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

New Hampshire with two ill and one death, joins Maine, Massachusetts (at least three ill), Connecticut, Maryland, North Carolina, New Jersey, New York, Pennsylvania, Virginia and likely Rhode Island (at least twenty ill) in a growing E. coli O157:H7 outbreak linked to over 546,000 pounds of hamburger produced by Fairbank Farms of New York and distributed via retail outlets including Trader Joe's, Price Chopper, Lancaster, Wild Harvest, Shaw's, BJ's, Ford Brothers, and Giant.

With the recent recall of 1,039 pounds of hamburger contaminated with E. coli O157:H7 in Massachusetts, and the additional 546,000 pounds of hamburger recalled in New York, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today, hamburger recalls since 2007 have now reached 41,958,504 pounds (from about 150,000 in 2006). And, this is not counting another recall from 2008. Then, Hallmark/Westland Meat Packing Co., a Chino, California establishment, voluntarily recalled approximately 143,383,823 pounds of raw and frozen beef products that FSIS had determined to be unfit for human food because the cattle did not receive complete and proper inspection.

The Daily Gleaner of Fredericton, New Brunswick reported on yet another E. coli outbreak linked to salads prepared at a Wendy’s.

Public Health Services is following four confirmed cases of E. coli believed to be linked to people who ate at the Wendy's Restaurant on Prospect Street.

"Public Health advises those who ate at the restaurant before Tuesday, Oct. 27, seek medical attention if they experience symptoms of gastro-intestinal illness, such as severe cramps, diarrhea (may be bloody and watery), abdominal pain and vomiting," Dr. Cristin Muecke, regional medical officer of health for the Fredericton area, said in a news release

The cases of E. coli 0157:H7 are believed to be linked to salads prepared and served at the Prospect Street restaurant. There's no evidence to suggest a public health concern at other restaurant locations. Public Health Services is continuing its investigation into the matter.

The restaurant has implemented control measures to help minimize any risks and has been inspected. The restaurant is co-operating with Public Health Services and, at this time, Public Health officials don't have any concerns with the restaurant remaining open.

Muecke said anyone experiencing symptoms should follow good hygiene practices, such as washing their hands thoroughly. They should avoid contact with persons who may be particularly susceptible, including the very young, the elderly and those with weakened immune systems.

So, who made the lettuce?

Rich Harbert of Gate House News Service reported that Rhode Island health officials said 15 students from Lincoln Middle School suffered diarrhea after a trip to Camp Bournedale in Cedarville last week.  Two of the students tested positive for E. coli bacterial contamination. Two students were hospitalized for treatment.

Rhode Island health officials said the sixth-grade students from Lincoln attended a three-day session at the camp from Oct. 13-16. Health officials were notified that several students had become sick on Monday, Oct. 19.  The Rhode Island Department of Health reported that Massachusetts health officials are investigating foods at the camp as the likely source of the illness. The Center for Disease Control and Prevention is said to be assisting in the investigation.

Arnie Gerson, owner and director of the camp, said state and federal health officials traced the outbreak to tainted raw hamburger.  Gerson said the camp will no longer cook raw hamburger. As a precaution, the camp will serve pre-cooked burgers to campers, if it serves hamburger at all.

Culebra Meat Market No. 1 announced Tuesday a recall of three beef cuts because of a possible E. coli contamination: beef asada, beef stew meat and ground beef.

The beef was sold to area restaurants and to individual customers from Oct. 2 through Thursday and bears state inspection legend No. 740.

The recall does not affect the chain’s other stores.

The announcement said that eating food contaminated with E. coli can cause illness if it’s not cooked to an internal temperature of at least 148 degrees.

Anne-Marie Hickey of the University of Saskatchewan’s research communications office wrote an interesting article on the work of David Asper, a graduate student at the University of Saskatchewan.

The veterinary microbiology student’s work, soon to be published, is premised on the idea that humans can be protected from harmful bacteria by vaccinating cattle that are the source of the bacteria. Asper’s work builds on groundbreaking research by his supervisor Andrew Potter, director of the Vaccine and Infectious Disease Organization (VIDO) International Vaccine Centre. Potter's work led to the first cattle vaccine against E. coli O157, the leading cause of “hamburger disease.” The vaccine prevents the bacteria from attaching to the animal’s intestines and from colonizing, cutting the disease off at the source.

“The E. coli O157 vaccine is the first of its kind worldwide and is expected to significantly lessen the amount of E. coli O157 present in food products and also in the environment,” said Potter. But while E. coli O157 is the most prevalent type of E. coli in North America, it’s just one of hundreds of E. coli bacteria around the world that cause disease by producing shiga toxin. These shiga toxin-producing E. coli (STEC) produce infections that can range from very mild to severe or even life-threatening. “Right now, STEC bacteria is the number one cause of renal (kidney) failure in children around the world,” said Asper. “It affects adults too, but children are the most susceptible.”

STEC bacteria cause disease in humans if meat becomes contaminated during slaughter or if feces mix with groundwater, polluting drinking or swimming water or food supplies. But the STEC bacteria that cause human illness generally do not make animals sick so healthy cattle often have STEC bacteria living in their intestines.

Due to improved detection methods, cases of non-O157 E. coli infection are on the rise, increasing the importance of having the second-generation vaccine.

“We can protect humans by vaccinating animals before they come in contact with the pathogen. I think that’s very important work that will lead to a lot fewer infections,” Asper said. His work could help prevent tragedies such as the 2000 incident in Walkerton, Ont. when fecal material from cattle seeped into the water system, contaminating drinking water and resulting in thousands of illnesses and seven deaths in the community.

Just as the E. coli O157 cattle vaccine will be a significant tool for use by beef and dairy producers to mitigate human infection risk, Asper’s vaccine could also lessen financial losses to meat producers. When STEC bacteria is found in just one meat sample, beef processors are required to destroy the entire shipment -- a significant cost to farmers.

Authors: Zhang, Guodong1; Ma, Li2; Beuchat, Larry R.2; Erickson, Marilyn C.2; Phelan, Vanessa H.2; Doyle, Michael P.2

Source: Journal of Food Protection®, Volume 72, Number 10, October 2009 , pp. 2028-2037(10)

Publisher: International Association for Food Protection

Abstract:

Survival and internalization characteristics of Escherichia coli O157:H7 in iceberg, romaine, and leaf lettuce after inoculation of leaf surfaces and soil were determined. A five-strain mixture of E. coli O157:H7 in water and cow manure extract was used as an inoculum for abaxial and adaxial sides of leaves at populations of 6 to 7 log and 4 log CFU per plant. The five strains were individually inoculated into soil at populations of 3 and 6 log CFU/g. Soil, leaves, and roots were analyzed for the presence and population of E. coli O157:H7. Ten (4.7%) of 212 samples of leaves inoculated on the adaxial side were positive for E. coli O157:H7, whereas 38 (17.9%) of 212 samples inoculated on the abaxial side were positive. E. coli O157:H7 survived for at least 25 days on leaf surfaces, with survival greater on the abaxial side of the leaves than on the adaxial side. All 212 rhizosphere samples and 424 surface-sanitized leaf and root samples from plants with inoculated leaves were negative for E. coli O157:H7, regardless of plant age at the time of inoculation or the location on the leaf receiving the inoculum. The pathogen survived in soil for at least 60 days. Five hundred ninety-eight (99.7%) of 600 surface-sanitized leaf and root samples from plants grown in inoculated soil were negative for E. coli O157:H7. Internalization of E. coli O157:H7 in lettuce leaves and roots did not occur, regardless of the type of lettuce, age of plants, or strain of E. coli O157:H7.

Document Type: Research article

Affiliations: 1: Center for Food Safety, University of Georgia, 1109 Experiment Street, Griffin, Georgia 30223-1797, USA; Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, 5100 Paint Branch Parkway, College Park, MD 20740, USA 2: Center for Food Safety, University of Georgia, 1109 Experiment Street, Griffin, Georgia 30223-1797, USA

Officials said another case had been confirmed since Wednesday and three children remained in hospital in a stable condition on Friday evening.  All those affected had visited Godstone Farm, near Redhill.  The farm closed on 12 September after the outbreak emerged. The first link to infection was dated back to 8 August.  Tests carried out confirmed that the E.coli bug was in animal droppings.

Four other farms have since closed, or partially closed, including Godstone's sister farm, Horton Park in Epsom, Surrey.  The others are White Post Farm in Nottinghamshire, the World of Country Life farm, in Exmouth, Devon, and Big Sheep And Little Cow Farm in Bedale, North Yorkshire.

An independent investigation into the outbreak, and the response to it, has been started by the HPA.  The HPA said on Wednesday the inquiry would be led by George Griffin, professor of infectious diseases at St George's, University of London.

In 2004 I gave a speech on the risks of petting zoos and E. coli - seems like the information did not make it to England.  I also put up a website - www.fair-safety.com as a place to showcase outbreaks and how to prevent them.  I now need to update it.

It seems that any serious discussion of E. coli O157:H7 always has to start with one event: the 1993 outbreak associated with the Jack in the Box restaurant chain. This, of course, is with good reason. That outbreak left over 700 persons ill and 4 children dead. The “9/11 for the food industry,” as a certain trial lawyer has occasionally referred to the outbreak, precipitated a whirlwind of events including media coverage, consumer outrage, lawsuits, and stricter federal regulations regarding meat safety. Though the swell of emotion that spiraled out of the Jack in the Box disaster dulls somewhat with each passing year, the federal regulations that sprung up in its wake continue to generate more questions.

To understand the significance of these regulations, a little background information is useful. The Food Safety and Inspection Service’s (FSIS) stated mission renders it “responsible for ensuring that the nation's commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged.” FSIS operates as part of the United States Department of Agriculture (USDA). To promote its mission, FSIS has the power—under the Federal Meat Inspection Act (FMIA)—to, among other things, seek the recall of products that have been deemed “adulterated.” FSIS drastically shifted how it interpreted and enforced the FMIA in 1994 when, following the Jack in the Box outbreak, the agency declared E. coli O157:H7 to be an adulterant. This marked a dramatic change from its previous stance that pathogens in raw meat were not adulterants.

The declaration of E. coli O157:H7 as an adulterant was met with strong opposition from the meat industry. In a lawsuit filed soon after the 1994 declaration, the industry accused the USDA of not following proper rulemaking procedures and of acting in an arbitrary and capricious manner beyond its legal authority. The United States District Court held, however, that the USDA was allowed to interpret the FMIA and that the USDA has the power to declare substances to be adulterants with the intended purpose of spurring the meat industry to create and implement preventative measures.

During the early part of this decade, however, it became readily apparent that O157:H7 was not the only deadly pathogen in E. coli family—in fact, far from it. The Centers for Disease Control (CDC) recognized this fact when, in 2000, the agency made all Shiga toxin-producing E. coli (STEC) nationally notifiable. The CDC subsequently referred to non-O157 STEC as emerging pathogens that pose a significant health threat, with more strains reported every year. Still, FSIS remained steadfast in its stance that O157:H7 is the only enterohemorrhagic E. coli strain that should be deemed to be an adulterant.

So what’s wrong with FSIS’s position regarding E. coli O157:H7? The simple answer is this: the people of this nation do not deserve another Jack in the Box-sized catastrophe as a pre-requisite for currently needed agency action. The scientific and medical communities have recognized the dangers of all enterohemorrhagic E. coli, not just O157:H7, again and again. Representatives of the CDC estimate that non-O157 STEC causes 36,700 illnesses, 1,100 hospitalizations, and 30 deaths annually. Nearly two years ago today, on October 17, 2007, the CDC and FSIS even went so far as to hold a public meeting to consider the public health significance of non-O157 STEC. In the Notice of the meeting, FSIS referred to the “growing awareness that STECs other than E. coli O157:H7 (non-O157:H7 STECs) cause sporadic and outbreak-associated illnesses.” Nevertheless, following the meeting, FSIS failed to re-interpret its policies.

This brings us to today. We’re nearing the end of 2009, closing in on seventeen years since the Jack in the Box outbreak. Millions of Americans have suffered foodborne illnesses, injuries, and deaths in that time, thousands of them likely due to enterohemorrhagic E. coli other than O157:H7. It is on behalf of those persons that the law firm of Marler Clark has authored a petition to FSIS requesting the agency to issue an interpretive rule declaring all enterohemorrhagic STEC, including non-O157:H7 serotypes, to be adulterants within the meaning of the Federal Meat Inspection Act.

The petition details the scientific and legal bases for the requested action, but perhaps more importantly it details the suffering that food contaminated with non-O157:H7 enterohemorrhagic E. coli inflicted upon three individuals: June Dunning, Megan Richards, and Shiloh Johnson. Ms. Dunning, whose infection was caused by E. coli O146:H21, unfortunately succumbed to her illness, passing in 2006. Ms. Richards and Ms. Johnson endured lengthy hospitalizations, kidney failure, and will both endure a lifetime of medical complications as a result of their E. coli O121:H19 and E. coli O111 infections (respectively).

It would be naïve to assume that a change to FSIS policy will immediately rid the world of all foodborne E. coli infections. It has been unequivocally proven, however, that all enterohemorrhagic E. coli are potentially lethal pathogens that we must fight tooth and nail to keep out of this nation’s food supply. If we trust science, and do our part to push government agencies to enact regulations to require better monitoring, we can no doubt begin to prevent further harm. In the end, after all, the requisite wading through the mess of bureaucracy required to change federal regulation is all worth it, so long as the outcome prevents at least one more case like that of June Dunning, Megan Richards, or Shiloh Johnson.