E Coli Lawyer & Attorney : Marler Clark Law Firm : E. coli Blog

The Commercial Appeal reports that Robert Tauxe, chief of the foodborne-disease unit at the U.S. Centers for Disease Control and Prevention, spoke at last week's Institute of Food Technologists' annual convention regarding the state of pathogenic outbreaks.

"There's been some real progress in the prevention of (food) pathogens," Tauxe said. But he reported that disease detectives "are finding more salmonella than we should," and that more needs to be done in the meat-and-produce industry to combat the pathogen.

Although salmonella is commonly associated with ground beef and poultry, there have been outbreaks traced to green onions and cantaloupe imported from Mexico, snow peas from Guatemala and alfalfa from Australia. About 6 percent of foodborne illness is associated with fresh produce, the CDC says.

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The Business Review reports that cider legally sold in New York state must now be treated to kill E. coli and other microorganisms, which will be a disappointment for those who enjoy natural unpasteurized apple cider.

Gov. George Pataki signed a bill into law this month that requires cider to be pasteurized or exposed to ultraviolet light. Each method destroys microorganisms like the potentially deadly E. coli 0157:H7, and cryptosporidium. Cider made for production of hard cider or vinegar is exempt from the treatment requirement.

The New York Apple Association asked the state Legislature to approve the cider-treatment requirement following an E. coli outbreak last fall that was traced to cider from an orchard in Peru, Clinton County. More than 300 people were sickened by the tainted cider.

The treatment requirement goes into effect in mid-January 2006, getting most orchards through the processing of the 2005 crop and giving farmers time to comply with the new rules.

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Nearly 30 state, county and community fairs are scheduled before the end of September all around the country.

As much as it is a great opportunity for kids to see a sheep sheared, a cow milked, a chick hatched and - best of all - to hug or pet a cuddly baby calf or a newborn goat, state officials are reminding families to be cautious, especially around the animals.

State officials don't want an outbreak of a potentially deadly strain of E. coli bacteria like the one that infected 26 people, most of them children, at fairs in Florida over the past winter.

This month, about 70 fair managers from across the state attended a two-day workshop on preventing food- and animal-borne illness.

Fairgoers will see more hand-washing stations this year than in the past, along with signs reminding them to do so. 4-H and Future Farmers of America volunteer groups have also joined in, to encourage visitors leaving animal barns to wash their hands.

In addition, the North Carolina General Assembly passed legislation this month that requires stricter sanitation requirements for petting zoos, and at the Saratoga County Fair in New York managers placed hand sanitizer on poles scattered about the grounds.

"Go to the fair and enjoy it," said John R. Brooks, deputy secretary of the Maryland Department of Agriculture and a veterinarian. "Interact with animals, but use good hygiene practices, commonsense things like washing your hands after petting the animals."

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Consumers are being urged to check the ground beef in their freezers in case they bought ground sirloin last month at four British Columbia grocery outlets that may be contaminated with E. coli 0157:H7 bacteria.

Westfair Foods is conducting a voluntary recall of the products.

The Canadian Food Inspection Agency and Westfair Foods warned that Westfair Foods ground beef sold during a small window in early to mid-June at Real Canadian Superstores in Burnaby and Duncan, and at Extra Foods in Vancouver should not be consumed.

There were two reported illnesses associated with the product.

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Scripps Howard News Service reports that accelerated testing of the meat supply may have caused a significant decline in rates of E. coli infections, but there is still very slow progress against contamination by drug-resistant strains of salmonella. There is also an increasing rate of contamination of shellfish - mainly raw oysters - from a bacterium called vibrio that can be lethal to people with chronic liver problems.

The U.S. Centers for Disease Control and Prevention last year detected salmonella infections at the rate of 14.7 cases per 100,000 people - more than double the government's "healthy people" goal. There were similarly high rates of salmonella infections from 2000 to 2003.

Robert Tauxe, chief of the foodborne-disease unit at the CDC in averting outbreaks of E. coli O157:H7, a particularly virulent strain of the common pathogen that can attack the kidneys of young children and has killed some.

Jim Hodges, president of the American Meat Institute Foundation, said that there has been a decline of salmonella in ground beef, but that contamination in poultry remains a problem.

The U.S. poultry industry produces about 9 billion birds a year, mainly chicken. U.S. Agriculture Department statistics indicate that about 12 percent of chickens were positive for salmonella in 2001, 11 percent in 2002, and 13 percent in 2003.

Researchers say one reason why outbreaks of food poisoning continue to be a problem is that people aren't heeding government food-safety warnings, such as avoiding alfalfa sprouts or heating deli meats before eating them.

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The Canadian Food Inspection Agency and Westfair Foods Ltd. are conducting a voluntary recall of all varieties of ground beef including ground sirloin sold from the four stores listed below. The beef, supplied by XL Grinding, may be contaminated with E. coli 0157:H7 bacteria.

• Real Canadian Superstore at 291 Cowichan Way, RR No. 6, Duncan, bearing a best-before date of JN15 to JN19, purchased between June 12 and June 17.

• Real Canadian Superstore at 1105 Eaton Centre, Metrotown, Burnaby, bearing a best-before date of JN08 to JN11, purchased between June 5 and June 8.

• Real Canadian Wholesale Club at 5335 Kingsway, Burnaby, bearing a best-before date of JN08 to JN12, purchased between June 6 and June 9.

• Extra Foods at 7190 Kerr St., Vancouver, bearing a best-before date of JN08 to JN12, purchased between June 6 and June 9.

E. coli 0157:H7 causes serious and potentially life-threatening illness by producing a toxin that can break down the lining of the intestines and damage the kidneys. Food contaminated with the E. coli bacteria will not look or smell spoiled. These products should not be consumed.

Although the affected products are not in the stores, some consumers may have affected products in their freezers. For this reason, consumers are advised to check their freezers and not to consume the affected products.

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Research and Markets, an online market research resource, has announced the addition of "Understanding Pathogen Behaviour: Virulence, Stress Response and Resistance" to their list of reports available online.

After two introductory chapters on ways of analysing and modelling pathogens, Part 1 summarizes current research on what determines pathogenicity, stress response, adaptation and resistance. Part 2 reviews the behaviour of particular pathogens, reviewing virulence, stress response and resistance mechanisms in such pathogens as Salmonella, E.coli and Campylobacter. The final part of the book assesses how pathogens react and adapt to particular stresses from heat treatment and the effects of low temperature to the use of disinfectants and sanitisers.

"Understanding Pathogen Behaviour" summarizes the wealth of recent research and its implications for the food industry. Its editor is Mansel Griffiths, Professor of Food Science at Guelph University and Director of the Canadian Research Institute for Food Safety.

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The Mississauga News reports that former owners of Trillium Banquest Hall in Mississauga will pay out as much as $1 million to high school students and other guests who became ill with E. coli poisoning.

Nearly 90 graduates from E.C. Drury High School in Milton, who were there celebrating their prom night, fell ill from eating food at the Brunel Rd. banquet hall on June 25, 2003.

During their investigation, Peel health officials determined the source of the E. coli infection in the students to be the meal served at the banquet hall. They also reported five confirmed cases of E. coli poisoning in people who attended three other events at the Trillium Banquet Hall around the same time, including a wedding and corporate functions.

The financial amount will be divided among at least 150 people and is part of a settlement reached this week during a class action lawsuit. Complainants will be paid on a scale of $500-$5,000 depending on the severity of the infection, according to the proposed settlement. A person who was sick for three days gets $500, while a person who displayed symptoms for more than a month receives $5,000.

A superior court judge will hold an approval hearing on Aug. 15, when he will review the settlement in a Brampton courtroom.

The hall shut down shortly after the lawsuit was filed.

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The Flint Journal reports that the increasing phenomenon of bacterial infection outbreaks from exposure to animals have led experts to produce guidelines for staying safe at petting zoos, county fairs and rodeos this summer.

Even healthy animals can make people sick, and the most common way for transmission is fecal-oral route, according to the CDC. But fur, hair, skin and saliva can be contaminated too with fecal organisms.

Transmission occurs when people pet, touch, or are licked by animals and then eat or touch their mouths without washing their hands. What often happens is that a toddler will pet a sheep or goat, then stick his fingers in his mouth, as children often do.

Guidelines from the Centers of Disease Control urge handwashing, staying clear of animal enclosures and steering families to places that have handwashing stations.

They certainly can go and visit (petting zoos), but handwashing should be a part of the day, said Dr. Wailed Abuhammour, a pediatric infectious disease expert at Hurley Medical Center.

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Scientists at Cornell University have developed a rapid, less costly and sensitive new technique for detecting group A streptococcus, the bacteria that cause scarlet fever. The technique can be applied to a wide variety of bacterial pathogens, including E. coli.

The new biosensor works in a test tube and a positive result shows up as a red line on a strip, much like a pregnancy test. The method may help researchers and companies that are in the business of tracking food-borne pathogens, allowing technicians to determine a source quickly. It may also help to analyze a throat culture swab, to tell if someone has an illness like strep throat.

Current biosensors rely on a time-consuming technique called gene amplification that requires costly equipment. With the new technique, the entire process takes only 35 minutes, while traditional gene amplification techniques may take many hours. Early results suggest this new method could detect fewer than 100 cells of a pathogen in just half an hour.

"We hope to see this technique commercialized, because it is very rapid compared to all the standard methods right now," said Sam Nugen, a graduate student in Cornell's food science department and the study's lead author. "It would be great if we came up with something that became a standard."

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Hemolytic uremic syndrome (HUS) is an uncommon disorder characterized by acute kidney failure, low red cell count and low platelet count. In children, HUS most often occurs after several days of diarrhea, often bloody, due to a specific strain of E. coli named O157:H7.

E. coli O157:H7 causes inflammation of the intestine. It also produces a toxin that causes damage and swelling in the lining of blood vessels, especially the small blood vessels (glomerular capillaries) in the kidney. As red blood cells travel through the damaged blood vessels, they're often destroyed (hemolysis). This may result in acute kidney failure.

Additional signs and symptoms of HUS include:

• Pale skin tone
• Fatigue and irritability
• Small, unexplained bruises or bleeding from the nose and mouth
• Decreased urination
• Swelling of the face, hands, feet or entire body

Treatment may include:

• Kidney dialysis
• Red blood cell transfusions to correct anemia
• Platelet transfusions if bleeding occurs

Most children with diarrhea-associated E. coli infection don't develop HUS. Those who do, require hospitalization and careful management.With appropriate treatment, the majority of children will recover with no permanent kidney damage.

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In a recent article about petting zoo safety, Dr. Jeanne Ellen Hyrciuk, MD, FCAP, discussed how to safeguard against the hazards of disease-inducing bacteria after contact with petting zoo animals and look out for signs of illness such as nausea, stomach cramps, diarrhea or fever.

With the rise in popularity of petting zoos, there will be increased potential for the rise of e-coli and salmonella infections, mostly as a result of people not washing their hands, especially young children who are susceptible to putting their hands in their mouths.

Taking the simple precautions of washing immediately after visiting a petting zoo and not preparing food with hands that have touched potentially infectious animals can make all the difference.

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Newsday reports that recent studies suggest that the nation's beaches are filled with E.coli and other organisms that may threaten human health.

Scientists conducting the studies say E.coli may not be the only infectious worry. Richard Whitman, chief of the Lake Michigan Ecological Research Station, says that his research shows that "there are other pathogens."

Whitman found that E.coli levels were 10 times higher in sand than in the water. The organisms can gain entry into the body through any opening, especially the eyes, ears and mouth. In addition to infection, swallowed water contaminated with high levels of certain organisms can trigger gastrointestinal symptoms.

Ocean waves are more likely to carry bacteria away from the shore. In lakes, the water is more stagnant and the risk of bacterial growth is higher, which is why more lake areas get closed due to contamination.

Federal public health laws currently only mandate the testing of water. The nonprofit Clean Beaches Council wants public health laws to include the testing of sand. The Environmental Protection Agency and Centers for Disease Control and Prevention have also expressed interest in testing sand.

Walter McLeod, president of the Clean Beaches Council, advises parents to make sure their children are washed down when leaving the beach, and make sure they keep their hands out of their mouths, ears and eyes.

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The Blade News reports that less than a month after officials warned they might close it for the summer because a routine animal screening detected an infectious bacteria, The Toledo Zoo's petting zoo is scheduled to reopen.

The petting zoo closed June 24, after one Lucas County child became infected with campylobacteriosis. Although a portion of the zoo reopened a short time later so that visitors could view the animals, today's full opening means that children can pet the animals again.

Campylobacteriosis is extremely common. Once passed to humans, it can cause a fever, diarrhea, and vomiting that typically lasts several days, according to the U.S. Centers for Disease Control and Prevention. However, in rare cases, it can be life-threatening.

Dr. Wynona Shellabarger, the zoo's interim veterinarian, said the petting zoo's cows, sheep, pigs, alpacas, miniature donkeys, and other animals have been tested for campylobacter. "The results are all coming back negative, and the animals are healthy," she said.

The animals in the petting zoo that are on loan at the zoo for the summer will be tested about once a month. Among other precautionary steps, the zoo now sanitizes petting zoo handrails twice daily. Sanitizing wipes and hand-washing stations are provided.

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The Brandon Times reports that since the E. coli outbreak earlier this year at the Florida Strawberry Festival, requests for Pony Party Plus have dried up.

Pony Party Plus, owned by Jennifer Borg, is a mobile petting zoo - complete with pony rides, goats, chicken, sheep, pigs and rabbits. The reptile portion of her business brings shows to children in the area featuring snakes, frogs, scorpions, alligators and tarantulas.

The decline in Borg's bookings is similar to other petting farms and mobile zoos. It started after a scare in March, when several people contracted life-threatening kidney infections after visiting petting zoos at fairs across the state. Most tested positive for the E. coli bacteria, becoming ill after touching the animals and not washing their hands properly.

The business has lost about $7,000 since the outbreak, and Borg doesn't know if things will improve any time soon. It costs between $600 and $800 a month just to feed the animals.

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The Herald-Leader reports that outbreaks of E. coli infection, from handling petting zoo animals at festivals and fairs around the nation, has prompted Lexington Lions Club Bluegrass Fair organizers to skip its popular live farm animal display and petting zoo.

Last winter, more than 26 people were infected with E. coli after handling petting zoo animals at three Central Florida fairs. The illnesses were traced back to animals from a traveling petting zoo. The North Carolina State Fair last fall also had a petting-zoo-related outbreak - 112 people were sickened with diarrhea and 15 of them developed a life-threatening complication of E. coli infection that causes kidneys to shut down.

Though they have had a petting zoo in the past, the Kentucky State Fair will also not be having one this year.

"Animals wallow around in feces," said Christine Atkinson, an environmental health supervisor at the Lexington-Fayette County Health Department. "Then kids touch the animals, kids stick their fingers in their mouths -- and the fun begins." Contact with animals is a rarer cause of E. coli infection -- such illness is more often caused by fecal contamination of undercooked ground beef or by ingesting human feces, resulting from a lack of handwashing after using the bathroom.

More than 25 outbreaks have been linked to animal exhibits between 1990 and 2000 nationwide.

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According to this month's Ontario Pork Newsletter, Patrick Boerlin, Department of Pathobiology professor at the University of Guelph, is collaborating with researchers at the University of Guelph and the Public Health Agency of Canada to understand and lesson antibiotic resistance in bacteria using a genetic approach.

Specifically, Boerlin and his collaborators are identifying and locating the bacterial genes responsible for disease and antibiotic resistance in two forms of E. coli bacteria - one good, one bad.

The bad form, pathogenic E. coli, can cause disease. The good form, known as commensal E. coli, isn't a direct threat - but it can aid in spreading antibiotic resistance genes to harmful bacteria. Because the two forms of E. coli can readily exchange genes for antibiotic resistance between one another, resistance in good E. coli may still increase antibiotic resistance levels in both bacteria types.

Knowing more about the linkage between genes will help researchers develop and select appropriate antibiotics for treatment - that is, antibiotics that effectively destroy these virulent bacteria without causing resistant strains.

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Animals are always a big draw at fairs, both for sale, show, and petting - and so their health and safety is a big concern.

Animals are checked for a variety of diseases and conditions, including ringworm, contagious warts, respiratory disease and general illnesses. Dr. John Been, the Sauk County Fair's head veterinarian, said with all the variety and number of animals, it's important to make sure all are healthy from the start and stay that way.

Some diseases can be spread through the air, or though nose contact or passage of fluids, so Been said it is helpful the fair has enough facilities to avoid overcrowding of animals.

Last year's swine erysipelas detection and subsequent mass quarantine was an example of fair organizers being safe instead of sorry, said Been.

Been and his staff will also be on the lookout for other diseases that can be passed to humans, though, including salmonella and cryptosporidium. "We watch for these especially because they can cause intestinal problems in humans," Been said.

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Seth Slabaugh of the Muncie Gannett reports that The Delaware County Health Department wants to prevent outbreaks of foodborne illness - but their crackdown on how local vendors handle their food might cause a few of them to stop selling their wares at the Minnetrista Farmers' Market.

"The health department is just doing their job," said Tari Lambert, director of marketing and merchandising at Minnetrista. "They're doing it not to be mean, but to keep us as safe as possible."

In addition, vendors who sell baked goods at Minnetrista must prepare their food in approved kitchens subject to inspection, such as church kitchens. Baked goods cannot be prepared in people's homes and sold to the public.

"We don't want food that is sold to the public to be coming from my house or your house or someone else's house. It has to come from an approved facility open to the public and subject to inspection," says Bob Jones, administrator of the Delaware County Health Department. "Home use of a freezer is not acceptable. We don't go into someone's home to do an inspection. By statute, rules and ordinance, you can't sell out of a home."

Vendors are looking at other farmers' markets to see if regulations might be different elsewhere.

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Larson Newspapers reports that Slide Rock State Park officials cleared visitors from the waters of Oak Creek during the Fourth of July weekend due to high readings of E. coli 0157:H7.

E. coli is a bacteria that can cause severe intestinal illness. Infection can occur from consuming contaminated foods or liquids, or by swimming in sewage-contaminated water, and an infected human can also pass the disease if hygiene or handwashing is inadequate.

It is not unusual for E. coli levels to rise in Oak Creek and other water in the area this time of year. Possible sources of contamination include wild and domestic animals waste. In addition, residences and businesses along the creek may have contributed, since the majority of septic tanks for summer homes between the confluence of West Fork Creek and Sedona are within 60 meters of the Oak Creek Channel.

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For fair managers, livestock exhibitors, animal health officials, and the public, this is the time of year to prevent such problems as E. coli O157, vesicular stomatitis or any other disease-related issues that may threaten the fun associated with going to the fair.

One way to keep fairs safe is to keep animals healthy. A certificate of veterinary inspection and an Oregon import permit are mandatory for all animals coming in from other states. Fair managers can and should double check the paperwork to ensure each animal is legally cleared to be in Oregon. Animals entering the fair are also routinely checked by on-site veterinarians who will report and treat sick livestock.

The animal-to-human disease issue is E. coli O157, which caused dozens of illnesses at the Lane County Fair in 2002. This year, there will be more handwashing stations to keeping food away from areas where livestock is kept.

Oregon Department of Agriculture reports that:

"At this year's fairs, look for more signs encouraging people to enjoy the animals safely and to thoroughly wash hands after interacting with animals," said John McCulley, executive secretary of the Oregon Fairs Association. "Fairs will provide handwashing stations to help fairgoers. However, people attending fairs should not eat or drink in the livestock barns. That goes for the exhibitors too. Small children should be carefully watched around animals so that their hands are washed immediately after visiting the petting zoo or seeing animals in the barns. It's a good idea to just look at the animals and not touch them. More and more fairs are also using cleansers to disinfect pens and walkways."

"Animals are one of the most popular attractions at a fair," he continued. "The advice to Oregonians is simple: Go to the fair, enjoy the animal exhibits, ask questions of those tending the livestock, and use common sense about the need for minimizing exposure to germs. That means following mom's advice: 'Always wash your hands.'"

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Angela Eckhardt of the Capital Press reports that across the nation, it has become more and more difficult for small farmers to access restaurants and grocery stores, especially if they produce meat, fish or dairy. With federal legislation requiring meat to be processed through USDA-licensed processing facilties, shipping products to and from those facilities is not cost-effective.

At present, there is nothing in place that allow for smaller ranchers to process their meats locally like they do in England. Here, in the United States, if meat is not processed at a USDA-licensed facility, it cannot be sold.

The problem with the requirement of only processing meat at larger, industrial-sized facilities is that when there is an E. coli outbreak, for instance, the problem and subsequent recall of the product is massive. So are the number of infected consumers and hospital bills.

Ranchers in Wallowa County, Oregon, have been meeting to discuss having a local USDA-licensed processing facility. Unfortunately, it is no cheap nor easy task to accomplish.

But a move towards more localized licensed facilities would allow for quicker, closer inspection should an outbreak occur, which would minimize risk for consumers. Not only would consumers and retail outlets know exactly where the meat came from, but producers and processors would also have a strong incentive to protect their reputations with quality commitments.

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The Daytona Beach News-Journal reports that a family nearly evicted as a result of unforeseen medical expenses prompted by an E. coli infection now has a bank fund set up to help with their costs.

The Port Orange chapter of the global Friendship Force, affiliated with chapters in 60 countries around the world, started a fund to help Kimberley Kleinschmidt, a single mother whose two sons are now home recovering from the E. coli outbreak. Kleinschmidt has been out of work for weeks, tending to her children. The fund has been started at the Fifth Third Bank with $100.

Medicaid paid for the boys' hospitalizations. But living expenses have been piling up for the single mother of three who has a daughter, Cynthia, 7.

An anonymous donor also came forward and paid the family's back rent until Aug. 1. A local business paid for August's rent.

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Reno Gosser, the Rush County Sanitarian and Environmentalist, recently issued a warning to county residents about any individuals saying they have some meat left over from a delivery and they are willing to "let it go at a reduced price."

There have been two recent reports in the county of efforts to sell meat that that has been recalled due to testing positive for E. coli bacteria.

E. coli can cause stomach cramping with little or no fever and bloody diarrhea. The symptoms can last up to 10 days. In rare cases, humans infected can develop a condition called hemolytic uremic syndrome (HUS) that can lead to kidney failure.

Because of the severity of the problems associated E. coli, the local health department is concerned about the tainted meat found locally and the possibility that other unsuspecting county residents may or may have purchased some of it.

"The individual selling the meat has no permit to do so and generally offers seven or eight different cuts or types of steaks at a reduced price to unsuspecting individuals. You should not purchase the meat," Gosser said, adding, "We have a lead on the individual that has been selling the meat in the county and law enforcement personnel is looking for him at this time."

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As E. coli O157:H7 can present with signs and symptoms often ascribed to the acute abdomen, it is imperative that doctors are all familiar with this infection and its clinical ramifications.

Originally described in 1983, E. coli O157:H7 is now recognized as a common cause of bloody and nonbloody diarrhea and is responsible for most cases of hemolytic-uremic syndrome in children in North America. In the United States alone, E. coli O157:H7 is believed to cause more than 20,000 infections and approximately 250 deaths each year.

Ingestion of undercooked bovine meat such as hamburger patties has been responsible for many of the large outbreaks of E. coli O157:H7, but other modes of transmission have been reported as well. Infection from pork, chicken, steak, unpasteurized milk, yogurt, vegetables from manured gardens, apple cider, and municipal drinking water have occurred. Sporadic cases have also been attributed to swimming in contaminated lakes, and person-to-person transfers have also been documented in child-care centers, nursing homes, and between family members in the home.

The range of symptoms are broad, often making diagnosis difficult. Patients may be asymptomatic or present with nonbloody diarrhea, bloody diarrhea, the hemolytic-uremic syndrome, thrombocytopenia purpura, seizure, coma, or death. Typically, patients experience crampy abdominal pain and diarrhea, which becomes bloody after 48 hours, and some may have nausea, vomiting, and low-grade fever.

No specific therapy has been proved effective in the treatment of E. coli O157:H7 colitis. Management of HUS includes meticulous attention to fluid balance and electrolyte replacement. Quite often, transfusion of blood products and plasmapheresis is required.

When seeing the patient in consultation, as always, obtaining a thorough history and physical at the time of presentation is of paramount importance. Early suspicion of E. coli O157:H7 infection should lead to more rapid diagnosis, improved hospital courses, and decreased long-term morbidity and mortality.

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While it's a pleasure to cook and eat outside during warm-weather months, the risks for contracting food-borne illnesses are higher when you prepare and serve a meal out of doors. There are several ways to make sure you don't unwittingly infect yourself and your guests with dangerous illnesses like salmonella, E. coli and campylobacter.

First, wash your hands with soap and running water before preparing, serving or eating any food. People often skip this step when eating outside because running water isn't readily available.

Secondly, handle raw meat and poultry safely. Make sure the raw meat and poultry or their juices don't come in contact with any raw fruits or vegetables that are on the menu. It's also important to not re-contaminate the cooked meat or poultry by putting it back on the dish that held it when it was raw, since bacteria could still be living there.

Thirdly, cook meat and poultry properly. Use a food thermometer that reads the meat or poultry's internal temperature. The USDA recommends that chicken breasts be cooked to 170 degrees, hamburgers to 160 degrees, and steaks to 145 degrees.

Finally, protect your salads by thoroughly washing fresh fruits and vegetables under running water to remove all dirt and visible contamination. Cut away bruised or damaged parts, which are great spots for bacteria to thrive. Once you have cleaned and cut up the produce, keep it cool until you are ready to serve it. Even fresh fruit and veggies can grow harmful bacteria like salmonella when sitting outdoors in warm temperatures.

These days, people don't make their own mayonnaise with raw eggs, instead using a store-bought product made with pasteurized eggs and an acid, like vinegar, when making things like potato salad. Though this keeps unsafe bacteria at bay, it's still important to keep dishes made with mayo cold.

To make sure your summer gatherings stay fun, follow this rule of thumb: keep your cold foods cold and your hot foods hot, and your guests will go away happy and healthy.

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William D. Marler, an attorney at Marler Clark LLP PS has extensive experience representing victims of bacterial and viral food poisonings. Since 1993, Marler Clark has represented victims of most of the largest foodborne illness outbreaks in the United States, including the 1993 Jack in the Box E. coli, 1998 Odwalla E. coli, 1999 Sun Orchard Salmonella, 2002 ConAgra E. coli and Chili's Salmonella outbreaks, the 2003 Chi Chi's Hepatitis A outbreak, and the 2004 Sheetz Salmonella outbreak.

Bill feels that a lawyer should do more than just sue corporations. That is why he speaks frequently on issues of safe food and formed Outbreak, Inc., a not-for-profit business dedicated to explaining to companies why it is in their interest to avoid food illness litigation. Bill also has created Marler Blog as a way of updating the Web on issues of interest to him.

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Two-year-old Aedin Gray was among the 43 people contracted E. coli at a petting zoo at the North Carolina State Fair last October. The Carrboro toddler spent 36 days in the hospital, sustained permanent damage to her kidneys and pancreas and now wears an insulin pump to handle the diabetes she has since developed.

Aedin was recognized by the General Assembly as lawmakers gave final approval to what has become known as "Aedin's Law".

The law requires petting zoos to obtain permits and undergo inspections. Hand-washing facilities will also be mandated at petting zoos under the new regulations. The North Carolina Department of Agriculture will hire two inspectors specifically to oversee petting zoos.

Kyle and Liz Gray, Aedin's parents, said they hope the legislation will prevent other children from going through the same trauma their daughter endured.

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Many people turn to cranking up the grill outside during warmer months, which is also when most food poisoning cases happen. Warmer weather is the perfect environment for bacteria in food to multiply rapidly so it's very important to take those extra precautions for safe food handling during this time, especially when you're preparing perishable foods such as meat, poultry, seafood and egg products, and salads that contain mayonnaise.

Below are some great tips that will help keep your outdoor feasts safe this summer:

• Wash your hands with hot, soapy water before and after handling food.

• When shopping, buy cold food like meat and poultry last

• Completely defrost meat and poultry before grilling so it cooks more evenly. Use the refrigerator for slow, safe thawing or thaw sealed packages in running water. Only defrost in the microwave if the food will be used immediately on the grill.

• When marinating for long periods of time, it is important to keep foods refrigerated. Don't use sauce that was used to marinate raw meat or poultry on cooked food. Boil used marinade before applying to cooked food.

• Be sure there are plenty of clean utensils and platters. To prevent food borne illness, don't use the same plate and utensils for raw and cooked meat and poultry.

• Use a meat thermometer to ensure that food reaches a safe internal temperature. Hamburgers should be cooked to 160F, whole large cuts of beef such as roasts and steaks may be cooked to 145F for medium rare, or to 160F for medium. Cook ground poultry to 165F and poultry parts to 170F. Fish should be opaque and flake easily.

• When carrying food to another location, keep it cold to minimize bacterial growth. Use an insulated cooler with sufficient ice or ice packs to keep the food at 40F or below. Pack food right from the refrigerator to the cooler immediately before leaving home. Keep the cooler in the coolest part of the car.

• Refrigerate any leftovers promptly in shallow containers. Discard any food that is left out more than two hours (one hour if the temperatures are above 90F).

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William Marler is the managing partner in the law firm Marler Clark L.L.P., P.S. Since 1993, Mr. Marler has represented thousands of victims of E. coli, Salmonella, Hepatitis A, Listeria, Shigella, Campylobacter and Norwalk Virus illnesses in over thirty States. As a trial lawyer, Mr. Marler has been involved with several cases of national importance. He represented the children murdered by Wesley Alan Dodd, an escaped Washington State convict; the family of William Louth, who died when a crane collapsed during Kingdome roof repairs; the Terlicker family in its suit against Martin Pang and the City of Seattle stemming from an arson fire; and Brianne Kiner in her $15.6 million E. coli settlement with Jack-in-the-Box. This settlement created a state record for an individual personal injury action. Mr. Marler resolved several other Jack-in-the-Box E. coli cases for more than $2.5 million each.

In May of 1998, he settled the Odwalla Juice E. coli outbreak for the families of children who were severely injured after consuming Odwalla apple juice for $12 million. He represented several children in an E. coli outbreak stemming from E. coli contaminated swimming pool water in Georgia. In 2001 he successfully tried to verdict an E. coli case involving a school lunch program in Washington State. The jury returned a verdict of $4.75 million. He also resolved dozens of E. coli cases in 2003 related to one of the largest meat recalls in United States. Mr. Marler recently settled an E. coli case for a young girl for $11 million.

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The Associated Press reports that "Aedin's Law," a bill to set stricter sanitation requirements for petting zoos, awaits North Carolina Governor Mike Easley's signature after winning final approval by the Legislature.

The legislation was prompted by an E. coli outbreak that struck 108 visitors to petting zoos at the North Carolina State Fair last fall.

The law will require petting zoo operators to be inspected and obtain a permit from the state Agriculture Department. It also allows the department to set rules regarding animal care, hand-washing facilities, signs warning the public of health and safety issues, and any other requirements to protect visitors from potential harm.

The bill is called "Aedin's Law" in honor of 2-year-old Aedin Gray of Orlando, Fla., one of 15 children whose exposure led to HUS, a life-threatening kidney ailment.

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On November 1, 2004, the North Carolina Department of Health and Human Services Division of Public Health reported to the Centers for Disease Control and Prevention 15 cases of culture- confirmed E. coli O157:H7 infections, including four patients diagnosed with hemolytic uremic syndrome (HUS).

Many of those reporting illness had a history of attending the NC State Fair. After researching all possibilities it was determined that the area occupied by the Crossroads Farm Petting Zoo had tested positive for E. coli.

There was another petting zoo at the farm, but their zoo only allowed touching through a railing. Crossroads' petting zoo allowed people to walk among and have extensive direct contact with sheep and goats, and touch various exotic species held in pens. The Crossroads' petting zoo also had a high number of animals, causing overcrowding in the area, resulting in stressed animals with loose stools in the petting zoo area.

Both petting zoos allowed feeding, and both had hand-sanitizer stations available. The Crossroads' petting zoo area also had signs recommending hand hygiene, but it is supposed that infection could have occurred from:

• skin contact other than hands (such as face and legs)
• possible exposure sufficient to infection prior to hand-santizer use
• delayed infection from touching shoes and stroller parts (such as wheels) after they had been being exposed to the floor of the petting zoo, which may have had manure contaminated with E. coli.
• possible contaminated hand-sanitizer gel
• lack of sufficient hand-sanitizer gel use

The CDC has recommended the following to assure that E. coli outbreaks are minimized:

• share information about zoonotic disease risks with all potential visitors prior to animal contact
• physical barriers to reduce direct contact with animals
• prohibit or discourage direct or extensive interaction with animals
• prompt removal of contaminated bedding regardless of animal health
• reduce large crowds of people and dense numbers of at any one time
• monitor for and assure removal of any animals ill with diarrhea
• separate animal areas from areas where foods and beverages are prepared, served or consumed
• hand hygiene stations between animal and non-animal areas
• hand-washing stations should be cleaned routinely to reduce cross-contamination, and maintained to assure continued service.

See also: final epidemiology report of the outbreak by U.S. Centers for Disease Control and Prevention

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An estimated 73,000 cases of infection and 61 deaths occur in the United States each year from E. coli O157:H7.

Most illness has been associated with eating undercooked, contaminated ground beef. Infection can also occur after drinking raw milk and after swimming in or drinking sewage-contaminated water, as well as through person-to-person contact.

Consumers can prevent E. coli O157:H7 infection by thoroughly cooking ground beef, avoiding unpasteurized milk, and washing hands carefully.

The Centers for Disease Control and Prevention have answered a few of the most frequently asked questions regarding E. coli:

What illness does E. coli O157:H7 cause?

E. coli O157:H7 infection often causes severe bloody diarrhea and abdominal cramps; sometimes the infection causes nonbloody diarrhea or no symptoms. Usually little or no fever is present, and the illness resolves in 5 to 10 days.

In some persons, particularly children under 5 years of age and the elderly, the infection can also cause a complication called hemolytic uremic syndrome, in which the red blood cells are destroyed and the kidneys fail. About 2%-7% of infections lead to this complication. In the United States, hemolytic uremic syndrome is the principal cause of acute kidney failure in children, and most cases of hemolytic uremic syndrome are caused by E. coli O157:H7.

How is the illness treated?

Most persons recover without antibiotics or other specific treatment in 5-10 days. There is no evidence that antibiotics improve the course of disease, and it is thought that treatment with some antibiotics may precipitate kidney complications. Antidiarrheal agents, such as loperamide (Imodium), should also be avoided.

Hemolytic uremic syndrome is a life-threatening condition usually treated in an intensive care unit. Blood transfusions and kidney dialysis are often required. With intensive care, the death rate for hemolytic uremic syndrome is 3%-5%.

What are the long-term consequences of infection?

Persons who only have diarrhea usually recover completely. However, about one-third of persons with hemolytic uremic syndrome have abnormal kidney function many years later, and a few require long-term dialysis. Another 8% of persons with hemolytic uremic syndrome have other lifelong complications, such as high blood pressure, seizures, blindness, paralysis, and the effects of having part of their bowel removed.

What can you do to prevent E. coli O157:H7 infection?

• Cook all ground beef and hamburger thoroughly. Because ground beef can turn brown before disease-causing bacteria are killed, use a digital instant-read meat thermometer to ensure thorough cooking. Ground beef should be cooked until a thermometer inserted into several parts of the patty, including the thickest part, reads at least 160F. Persons who cook ground beef without using a thermometer can decrease their risk of illness by not eating ground beef patties that are still pink in the middle.

• If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking. You may want to ask for a new bun and a clean plate, too.

• Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties. Wash meat thermometers in between tests of patties that require further cooking.

• Drink only pasteurized milk, juice, or cider. Commercial juice with an extended shelf-life that is sold at room temperature (e.g. juice in cardboard boxes, vacuum sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Juice concentrates are also heated sufficiently to kill pathogens.

• Wash fruits and vegetables thoroughly, especially those that will not be cooked. Children under 5 years of age, immunocompromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated.

• Drink municipal water that has been treated with chlorine or other effective disinfectants.

• Avoid swallowing lake or pool water while swimming.

• Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers. Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

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Use a food thermometer to make sure food is safe.

Most people think they can check the doneness of burgers, pork chops and chicken breasts just by "eyeballing it." They look at it and judge the doneness by its appearance. They trust their experience. Experience is good, but it might be misleading.

According to a recent USDA study, one out of every four hamburgers turns brown in the middle before it has reached a safe internal temperature.

Eating undercooked meats or poultry increases the risk of food-borne illness. Many pathogens live naturally in the intestinal tracts of food animals.

Surveys of meat sold in retail food stores indicate that between one-fourth and three-fourths of all meat and poultry cuts sold in 1999 might have been contaminated with food-borne pathogens.

Bacteria most commonly associated with undercooked meats are campylobacter, salmonella and E. coli O157:H7.

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The Centers for Disease Control and Prevention (CDC) estimates that there are 76 million cases of food-borne illness a year in the United States. The problem sends nearly 325,000 people a year to the hospital; 5,000 a year die from it. The young, the old and the immune-compromised are hit hardest.

One of the main reasons for this is that many sick people don't seek attention, resulting in most food-borne infections going undiagnosed and unreported. Of those who do, many are not tested. In the case of salmonellosis, the CDC estimates that 38 cases occur for every one that's actually reported.

Of those that are admitted to hospitals, stool cultures are rarely taken due to the length of time - a few days - that it takes for results to come back. By then the patient has usually been released - unfortunate, because stool cultures are the standard diagnostic test for food-borne illness.

In addition, many doctors try to quickly diagnose the symptoms as appendicitis or a gastrointestinal virus, rather than take the steps to guarantee that it isn't a food-borne illness.

Although infections caused by E. coli O157:H7, campylobacter, cryptosporidium, listeria and yersinia have declined, salmonella infections have showed the smallest declines. Of 15,806 laboratory-diagnosed cases of food-borne, more cases were from salmonella than any other pathogen.

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Wisconsin Ag News reports that Wisconsin Senators Herb Kohl and Russ Feingold joined Sen. Tom Harkin of Iowa in co-sponsoring legislation to strengthen rules against microbial pathogens in meat and poultry.

"Kevin's Law" was named after Kevin Kowalcyk of Mount Horeb, who died in 2001 at the age of two from E. coli infection.

"Kevin's Law" would give the U.S. Department of Agriculture the authority to enforce basic safety and sanitation standards in the production of meat and poultry. These rules, called Pathogen Reduction and Hazard Analysis Critical Control Points, are critical to ensuring that microbial pathogens are kept out of meat and poultry sold to consumers in restaurants and on grocery store shelves.

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A new review by the Centers for Disease Control and Prevention in Atlanta shows that ground beef continues to be the main consumed food contaminated by E. coli.

Approximately 52 percent of all E. coli outbreaks during the 20-year period were caused by food sources, and of these, 41 per cent resulted from ground beef, by far the largest single food source. Many stemmed from home-prepared meals, where ndercooked ground beef, as well as uncooked raw vegetables, have been implicated in several outbreaks.

Although the median size of E. coli outbreaks has declined over the 20-year period, a newly recognised transmission route has emerged in the form of direct live animal contact with humans.

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