contaminated with E. coli O111:H8.
The Minnesota Department of Health has confirmed that at least 22 people on the Fond du Lac Band of Lake Superior Chippewa Reservation near Duluth have recently been sickened by foodborne illness linked to E. coli bacteria. The first illness was reported July 17.
The investigation is ongoing, but no specific cause has yet been found. The outbreak strain is believed to be E. coli O157, according to a department spokesman, which is not the one recently linked to Applebee’s restaurants in Minnesota.
The sickened reservation residents are being called and interviewed by a state epidemiologist, an environmental health supervisor and University of Minnesota graduate epidemiology students, the spokesman said.
Recent events on the reservation, including powwows, picnics, weddings, potlucks and outdoors meetings, have likely contributed to opportunities for foodborne illness. Residents were encouraged to throw away any leftover foods from these events.
Those experiencing symptoms of foodborne illness are advised to contact a health care provider or the local emergency room. More information and specific symptoms related to E. coli infection is available here.
The Minnesota Department of Health has provided the following contact numbers: toll free is 1-877-FOOD ILL (1-877-366-3455) or 1-651-201-5277 for individuals who have questions or would like to learn more about E. coli or any other foodborne illness. They advise callers to leave a message and someone will call back promptly.
The CDC reported on December 11, 2013, a total of 33 persons infected with the outbreak strain of E. coli O157:H7 were reported from four states. The number of ill persons identified in each state was as follows: Arizona (1), California (28), Texas (1), and Washington (3). 32% of ill persons were hospitalized. Two ill persons developed hemolytic uremic syndrome (HUS), and no deaths were reported.
Epidemiologic and traceback investigations conducted by local, state, and federal officials indicated that consumption of two ready-to-eat salads, Field Fresh Chopped Salad with Grilled Chicken and Mexicali Salad with Chili Lime Chicken, produced by Glass Onion Catering and sold at Trader Joe’s grocery store locations, was the likely source of this outbreak of E. coli O157:H7 infections.
On June 17, 2014, the California Department of Public Health Report that concluded that:
An outbreak of E. coli O157:H7 infections occurred in October and November of 2013, affecting 33 individuals in four western states. The outbreak disproportionately affected California residents, accounting for 85 percent of all case-patients. Two varieties of prepackaged RTE salads produced by “Company A” (Atherstone Foods – Glass Onion Catering) and sold by “GCA” (Trader Joe’s) were implicated as the source of infection. This is supported by the statistically significant association of case-patients with consumption of one of the two implicated “GCA” salad varieties and by the regional distribution of reported cases matching the regional distribution of these two salads. No other food items or exposures were associated with illness. While these salads were strongly associated with the outbreak, the exact source of the contamination remains undetermined.
Today the Food and Drug Branch – Emergency Response Unit – of the California Department of Public Health produced the Environmental Investigation of an E. coli O157:H7 Outbreak in October 2013 Associated with Pre-packaged Salads. The report 28 pages long with several hundred pages of attachments, traces the consumption of the salads to the possible source of the E. coli O157:H7 contamination.
This report not only implicates the two varieties of prepackaged salads noted above, but also two others – one produced by Atherstone Foods – Glass Onion Catering – and another produced by an unnamed manufacturer in Oakland – both for sale at Walgreens.
The investigators concluded that the one common item between the two manufacturers and the four salads was romaine lettuce from a single filed in Modesto, California grown by Ratto Bros. Five of 44 environmental samples collected in areas around the implicated farm tested positive for E. coli O157:H7, however, the “positive samples were not a genetic match to the outbreak strain” – not a match to the ill people.