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

Two recent infections with toxin-producing E. coli (E. coli O157) have been identified in Washington residents who drank raw, unpasteurized milk. The two cases confirmed this month bring the count of infections this year associated with one Bellingham dairy to eight.

Although it’s legal to buy and sell raw milk in Washington, the state departments of Health and Agriculture (WSDA) remind consumers that raw milk can be dangerous.

The two new patients say they drank raw milk produced by Jackie’s Jersey Milk in Whatcom County. WSDA has conducted additional testing of the firm’s product, but has not found E. coli in the milk. WSDA continues to work with the farm to review the dairy's production and product handling practices.

The firm issued a product recall notice in February after WSDA found E. coli during routine sampling of the farm’s raw milk. Soon after the February recall, six patients with E. coli infections reported drinking the dairy’s product. People who were sick said they got the milk at retail stores in King, Snohomish, and Skagit counties.

Many strains of the bacteria Escherichia coli (abbreviated as E. coli) are harmless. Some, including E. coli O157, produce a toxin that can cause infections. Those infections may lead to severe diarrhea, stomach cramps and bloody stool. Symptoms can take up to nine days to appear, but typically begin within three or four days. People with symptoms should get medical care.

Each year, toxin-producing E. coli causes about 100,000 illnesses, 3,000 hospitalizations and 90 deaths in the United States. The infection can cause hemolytic uremic syndrome. It destroys red blood cells and leads to kidney failure. Most at risk are infants, children, pregnant women, the elderly and people with compromised immune systems.

Raw milk isn’t heated to kill harmful bacteria, making it riskier than pasteurized milk. Pasteurization kills illness-causing bacteria. Raw milk can also contain other bacteria that can cause illness or threaten lives, including Salmonella, Campylobacter, and Listeria.

Consumers who buy raw milk should read the container’s warning label carefully, and should verify the milk was produced and processed by a Washington State Department of Agriculture-licensed operation. Consumers should be aware that while licensure to sell raw milk represents a basic level of sanitation, it doesn’t assure that raw milk is free of illness-producing bacteria.

May 20, 2010: The distribution of the product subject to recall has been amended to wholesalers, restaurants, institutions, and federal establishments for further processing.

May 15, 2010 - Montclair Meat Co., Inc., a Montclair, Calif., establishment is recalling approximately 53,000 pounds of ground beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

The products subject to recall include:

• Various pound packages of "MONTCLAIR MEAT CO. GROUND BEEF"
• Various pound packages of "MONTCLAIR MEAT CO. ALL BEEF PATTIES"

Each package bears establishment number "Est. 6116" inside the USDA mark of inspection. These ground beef products were produced between the dates of May 3, 2010 through May 13, 2010, and were shipped to wholesalers, restaurants, institutions, and federal establishments for further processing in the Los Angeles, Calif., metropolitan area.

The problem was discovered through FSIS microbiological sampling. FSIS has received no reports of illnesses associated with consumption of these products. Individuals concerned about an illness should contact a physician.

E. coli O157:H7 outbreaks associated with lettuce or spinach, specifically the "pre-washed" and "ready-to-eat" varieties sold under various brand and trade names, are clearly by no means a new phenomenon. The FDA efforts to lead the lettuce industry to safer practices were nothing new. In 1998, the FDA issued guidance to the industry entitled "Guide to Minimize Microbial Food Safety Hazards for Fruits and Vegetables." The guide is specifically designed to assist growers and packers in the implementation of safer manufacturing practices. On February 5, 2004, the FDA wrote a letter to the lettuce and tomato industries to voice its concern about the frequent outbreaks linked to those products. In the letter, the FDA counted 14 such outbreaks since 1996 that it had investigated. Among other things, the letter stated:

In view of continuing outbreaks associated with fresh lettuce and fresh tomatoes, we strongly encourage firms in your industries to review their current operations in light of the agency’s guidance for minimizing microbial food safety hazards in fresh lettuce and fresh tomatoes, as well as other available information regarding pathogen reduction or elimination on fresh produce. We further encourage these firms to consider modifying their operations accordingly, to ensure that they are taking the appropriate measures to provide a safe product to the consumer. Since the available information concerning some of the recent outbreaks does not definitively identify the point of origin of the contamination, we recommend that firms from the farm level through the distribution level undertake these steps.

After an outbreak involving Dole lettuce, in November 2005, the FDA elucidated its past efforts and present concerns in its "Letter to California (should have added Arizona) Firms that Grow, Pack, Process, or Ship Fresh and Fresh-Cut Lettuce." The letter began:

This letter is intended to make you aware of the Food and Drug Administration's (FDA's) serious concern with the continuing outbreaks of food borne illness associated with the consumption of fresh and fresh-cut lettuce and other leafy greens.

The FDA went on to identify 18 outbreaks of E. coli O157:H7 associated with fresh or fresh-cut lettuce, resulting in 409 illnesses and two deaths since 1995. According to the FDA, completed trace back investigations in eight of the outbreaks “the 2005 Dole outbreak included” were traced to Salinas, California. The FDA further states that the industry's role in preventing these illnesses is crucial because "these products are commonly consumed in their raw state without processing to reduce or eliminate pathogens."

The 2005 Dole outbreak prompted even more industry-admonition by the FDA: "In light of continuing outbreaks associated with fresh and fresh-cut lettuce and other leafy greens, particularly from California, we are issuing this second letter to reiterate our concerns and to strongly encourage firms in your industry to review their current operations." This November 2005 FDA letter explicitly rejected industry excuses for not having taken prior action. Further, the FDA cited to research linking some or all of the outbreaks to sewage exposure, animal waste, and other contaminated water sources. The research further indicated that industry practices, including irrigation and field drainage methods, might have led directly to the contamination of the lettuce with E. coli O157:H7. As a result the FDA stated that it considers "adulterated" any ready to eat crops that have come in contact with flood waters. The FDA closed by warning industry members that food produced under unsanitary conditions is adulterated under ß402 (a)(4) of the Food, Drug, and Cosmetic Act, and that enforcement actions would be considered.

And, then we had the massive Dole spinach E. coli case that sickened 205 and killed five in 2006. So, how far have we actually come? Since Dole 2006 there has been Taco Bell, Taco Johns, Aunt Mids and many others that never saw the light of an investigation (primarily due to a lack of funding by FDA and California).