Olivia Garrett of the Telegraph Herald reports:

MAQUOKETA, Iowa — Several Maquoketa children are receiving care at University of Iowa Stead Family Children’s Hospital in Iowa City after developing serious complications from E. coli.

But local health officials have not yet identified the source.

Multiple Maquoketa children developed hemolytic uremic syndrome, prompting the treatment in Iowa City. HUS is a serious complication that can be caused by shiga toxin-producing E. coli, also known as STEC.

The Jackson County Health Department, through Genesis VNA, is working to determine what might have caused the outbreak. Community Health Manager Michele Cullen said Monday that this process involves contact tracing, but a source has not yet been identified.

Two-year-old Calvin “Cal” Notz is one of the children suffering from the rare and serious illness.

His mother, Nichole Notz, said it started on May 21, when Cal was tired and wouldn’t eat. By May 23, more concerning symptoms had emerged, including bloody and loose stools.

“That’s when we knew it was something more than just a little bug,” Notz said.

Cal’s parents took him to urgent care, where he was quickly sent to the hospital. On May 25, Cal was transferred to the Iowa City hospital for more specialized care. Cal suffered from seizures and a stroke and was placed in a medically induced coma, Notz said.

“He is improving at this point now,” Notz said Monday. “He is coming off the coma. … Today, he is doing well.”

According to the Blue Mountain Eagle:

Members of the Maquoketa community gathered June 2 at the Grove Street Park for a prayer vigil to support Cal Notz and Briella Davis, two children stricken with a rare kidney illness caused by E. coli.

Tara Notz, the sister-in-law of Cal’s parents Matt and Nichole Notz, welcomed people and thanked everyone on behalf of the family for their prayers and support and for attending the vigil, which included singing and prayers led by Pastor Nathan Combs of Prairie Creek Church.

“We want people to know our hearts are so full,” Nichole Notz said during a phone call after the vigil. “We are feeling everyone’s love, prayers and well-wishes. We love Maquoketa and being back in our home town. The support we’ve felt just confirms we are supposed to be here. We are so blessed.” 

Maggie Ward and Caleb Davis, Briella’s parents, also expressed their thanks to the community for its support.

“It has been so heartwarming. We appreciate all the messages and offers to help in any way,” Ward said.

Since the vigil, a third child, Shane Howell, also has been diagnosed with the same illness. All three children are being treated at the University of Iowa Stead Family Children’s Hospital.

According to Nancy Mayfield of the Maquoketa Sentinel-Press:

Jessi Howell’s motherly instincts kicked in when she noticed her 12-year-old son Shane wasn’t acting quite like himself.

 “I would like to share with everyone to never second guess their instincts,” she said to the Sentinel-Press via Messenger Friday. Shane is one of three Maquoketa children hospitalized at the University of Iowa Stead Family Children’s Hospital with complications from a rare strain of E. coli.

“We knew something wasn’t right. Shane doesn’t like to complain about anything and doesn’t like going to doctors for even simple routine visits. When he stopped being his normal 12-year-old self and didn’t have a football in his hands, we knew it was bad, but we never could have dreamed of just how bad it was about to get,” she said.

His parents quickly got him medical attention. Shane is currently on dialysis as he battles Hemolytic Uremic Syndrome (HUS), a rare complication that can occur with a shiga toxin-producing Escherichia coli (STEC) infection. Briella Davis, 18 months, and Cal Notz, 2, both from Maquoketa, are also at the children’s hospital battling the same illness.

The parents of the three hospitalized children have been keeping friends and family updated through Facebook posts, from which they gave the Sentinel-Press permission to share information. They also have shared information with the newspaper via texts, phone calls and messenger.

Briella is progressing well, and her dialysis stopped earlier this week, said her mother, Maggie Ward, via text late Friday afternoon.

“She just got moved out of the Pediatric Intensive Care Unit to inpatient a few hours ago,” she wrote.

Howell reported Friday that Shane was still on dialysis and was able to take a small walk and about five laps around the children’s unit in a wheelchair. On Saturday morning she said she expected him to be moved from intensive care later in the day.

Cal’s condition is more serious, and he was in a medically induced coma due to seizures and receiving dialysis, his mother, Nichole Notz, reported. On Saturday morning, the family reported on the Facebook page Prayers for Cal that he had had a stable night with no seizures.

All three families are thankful for the community support and prayers, the mothers said.

On May 12, 2021, The Washington State Department of Health (DOH) announced a multi-county outbreak of E. coli O157:H7 that began as a Public Health-Seattle & King County investigation involving several children with E. coli. The outbreak is likely linked to PCC Community Market brand yogurt produced by Pure Eire Dairy.

Public health message

If you have PCC Community Market brand yogurt or Pure Eire yogurt at home, do not eat it and throw it away.

E. coli infections can cause serious complications. Symptoms include diarrhea, stomach cramps and blood in the stool.

If you notice symptoms, especially bloody diarrhea, contact your health care provider right away.

Case information

DOH is reporting confirmed cases infected with bacteria that have been genetically linked. Local health jurisdictions may report higher numbers for their counties that include cases still under investigation and may provide additional detail on their cases.

Linked product information

On May 15, DOH announced a likely link to PCC Community Market brand yogurt produced by Pure Eire Dairy. Pure Eire Dairy issued a voluntary recall of affected products and PCC removed the products from shelves. Anyone who has PCC Community Market or Pure Eire brand yogurt at home should not eat it and should throw it away.

The investigation is ongoing, and we may identify additional links to products as we continue to gather information from new cases. DOH will provide updates as the investigation progresses.

OLYMPIA – During the ongoing investigation into an E. coli O157:H7 outbreak, the Washington State Department of Health (DOH) has identified a likely link to PCC Community Market brand yogurt produced by Pure Eire Dairy.

Pure Eire Dairy is working with the state Department of Agriculture to identify and recall all affected products. Anyone who has PCC Community Market brand yogurt at home should not eat it and should throw it away.

The outbreak now includes 11 confirmed cases, including six children under the age of 10, infected with bacteria that have been genetically linked. Counties with cases include Benton (1), King (8), Snohomish (1) and Walla Walla (1). Seven people have been hospitalized. Three people have developed hemolytic uremic syndrome, a serious complication of E. coli infection.

Symptoms of an E. coli infection include diarrhea, stomach cramps and blood in the stool. There is usually no fever. If you notice symptoms, especially bloody diarrhea, contact your health care provider right away. E. coli O157:H7 infections can cause serious complications.

DOH and partner agencies are continuing to test food samples and gather case information in this ongoing investigation. DOH will provide more information as it becomes available.

The Washington State Department of Health (DOH) is working with local health jurisdictions to respond to a multi-county outbreak of E. coli O157:H7 that may be linked to fresh produce.

The outbreak currently includes six confirmed cases across Benton County (1), King County (3), Snohomish County (1) and Walla Walla County (1). DOH is only reporting confirmed cases infected with bacteria that have been genetically linked, but local health officials may report higher numbers for their counties that include cases still under investigation.

There is one case in the outbreak between ages 0-9, two cases age 10-19, one case age 20-29, one age 30-39, and one case age 70-79. Three cases have been hospitalized and one case developed hemolytic uremic syndrome (HUS). HUS is a serious complication of E. coli O157:H7 infection that can damage the kidneys and other organs. The earliest case in the outbreak started having symptoms March 9, and the most recent case had symptoms starting April 21.

The Snohomish Health District announced Tuesday evening that it has identified two cases of Shiga toxin-producing E. coli (STEC) in Snohomish County residents. Following public health interviews, these cases do appear to be connected to a cluster of STEC cases among seven children in King County.

The local cases involve a woman in her 20s and a child under 10 years of age from separate households. The child has been hospitalized, but no further information will be shared on the cases due to patient privacy.

Seattle King County Public Health is investigating a cluster of seven children infected with Shiga toxin-producing E. coli (also known as STEC) in King County. All cases are currently under 15 years of age, and three are under 5 years of age. Cases have been reported during April 22–May 1, 2021.

All 7 children developed symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. Illness onsets occurred during April 17–29, 2021. Six children have been hospitalized; this includes two children who developed a type of kidney complication called hemolytic uremic syndrome (HUS) and both are recovering.

From PCC:

From Pure Eire Dairy Facebook page:
Notice of Recall on our Yogurt Products:
We regret to inform you that we have been contacted by the Washington State Department of Health due to a possible link between our yogurt products (Pure Eire and PCC brands) and possible E. Coli contamination. We are awaiting further testing information. However, out of an abundance of caution we are voluntarily recalling all of our yogurt products and halting yogurt production until further investigations are conducted.

The Snohomish Health District said Tuesday it has identified two cases of Shiga toxin-producing E. coli (STEC) in Snohomish County residents. Following public health interviews, these cases do appear to be connected to a cluster of STEC cases among seven children in King County.

Seattle King County Public Health is investigating a new cluster of seven children infected with Shiga toxin-producing E. coli (also known as STEC) in King County. All cases are currently under 15 years of age, and three are under 5 years of age. Cases have been reported during April 22–May 1, 2021.

Our investigation is ongoing. We have identified multiple types of fresh produce, mostly organic, in common among the majority of cases but cannot yet rule out other possibilities. We are still uncertain if these cases share the same source of their infection or not. Updates will continue to be posted when more information is available.

All 7 children developed symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. Illness onsets occurred during April 17–29, 2021. Six children have been hospitalized; this includes two children who developed a type of kidney complication called hemolytic uremic syndrome (HUS) and both are recovering.

The local cases involve a woman in her 20s and a child under 10 years of age from separate households. The child has been hospitalized, but no further information will be shared on the cases due to patient privacy.

Summary

Public Health is investigating a new cluster of seven children infected with Shiga toxin-producing E. coli (also known as STEC) in King County. All cases are currently under 15 years of age, and three are under 5 years of age. Cases have been reported during April 22–May 1, 2021.

Our investigation is ongoing. We have identified multiple types of fresh produce, mostly organic, in common among the majority of cases but cannot yet rule out other possibilities. We are still uncertain if these cases share the same source of their infection or not. Updates will continue to be posted when more information is available.

Illnesses

All 7 children developed symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. Illness onsets occurred during April 17–29, 2021. Six children have been hospitalized; this includes two children who developed a type of kidney complication called hemolytic uremic syndrome (HUS) and both are recovering.

Public Health actions

Public Health is conducting interviews with cases and their parents/guardians to help identify any common exposures. We are also working with the Washington State Department of Health to complete further testing, to help identify possible related cases in other counties, and to begin traceback of any products in common.

Public Health message

Fruits and vegetables can sometimes have germs like STEC on them, and many types have been associated with outbreaks in the past. You should always wash all fresh produce well before consuming. See this CDC link on fruit and vegetable safety for more details.

If you or your child develop painful or bloody diarrhea, diarrhea that lasts more than 3 days or is accompanied by a high fever or decreased urine, contact your healthcare provider to see if testing for STEC is indicated.

STEC and other foodborne infections occur throughout the year but may increase in frequency during late spring and summers months.

Anyone ill with suspected or known STEC should not work in or attend childcare or preschool, or work in food handling or healthcare until cleared by Public Health.

Laboratory testing

Six of the cases have preliminary testing indicating infections with E. coli O157 via PCR, and the seventh case has a positive EIA test for STEC. Further testing to confirm the strain and do genetic fingerprinting (whole genome sequencing or WGS) is underway at the Washington State Public Health Laboratory. These WGS results will help determine whether these cases were infected with the same strain of STEC.

JBS USA Food Company, a Greeley, Colo. firm and Importer of Record, is recalling approximately 4,860 pounds of imported boneless 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 raw, frozen, boneless beef products were imported on or around Nov. 10, 2020 and distributed for further processing. The following products are subject to recall:

  • 60-lb. cardboard boxes containing “95CL BONELESS BEEF PRODUCT OF AUSTRALIA” with “PACKED ON: 02-SEP-20” and Australian “EST. 4” on the packaging label.

The products were shipped to distributors and further processors in New York and Pennsylvania.

The problem was discovered when FSIS collected a routine product sample that confirmed positive for the presence of E. coliO157:H7. There have been no confirmed reports of adverse reactions due to consumption of these products.

Anyone concerned about an illness should contact a healthcare provider. E. coliO157:H7 is a potentially deadly bacterium that can cause dehydration, bloody diarrhea and abdominal cramps 2–8 days (3–4 days, on average) after exposure the organism. While most people recover within a week, some develop a type of kidney failure called hemolytic uremic syndrome (HUS). This condition can occur among persons of any age but is most common in children under 5-years old and older adults. It is marked by easy bruising, pallor, and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately.

FSIS is concerned that some product may be frozen and in cold storage at distributor or further processor locations. Distributors and further processors who received these products are urged not to utilize them.

Escherichia coli (E. coli) is a gram-negative bacterium that is highly diverse; there are an enormous number of types and strains with different characteristics. Most types of E. coli occur as normal inhabitants of the intestines of animals and do not cause disease. Some, however, can cause devastating illness, such as E. coli O157:H7. 

As the most notorious Shiga toxin-producing E. coli (STEC) serotype in the United States, E. coli O157:H7 is a common cause of bloody diarrhea and the most common cause of hemolytic uremic syndrome (HUS), a severe complication that involves kidney failure and is fatal in approximately 5-6% of cases. E. coli O157:H7 causes an estimated 63,153 illnesses, 2,138 hospitalizations, and 20 deaths in the United States each year due to foodborne transmission alone. 

Beef is the most common vehicle of foodborne E. coli O157:H7 outbreaks, accounting for almost half of outbreaks. Most beef outbreaks are associated with ground beef, but other types of beef products have also been implicated. Leafy greens (e.g., romaine lettuce, iceberg lettuce, spinach) are the second most common cause of E. coli O157:H7 outbreaks; this has been an important and difficult food safety problem for more than two decades. 

People can acquire STEC infection from food, recreational water (swimming), drinking water, contact with animals (especially cattle, goats, and sheep), and contact with a person who is or has recently been ill. Sometimes circumstances are beyond people’s control, and it is impossible to prevent becoming infected during the course of day-to-day life. However, there are certain things that can be done to reduce risk. Rinse fresh fruits and vegetables under running water without soap, bleach, or commercial produce washes. Do not wash meat, poultry, eggs, or bagged produce marked “pre-washed.” Wash your hands often, especially before, during, and after preparing food, after handling raw meat, before eating, after using the toilet, and after changing diapers or cleaning up a child who has used the toilet.

As of March 10, 2021, a total of 22 people infected with the outbreak strain were reported from 7 states (see map). Illnesses started on dates ranging from December 18, 2020, to January 12, 2021.

Sick people ranged in age from 10 to 95 years, with a median age of 28, and 68% were female. Of 20 people with information available, 11 were hospitalized. Of 18 people with information, 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS). One death was reported from Washington.

State and local public health officials interviewed people about the foods they ate in the week before they got sick. CDC analyzed the interview data and did not identify a specific food item as a potential source of this outbreak. People reported eating a variety of food items, including leafy greens, broccoli, cucumbers, and strawberries. However, none of the food items were reported significantly more by sick people in this outbreak when compared to healthy people in the FoodNet population survey.

5 states, 16 sick with 1 death. Whole genome sequencing (WGS) shows cases are likely related to same food.  Previous outbreak with same WGS linked to romaine lettuce, ground beef, and recreational water. 

CDC, public health and regulatory officials in several states, the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are collecting different types of data to identify the food source of a multistate outbreak of E. coli O157:H7 infections.

As of February 1, 2021, a total of 16 people infected with the outbreak strain have been reported from 5 states. This map shows where sick people live.

Illnesses started on dates ranging from December 23, 2020, to January 7, 2021. This chart shows when people got sick. Recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to link illnesses to an outbreak.

Sick people range in age from 10 to 95 years, with a median age of 31, and 88% are female. Of 12 people with information available, 9 have been hospitalized. Of 11 people with information, 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS). One death has been reported from Washington.

State and local public health officials are interviewing people to find out what foods they ate in the week before they got sick.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from eating the same food.

WGS also showed that this outbreak strain has been previously linked to various sources, including romaine lettuce, ground beef, and recreational water. More information is needed to identify the source of this outbreak.