E. coli Blog - Surveillance & analysis on e. coli news & outbreaks

An isolated case in an isolated place where no one has had E coli in four years.   However, 8-year old Evie Hope Wray of Theodosia, MO was a confirmed E coli case; one that evolved into Hemolytic-uremic syndrome (HUS),   And HUS killed Evie, who was a soccer and cat-loving second-grader at Lutie Elementary School.

The farm, where she lived with her parents and brother, has well-water that was found to be clean and safe.   Ozark health officials are tying to find out where Evie was exposed to E. coli, but say its really difficult with an isolated case.

KSPR-TV, the ABC affiliate in Springfield, MO is telling the sad story.  They report that:

When this close-knit family's youngest daughter became horribly ill, it was devastating.
“Her vitals started dropping… they hooked her up to oxygen and when that didn’t work, they had her on all kinds of drips,” Evie’s dad Tom Wray remembers.

She was diagnosed with a serious strain of E. Coli, but it was HUS that caused her death.
With no way to treat the infection, doctors could merely provide dialysis to support her failing kidneys and sedatives to reduce her pain.

“She was on about seven different machines. I just touched her and said, ‘momma’s here.’” Evie passed away at a Columbia hospital, surrounded by people who loved her.
But those people are still haunted by how- how did this happen?

For more on Evie, go here.

Evie Hope Wray

Dr. Richard A. Raymond is Medical Doctor from Nebraska.  Since July 2005, he has been Undersecretary for Food Safety at the United States Department of Agriculture.  He was asked by the U.S. House Subcommittee on Oversight and Investigations why there's been an uptick in e coli-related recalls.

Dr. Raymond listed several reasons why e coli related recalls involved only a few thousand pounds in 2006 to 33 million pounds in 2007.   Among those reasons:

• More sensitive testing
• More use of Pulsenet by state and local/regional health officers, which can connect distant confirmed cases into a single outbreak.
• Changes he has made to Food Safety & Inspection Service policies to be more aggressive in using recalls.
• And finally, what the former rural medical doctor called "Raymond's theory."  He believes there has been "an increased load" of e coli in the hind  guts of cattle. 

Dr. Raymond, Nebraska's former chief medical officer, did not say what he thinks increased the load.

We think the use of such phrases as "tipping point" and "perfect storm" are often over-used.  However, something may have happened this past week when comes to meaningful reform of the broken system for food safety.

After the cruel treatment of "downer" cows, the assault on the nation's school lunch program, and the nation's biggest beef recall in history,  Chairman John D. Dingell of the House Energy & Commerce Committee called a time out.  He had those who should know sharpen their pencils and raise their hands to testify about what's to be done.

One who came ready, ofcourse, was our own Bill Marler, who represents victims of  E coli and other food borne illnesses in the courts across the land.  Because there's been interest and because we think its important, we are going to publish what Bill had to say specifically about reforms before the House committee. Here goes:

Things are different from Sinclair’s critical view of packing plants of the 1900’s. We now face things Sinclair could not even begin to imagine. Those two things must drive food safety decisions now. The first is the threat of terrorist attacks via the food system. Just as too many could not imagine the horror of 9/11, too many cannot envision this kind of food disaster today. When a terrorist attacks our food system it will look eerily similar to any other outbreak of foodborne illness. Second, is the growth of food imports. Sinclair could not have imagined a world where the meat that may be in one hamburger could originate in Argentina, Canada and Colorado or that we would have fruits and vegetables year-round shipped in from South America, Asia and Africa. It is with these two enormous issues in mind, that I offer suggestions on how to put me out of business.

First, create a local, state and national public health system that catches outbreaks before they balloon into a personal and business catastrophe. Everyone believes that the Jack in the Box outbreak started in Seattle in January 1993. It did not. It actually began in November 1992 when young Lauren Rudolph died and another 30 people were sickened in and around southern California. However, because E. coli O157:H7 was not a reportable illness at the time, the death and illnesses were not recognized as an outbreak and the contaminated meat was shipped to Seattle. CDC’s PulseNet and Food Net were launched and are rightly credited with helping reduce the size of outbreaks by helping to more quickly conclude what suspect product is causing harm. But surveillance of human bacterial disease is lacking. For many foodborne illnesses, for everyone culture positive case, 20 to 50 other cases are missed because of lack of surveillance. Most people who become ill with a bacterial or viral disease are either seldom seen or never cultured. The more people are tested, the greater the likelihood that a source, accidental or not, will be found sooner.

Second, actually inspect and sample food before it is consumed. At present, Local and State authorities, along with the USDA and FDA, employ thousands of inspectors across the nation and world to inspect tens of thousands of plants that produce billions of pounds of food at farms, processing plants and retail outlets. The GAO has warned in the past that our food sampling and inspection is so scattered and infrequent that there is little chance of detecting microscopic E. coli or any other pathogen for that matter.

Third, consider mandatory recall authority on all food products. Recalls must be completely transparent. If a recall is ordered, consumers need to know what in fact is being recalled. Full disclosure must be the rule. Under the present system of voluntary recalls, last September we saw the disastrous Topps recall where the company knowingly left E. coli contaminated product on store shelves three weeks after being confronted with an ill customer and its product both testing positive for E. coli O157:H7. But recalls are not perfect. Although stunned by the video of animal abuse at Hallmark/Westland, I am more stunned that the recall has ballooned to 143 million pounds of meat and is quickly encompassing products that might contain trace amounts of the meat. No people have been sickened. I wonder if resources are better spent elsewhere.

Fourth, on a national level merge and then adequately fund the three federal agencies responsible for food safety. Right now, USDA's Food Safety and Inspection Service and the inspection arm of the Food and Drug Administration share this mission with the CDC. The system is trifurcated, which leads to turf wars and split responsibilities. We need one independent agency that deals with food-borne pathogens. You have a moral responsibility to consumers in your hometown or anywhere U.S. goods are sold. It is time to adequately fund our health and safety authorities to help business protect their customers.

Fifth, we cannot regulate ourselves out of this. Standards need to be set with the entire food chain at the table – from farmer, to manufacturer, to retailer and customer. Standards must also be based upon good science. We must invest in solid research at our land grant institutions to help producers manufacturer food that is safe, nutritious and the envy of the world.

None of this will stop bacterial and viral illnesses entirely. These invisible poisons have been around a long time. However, these five steps will enable us to help prevent it, help detect it far more quickly, to alert stores and families, and to keep our most vulnerable citizens - kids and seniors - out of harm's way. Thank you Mr. Chairman.