The CDC, public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) investigated a multistate outbreak of Shiga toxin-producing Escherichia coli O26 (E. coli O26) infections.

As of September 19, 2018, 18 people infected with the outbreak strain of E. coli O26 were reported from 4 states.

Illnesses started on dates ranging from July 5, 2018 to July 25, 2018. Ill people ranged in age from one year to 75, with a median age of 16. Sixty-seven percent of ill people were male. Of 18 people with information available, 6 (33%) were hospitalized, including one person who died in Florida.

WGS analysis of isolates from 13 ill people did not identify any antibiotic resistance.

Epidemiologic, laboratory, and traceback evidence indicates that ground beef from Cargill Meat Solutions was a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Fourteen (100%) of 14 people interviewed reported eating ground beef. Ill people purchased ground beef from several different grocery stores.

USDA-FSIS conducted traceback investigations from stores where ill people reported buying ground beef. Initial information collected from ill people in Florida indicated that the ground beef was purchased from various Publix grocery stores. On August 30, 2018, Publix Super Markets, Inc. recalled ground chuck products sold in several Florida counties.

Further traceback investigation by USDA-FSIS identified Cargill Meat Solutions in Fort Morgan, Colorado as the source of the contaminated ground beef linked to illness, including the recalled ground beef sold at Publix stores in Florida. On September 19, 2018, Cargill Meat Solutions recalled ground beef products that were produced and packaged on June 21, 2018. Products are labeled with the establishment number “EST. 86R” inside the USDA mark of inspection. The products were shipped to retailers nationwide. Visit the USDA-FSIS website for a list of recalled products.

Laboratory testing identified the outbreak strain of E. coli O26 in leftover ground beef collected from the home of one ill person in Florida. WGS analysis showed that the E. coli O26 strain identified in the leftover ground beef was highly related genetically to the E. coli O26 strain isolated from ill people.

Public Health- Seattle & King County investigated an outbreak of Shiga toxin-producing E. coli (STEC) O26 associated with I Love Sushi and Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. I Love Sushi is a food establishment that operates out of Café Mario once a week. At this time, the source of the illnesses has not been identified.

Since July 2, 2018, investigators learned of at least 16 people who have developed symptoms consistent with a STEC illness, including diarrhea (bloody or non-bloody) and abdominal cramps. All of the ill people work at the Nintendo of America campus in Redmond. Illness onsets occurred during June 11-July 5th, 2018. The 16 ill people all consumed food from Café Mario on multiple days before becoming ill, and only four of the ill people also ate at I Love Sushi before becoming ill.

On July 3, 2018, Public Health- Seattle & King County Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi. At Café Mario, potential risk factors were identified, including inadequate hand washing practices and improper cold holding temperatures of food; corrective actions discussed with Café Mario’s management. At I Love Sushi, potential risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on the July 4 holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Investigators revisited both food establishments on July 11, 2018, and both were allowed to reopen the same day. Café Mario and I Love Sushi both completed a thorough cleaning and disinfection of their facilities before reopening, and any remaining processed ready-to-eat food products were discarded.

Public Health investigators did not identify any employees of either restaurant who had a recent diarrheal illness. Investigators also reviewed with management of both food establishments the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

Of the 16 people who got sick, 4 tested positive for STEC by a healthcare provider. Further testing at the Washington State Public Health Laboratory is pending, but so far three of those tested are positive for STEC O26. Genetic fingerprint results are still pending.

Environmental swabs were collected from both food establishments for laboratory testing and all came back negative for STEC.[1]

[1]https://www.kingcounty.gov/depts/health/communicable-diseases/disease-control/outbreak/I-Love-Sushi-Cafe-Mario.aspx

In May 2018, Public Health Seattle and King County (PHSKC) officials investigated an outbreak of Shiga toxin-producing E. coli(STEC) associated with three Homegrown restaurants. The results of the investigation implicated pesto used exclusively on the chicken pesto sandwich.

Four people tested positive for STEC O26 after consuming food from three different Homegrown restaurants in King County. Symptoms included abdominal cramps and diarrhea, with one person reporting bloody diarrhea. All four ate the chicken pesto sandwich from one of the following locations: Redmond, Kirkland or Seattle (Westlake Ave). Of the four ill persons, three were adults and one was a child. Illness onsets occurred during April 24–May 6, 2018. Meal dates occurred during April 24–26, 2018.

On May 24, 2018, PHSKC Environmental Health investigators visited the three Homegrown locations where the ill people reported eating. During the field inspections, potential risk factors, including handwashing facilities violations at two of the three locations, and a cold holding temperature violation at one of the three locations, were identified and discussed with the restaurant managers. PHSKC did not identify any employees who experienced similar symptoms before or after meal dates for the ill customer.

The various ingredients of the chicken pesto sandwich were also investigated. All Homegrown locations in King County stopped selling this particular sandwich while the investigation was ongoing. The three restaurants under investigation were required to complete a thorough cleaning and disinfection. No employees reported working at Homegrown while experiencing illness in the three weeks prior to the illness onset dates of the customers who got sick. Investigators also reviewed the requirement that restaurant employees are not allowed to work while having vomiting or diarrhea.

Three of the four people who got sick, tested positive for STEC O26 with the same genetic fingerprint, suggesting that they have a common source of infection; genetic fingerprinting for the other ill person could not be completed. Pesto from each location tested negative for STEC O26.[1]

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[1]https://kingcounty.gov/depts/health/communicable-diseases/disease-control/outbreak/homegrown-2018-05-25.aspx

In June and early July 2016, the Chicago Department of Public Health (CDPH) identified an outbreak of Shiga toxin-producing E. coli O157:H7 (STEC), associated with the consumption of food at Carbón Live Fire Mexican Grill in Chicago.  CDPH officials eventually identified at least 67 cases of illness involved in the outbreak.  As part of the CDPH investigation, Carbón Live Fire Mexican Grill located at 300 W. 26th Street was temporarily closed. At least 16 individuals were hospitalized as part of this outbreak. 

“This is a serious condition that is treatable,” said CDPH Commissioner Julie Morita, M.D. “Anyone who believes they may be symptomatic and ate at this restaurant should see their medical provider immediately. CDPH is taking every precaution as part of our robust response in order to limit the impact of this outbreak.”

STEC can be transmitted through consumption of contaminated foods including undercooked beef, unpasteurized juice, raw milk and unwashed, raw produce. According to CDPH, the menu items responsible for the outbreak were not identified.

CDPH issued an alert to area physicians of the outbreak, providing medical guidance. Medical providers who suspected STEC were requested to submit specimens for testing. CDPH recommended that Antibiotics and anti-diarrheal medicines not be used to treat STEC as they may worsen symptoms. Medical experts instead encouraged supportive medical care, including intravenous fluids, where necessary.

La Rosita Fresh Market Inc., a Mt. Prospect, Ill. retail store, is recalling approximately 54 pounds of raw 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 raw ground beef items are ground in the store and packaged for consumers behind the meat counter in varying weights. The raw ground beef items were packed on March 13, 2019 and March 14, 2019. The following products are subject to recall: [View Labels (PDF only)]

  • Varying weights of ground beef packed in white trays with plastic wrap, containing “MOLIDA DE RES GROUND BEEF” with “Packed On 3/13/19 Sell By 3/20/19” or “Packed On 3/14/19 Sell By 3/21/19”.

These items were only sold in the La Rosita Fresh Market Inc. retail store, located at 1805 W. Algonquin Rd., Mt. Prospect, IL, 60056.

The problem was discovered on March 14, 2019, by FSIS investigators through routine product sampling. There have been no confirmed reports of adverse reactions due to consumption of these products.

 Anyone concerned about an injury or illness should contact a healthcare provider. E. coli O157: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 in consumers’ refrigerators or freezers. Consumers who have purchased these products are urged not to consume them.

Fifty-nine people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 have been reported from 15 states and the District of Columbia. Since the last CDC update on December 6, an additional 7 ill people have been included in this investigation – California 12, Connecticut 1, District of Columbia 1, Florida 1, Illinois 2, Louisiana 1, Massachusetts 1, Maryland 1, Michigan 7, New Hampshire 6, New Jersey 12, New York 7, Ohio 1, Pennsylvania 4, Rhode Island 1, Wisconsin 1.

Illnesses started on dates ranging from October 5, 2018 to November 16, 2018.

Twenty-three people have been hospitalized, including two people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

FDA Update.

The Public Health Agency of Canada has identified ill people infected with the same DNA fingerprint of E. coli O157:H7 bacteria in Canada. In Canada, as of December 6, 2018, there have been 27 confirmed cases of E. coli illness investigated in Ontario (4), Quebec (19), New Brunswick (1), and British Columbia (3). The illnesses in British Columbia were related to travel to Quebec, Ontario and the United States. Individuals became sick between mid-October and early November 2018. Nine individuals have been hospitalized, and two individuals suffered from hemolytic-uremic syndrome (HUS), which is a severe complication that can result from an E. coli infection. No deaths have been reported. Individuals who became ill are between 2 and 93 years of age. The majority of cases (52%) are male.

The FDA, along with CDC and state partners, is investigating farms and cooling facilities in California that were identified in traceback. CDC identified the outbreak strain of E. coli O157:H7 in sediment collected within an agricultural water reservoir on Adam Bros. Farming, Inc. farm, which was identified in traceback.

CDC is advising that consumers not eat any romaine lettuce harvested from Monterey, San Benito, and Santa Barbara counties in the Central Coastal growing regions of northern and central California. FDA continues its investigation of farms identified in traceback.

Laboratory analysis indicates that the illnesses reported in this outbreak are genetically related to illnesses reported in a previous E. coli outbreak from December 2017 that affected consumers in both Canada and the U.S. This tells us that the same strain of E. coli is causing illness in Canada and the US as was seen in 2017 and it suggests there may be a reoccurring source of contamination. Investigators are using evidence collected in both outbreaks to help identify the possible cause of the contamination in these events.  Twenty-five people infected with the outbreak strain of STEC O157:H7 were reported from 15 states. Illnesses started on dates ranging from November 5, 2017 to December 12, 2017. Nine people were hospitalized, including two people who developed hemolytic uremic syndrome, a type of kidney failure. One death was reported from California.

In December 2017, the Public Health Agency of Canada (PHAC) investigated an outbreak of STEC O157:H7 infections in several provinces linked to romaine lettuce. In total, there were 42 cases of E. coli O157 illness reported in five eastern provinces: Ontario (8), Quebec (15), New Brunswick (5), Nova Scotia (1), and Newfoundland and Labrador (13). Individuals became sick in November and early December 2017. Seventeen individuals were hospitalized. One individual died. Individuals who became ill were between the ages of 3 and 85 years of age. The majority of cases (74%) were female.

Thirty-two people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 have been reported from 11 states – California 10, Connecticut 1, Illinois 2, Massachusetts 2, Maryland 1, Michigan 7, New Hampshire 2, New Jersey 3, New York 2, Ohio 1, Wisconsin 1.

Illnesses started on dates ranging from October 8, 2018 to October 31, 2018.

Thirteen people were hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

The Public Health Agency of Canada has identified 18 ill people infected with the same DNA fingerprint of E. coli O157:H7 bacteria in two Canadian provinces: Ontario and Quebec.

Epidemiologic evidence from the United States and Canada indicates that romaine lettuce is a likely source of the outbreak.

Ill people in this outbreak were infected with E. coli bacteria with the same DNA fingerprint as the E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada.The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce.

CDC is advising that consumers do not eat any romaine lettuce because no common grower, supplier, distributor, or brand of romaine lettuce has been identified.

Swift Beef Co., a Hyrum, Utah establishment, is recalling approximately 99,260 pounds of raw non-intact 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 bulk ground beef was produced on Oct. 24, 2018. The following products are subject to recall: [View Labels (PDF only)]

  • 2,000 lb. – bulk pallets of Swift Ground Beef 81/19 (81% lean) Fine Grind Combo bearing product code 42982.
  • 8-10 lb. – plastic wrapped chubs of “blue ribbon BEEF” Ground Beef 81/19 (81% lean) Coarse Grind bearing product code 42410.
  • 8-10 lb. – plastic wrapped chubs of “blue ribbon BEEF” Ground Beef 93/07 (93% lean) Coarse Grind bearing product code 42413.
  • 8-10 lb. – plastic wrapped chubs of “blue ribbon BEEF” Ground Beef 85/15 (85% lean) Coarse Grind bearing product code 42415.
  • 8-10 lb. – plastic wrapped chubs of “blue ribbon BEEF” Ground Beef 73/27 (73% lean) Coarse Grind bearing product code 42510.

The products subject to recall bear establishment number “EST. 628” inside the USDA mark of inspection. These items were shipped to retail distributors for further processing and food service distributors for institutional use in locations in California, Nevada, Oregon, Utah, and Washington.

The problem was discovered on November 15, 2018, when FSIS visited Swift Beef Company in response to a FSIS ground beef sample that was collected at a further processing establishment and was confirmed positive for E. coli O157:H7. FSIS confirmed that Swift Beef Company was the sole source supplier for the ground beef products. That affected product was recalled on Nov. 16 and information on that recall can be found here. There have been no confirmed reports of adverse reactions due to consumption of these products.

Anyone concerned about an injury or 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.

Utah public health officials are investigating an increase in Shiga toxin-producing Escherichia coli (STEC) infections across the state. While the source of these infections has not been identified, several ill individuals reported visiting petting zoos, corn mazes, and farms.

Since October 1, 2018, 20 cases of STEC have been reported along the Wasatch Front and in the Central and Southwestern regions of Utah. Cases range in age from 10 months to 71 years old. Eleven cases are younger than 18. Six people were hospitalized and no deaths have been reported. “For the past five years, Utah has averaged about 13 cases of STEC during the month of October,” said Kenneth Davis, epidemiologist with the Utah Department of Health (UDOH). “An average of 113 STEC cases and 25 hospitalizations are reported each year in Utah. This increase in October is higher than normally expected,” said Davis. UDOH is working with Utah’s local health departments to investigate the illnesses and determine the source of infection.

E. coli is a bacteria spread by consuming contaminated food or water, unpasteurized (raw) milk, contact with cattle, or contact with the feces of infected people. People visiting petting zoos and areas where cattle have been are at greater risk of contracting E. coli, especially if they are not practicing good hand hygiene. Symptoms usually appear 3–4 days after exposure and can vary, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Most people get better within 5–7 days, but some infections are severe or even life-threatening. Hemolytic uremic syndrome (HUS), a type of kidney failure, is a potentially life-threatening complication of E. coli infection. Very young children and the elderly are more likely to develop severe illness and kidney failure than others, but even healthy, older children and young adults can become seriously ill.

Practicing good hand hygiene is one of the best ways to reduce your chance of getting and spreading E. coli infection. Always wash your hands:

  • Before and after preparing or eating food
  • After using the bathroom or changing diapers
  • After touching or being around animals or places where animal feces may be present (e.g., farms, petting zoos, fairs, corn mazes, or even your own backyard)

Other protective measures include:

  • Stay home from school or work while you have diarrhea. Most people can return to work or school when they no longer have diarrhea, but special precautions are necessary for food handlers, healthcare workers, and childcare providers and attendees. Check with your employer before returning to work, and check with your child’s child care center before resuming child care.
  • Follow the four steps to food safety when preparing food: clean, separate, cook, and chill.
  • Avoid raw (unpasteurized) milk, unpasteurized dairy products, and unpasteurized juices (such as fresh apple cider).
  • Don’t swallow water when swimming and when playing in lakes, ponds, streams, swimming pools, backyard “kiddie” pools, and splash parks.

Contact your healthcare provider if you have diarrhea that lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine. Antibiotics should not be used to treat this infection. There is no evidence that treatment with antibiotics is helpful, and taking antibiotics may increase the risk of HUS. Antidiarrheal agents may also increase that risk.

Many families are celebrating Halloween this weekend and next, and the Iowa Department of Public Health (IDPH) has some safety tips for people making trips to apple orchards and pumpkin patches. The agency says trips to these places can be educational and fun, but it also carries some risks. Bacteria like E. coli, parasitic Cryptosporidiumand many others can be spread by farm and animal contact or drinking unpasteurized liquids. To reduce your risk of potential contamination, be sure to clean any apples or produce before eating them, check that any milk, juice or cider is pasteurized before drinking it and wash your hands with soap and warm water after visiting.