Fresno E. coli outbreak update

KFSN-TV reported that health officials are investigating 20 reported E. coli cases - 16 from the same source - in an outbreak that apparently began after two graduation parties on May 19.

Food from the same Fresno market was served at both graduation parties.

A number of food sources are under scrutiny, but the parties were catered by the same company, said Tim Casagrande, the county's director of environmental health.

Health workers are talking to people in attendance at two other parties held on the same day to determine if more people have become ill.
 

Bakersfield-area E. coli outbreak investigation continues

California health officials continue their investigation into an E. coli outbreak that has sickened at least a dozen people in the Bakersfield, California, area.

A common thread is a restaurant in Bakersfield, but the Kern County Health Department will not reveal its location. Health officials continued to say there is no immediate threat to the public and that is why the health department will not officially name the pizzeria.

Two of the hospitalized children have been released, and two developed hemolytic-uremic syndrome -- a condition marked by kidney failure and seen in serious foodborne illnesses -- and were transferred to hospitals outside Kern County.
 

E. coli infosheet from Food Safety Network

This week's food safety infosheet from the International Food Safety Network focuses on E. coli outbreaks in California and Minnesota.  Both outbreaks were traced to ground beef, and both are still being investigated by health officials. 
Minnesota E. coli Outbreak

California kindergarteners sick with possible E. coli

The Bakersfield Californian reported today that at least four children have become ill with symptoms of E. coli infection, and have been hospitalized - two with hemolytic uremic syndrome (HUS).  Health officials are continuing their investigation into the apparent outbreak, and are assessing potential common exposures the children may have had.  According to the article, "At this point, all that's known is that the four children, who know one another from school or play dates, suffered bloody diarrhea after attending several parties and playing at a local park."

KGET reported
that seven children had been counted as being part of the potential outbreak:
[S]ix kindergardners are sick, some of them hospitalized with the sometimes fatal disease.

An eighth student is a 10-year-old relative of of one of the kindergarders.
HUS develops when the toxin from E. coli bacteria, known as Shiga-like toxin (SLT) [1,2], enters the circulation by binding to special receptors. These Shiga-toxin receptors, known as Gb3 receptors [1], are probably heterogeneously distributed in the major body organs allowing disparate thrombotic (blood clotting) impacts in different HUS victims, although the greatest receptor concentration appears to be in the kidneys, especially in children. As the inflammatory reaction process accelerates, red blood cells are destroyed and cellular debris aggregates within the microvasculature while the body’s inherent clot breaking mechanisms are disrupted. The result is formation of microthrombi within particularly susceptible organs such as the kidneys and brain. Because there exists no way to halt the progression of HUS, doctors are left to support the HUS victim while the acute process runs its course.

E. coli video Some organs appear more susceptible than others to the damage caused by these toxins, possibly due to the presence of increased numbers of toxin-receptors. These organs include the kidney, pancreas, and brain.  An animated video of how E. coli attaches to the intestinal wall and releases shiga-toxins, causing infection, is available at the Howard Hughes Medical Institute Web site.


[1]  Recent research suggests that E. coli O157:H7 acquired its pathological character when a bacteriophage (virus that infects bacteria) transmitted genetic material for the creation of the toxin from a closely related Shigella bacterial species (hence the epithet, Shiga-like toxin) to a formerly benign species of E. coli.

[2]  Verotoxin-globotriaosyl ceramide binding receptors.

4-year-old Fallon girl battling severe infection

Four-year old Lanie Hope Smith of Fallon, daughter of Ken Smith of Reno and Melanie Smith of Fallon, fell ill last weekend and was admitted into Banner Churchill Community Hospital on Sunday.

Lanie's kidneys began failing and she was transferred to Washoe Medical Center, where it was determined she had an E. coli infection. While at Washoe Med, Lanie's kidneys began shutting down and her blood cell counts became dangerously abnormal.

She was then transferred to The Children’s Hospital and Research Center in Oakland, California, where she had to undergo surgery to insert two shunts for kidney dialysis.

Because Lanie's kidneys are compromised, excess fluid is building in her system and she now has fluid in her lungs. The little girl is hooked up to continuous dialysis and oxygen.