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The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns that ground beef products in HelloFresh meal kits may be associated with Escherichia coli (E. coli) O157:H7illness. A recall was not requested because the products are no longer available for purchase.

The meal kits containing ground beef for this public health alert were shipped to consumers from July 2-21, 2022. The following products are subject to the public health alert:     

  • 10-oz. plastic vacuum-packed packages containing “GROUND BEEF 85% LEAN/15% FAT” with codes “EST#46481 L1 22 155” or “EST#46481 L5 22 155” on the side of the packaging.

 The ground beef packages bear “EST.46841” inside the USDA mark of inspection and on the plastic ground beef package.

FSIS, the Centers for Disease Control and Prevention, and state public health partners are investigating an outbreak of E. coli O157:H7 and raw ground beef is the probable source of the reported illnesses. Traceback information identified that multiple case-patients received ground beef produced at establishment M46841 and distributed by HelloFresh in meal kits from July 2-21, 2022. Traceback of materials used to produce the ground beef is ongoing and FSIS continues to work with suppliers and public health partners on the investigation.

FSIS is concerned that some product may be in consumers’ freezers. Consumers who have purchased these products are urged not to consume them. These products should be thrown away.

According to the CDC’s latest report:

97 Sick with E. coli O157:H7
43 Hospitalized
10 with Hemolytic Uremic Syndrome (HUS)
Age range 3 to 94
45% Female and 55% Male

We are representing 36 of the folks sickened and have filed 6 lawsuits in Ohio and Michigan so far. We have identified the grower and the shipper of the lettuce. We are working on the processor.

Since the last update on August 25, 2022, 13 more illnesses have been reported to CDC. As of August 31, 2022, a total of 97 people infected with the outbreak strain of E. coli O157:H7 have been reported from six states – Ohio, Michigan, Indiana, New York, Pennsylvania and Kentucky.

Note: The State of Ohio is reporting 24 cases, but Wood County alone is reporting 23, so the actually number for Ohio is likely 48.

Note: The State of Michigan is reporting 58 cases though the CDC, but earlier it reported at least 98, so the actual number in Michigan is at lease 100.

The CDC is reporting confirmed cases (by WGS) as follows: Indiana (11), Kentucky (1), Michigan (58), New York (1), Ohio (24) and Pennsylvania (2).

Illnesses started on dates ranging from July 26, 2022, to August 15, 2022.

Sick people range in age from 3 to 94 years, with a median age of 22 years, and 55% are male. Of 81 people with information available, 43 have been hospitalized and 10 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

State and local public health officials have been interviewing people about the foods they ate in the week before they got sick. Among 67 people with detailed food history, 54 (81%) reported eating at a Wendy’s restaurant in the week before their illness started. The Wendy’s restaurants where sick people ate are in Indiana, Michigan, Ohio, and Pennsylvania. People reported eating a variety of menu items, including burgers and sandwiches. Of 54 people with detailed information about what they ate at Wendy’s, 37 (69%) reported eating romaine lettuce served on burgers and sandwiches. 

The Michigan Department of Health and Human Services (MDHHS), the Michigan Department of Agriculture and Rural Development (MDARD) and three local health departments – Kent, Ottawa and Oakland – are investigating a recent increase in the number of illnesses related to E. coli bacteria. 

MDHHS had received reports of 98 cases of E. coli infection in August, compared to 20 cases reported during the same time period in 2021. The current investigation is in the early stages. Laboratory results have linked some of these cases to each other.

Some kinds of E. coli cause disease by making a toxin called Shiga toxin. The bacteria that make these toxins are called “Shiga toxin-producing” E. coli, or STEC. The most commonly identified STEC in North America is E. coli O157:H7. STEC has been connected to the recent increase in infections. 

“While reports of E. coli illness typically increase during the warmer summer months, this significant jump in cases is alarming,” said Dr. Natasha Bagdasarian, MDHHS chief medical executive. “This is a reminder to make sure to follow best practices when it comes to hand hygiene and food handling to prevent these kinds of foodborne illness. If you are experiencing symptoms of E. coli infection like cramping and diarrhea (or gastrointestinal distress), especially if they are severe, make sure to let your health care provider know.” 

Symptoms vary for each person, but often include: 

  • Severe stomach cramps.
  • Diarrhea – often bloody.
  • Vomiting. 
  • Fever.

People experiencing symptoms of E. coli infection should consult a health care provider as soon as possible. Health care providers should contact their local health department to report suspect or confirmed cases.

Symptoms of E. coli infection usually appear three to four days after the exposure but may appear in as short as one day or as long as 10 days. Symptoms often improve within five to seven days. Some infections are very mild, but others can be severe or even life-threatening. Younger children and older adults may be more likely to experience severe illness. Approximately 5% to 10% of people diagnosed with this infection develop a complication known as hemolytic uremic syndrome that typically appears seven days after symptoms begin, often when diarrhea is improving. Symptoms of hemolytic uremic syndrome can include decreased frequency of urination, feeling very tired and losing color in cheeks and inside the lower eyelids. 

Prevention of E. coli is often directly connected to proper hand hygiene and food handling practices, such as:

  • Washing hands with warm water and soap for at least 20 seconds, or using an alcohol-based sanitizer with at least 60% alcohol:
    • Before and after handling food. 
    • After using the bathroom or changing a diaper.
    • After contact with animals or their environments, such as farms, petting zoos, fairs or even the backyard. 
  • Always marinating foods in the refrigerator, not on the counter or outdoors. Never reuse sauce on cooked food used to marinate raw meat or poultry. 
  • Never placing cooked food on a plate that previously held raw meat, poultry, seafood or eggs. Be sure to have on hand plenty of clean utensils and platters.
  • Never letting raw meat, poultry, eggs or cooked food sit at room temperature more than two hours before putting them in the refrigerator or freezer (one hour when the temperature is above 90 degrees Fahrenheit.
  • Cooking meats thoroughly. Ground beef and meat should be cooked to an internal temperature of at least 160 degrees Fahrenheit. Consumers should use a food thermometer as color is not an indicator of “doneness.” 
  • Rinsing fruits and vegetables well under running water. There is no need to use soap.
  • Avoiding raw milk, unpasteurized dairy products and unpasteurized juices (like fresh apple cider).
  • Avoiding swallowing water when swimming or playing in lakes, ponds, streams, swimming pools and backyard “kiddie” pools.

Ohio: According to Wood County Department of Health, sixteen people in Wood County, Bowling Green, Ohio area have come down with E. coli in the past week, prompting the health department to begin investigating. From 2016 to 2020 the county only saw twenty-seven cases altogether. Those who have fallen ill range from ages 13 to 60 years old and those who contract the virus can experience different levels of sickness and gastrointestinal symptoms. Out of the 16 people who have contracted the virus in Wood County, five are currently in the hospital.  One woman who I spoke to tonight was just released and indicated that the health department seems to be focusing on a local restaurant. The Wood County Health Department has sent lab samples to the Ohio Department of Health to learn whether the illnesses are connected. Results, and more information, are expected early next week.

Michigan: The Ottawa County Department of Public Health in Holland, Michigan is alerting the public to The Ottawa County Department of Public Health in Holland, Michigan is alerting the public to increasing cases of Shiga-toxin producing E. coli infections in the community. The Department is currently monitoring twelve cases of STEC, which is significantly higher than the typical number of cases reported at this time of the year. The Department is working with the Michigan Department of Agriculture and Rural Development (MDARD) and the Michigan Department of Health and Human Services (MDHHS) to investigate possible links between the cases. Five of the twelve cases (two children) have been hospitalized for their symptoms.

On June 7, 2021, the Pennsylvania Department of Health (PADOH) received multiple complaints of gastrointestinal illness from patrons of a community swimming pool. Two patrons reported positive Shiga toxin-producing Escherichia coli (STEC) and Clostridioides difficile from stool specimens. PADOH issued pool closure orders and initiated an outbreak response to identify a source and prevent additional illnesses.

Confirmed cases were defined as isolation of E. coli O157:H7 or detection of Shiga toxin or Shiga toxin genes from stool specimens of persons who visited the pool during May 31–June 7, 2021. Probable cases were defined as three or more loose stools in 24 hours with nausea, vomiting, fever, or cramps in persons who visited the pool during the same time frame. C. difficile results were deemed incidental upon consultation with experts (LC McDonald, MD, CDC, personal communication, June 2021) and were not included in the case definition.

Fifteen cases (nine confirmed, six probable) in persons aged 4–14 years were identified; 10 patients were male. All persons reported swimming at the pool on May 31, 2021, the seasonal opening date, and had no other common exposures. The total number of pool visitors on this date is unknown. Symptom onsets occurred during June 2–June 4, 2021. Thirteen patients sought medical evaluation, and six were hospitalized. Four received antibiotics for C. difficile. None developed hemolytic uremic syndrome.

Early findings suggested an unusual association between exposure to a chlorinated swimming pool and infections caused by two pathogens susceptible to chlorine. Pool inspection revealed an automatic chlorinator malfunction. Record-keeping was inconsistent with local requirements, and the few available records demonstrated at least one instance of no detectable chlorine. The pool reopened following chlorinator repair, after which no additional cases were identified.

The investigation highlighted three important points regarding evaluation of outbreaks of childhood diarrheal disease. First, C. difficile testing is only recommended for children aged ≥2 years with prolonged or worsening diarrhea and risk factors, including immunocompromising conditions or relevant exposures (e.g., recent health care visits or antibiotics). Reported prevalence of asymptomatic C. difficile colonization might vary by study population, laboratory detection method, and environmental setting. One study of children aged 1 month–12 years with diarrhea identified C. difficile toxin B in 3% of outpatients, 5% of inpatients, and 7% of asymptomatic controls). Recent studies using molecular techniques reported rates up to 25% in asymptomatic children aged 1–5 years and 24% in persons aged 1–18 years without diarrhea. In the current outbreak, all children were previously healthy and considered to be at low risk for C. difficile infection. Thus, C. difficile testing was not indicated and provided no relevant clinical or epidemiologic data. Second, laboratory reports should include age-based interpretive suggestions for colonization versus infection and reminders that clinical symptoms are required for a diagnosis of C. difficile infection. Provider interpretations should include clinical and epidemiologic information. Finally, antibiotics are usually not required for treatment of diarrheal illnesses. In this STEC outbreak, no adverse outcomes were reported among the children receiving antibiotics. However, among STEC-infected persons, current guidance recommends against antibiotic use because of the risk for hemolytic uremic syndrome.

Enteric disease outbreaks caused by multiple pathogens rarely occur. Coinfections with C. difficile and other pathogens are unusual, but possible. Full investigation revealed that this outbreak was likely the result of STEC infections among children, some of whom were colonized with C. difficile. Recreational waters should be properly treated and maintained, and persons experiencing diarrhea should abstain from swimming.

The Loudoun County Health Department is notifying the public of the exposure to a specific type of bacterium, called Shiga Toxin Producing E. coli (STEC), by several people who came in contact with goats at Georges Mill Farm in Lovettsville between March 6 and April 20, 2022. Several individuals experienced diarrhea and other symptoms of illness. The bacterium was isolated and identified by the Virginia Division of Consolidated Laboratory Services.

Coming into direct contact with animals, particularly livestock, presents a risk for illnesses. People should remember that, while animal interactions can be fun and educational, it’s always important to practice healthy habits around pets and other animals, such as washing your hands after being in contact with animals. The Loudoun County Health Department is communicating directly with those who are known to have come in contact with goats at Georges Mill Farm. Anyone who had contact with these goats during this time frame and has not yet communicated with the Health Department should:

Monitor for illness and seek medical attention if you become ill. Let your healthcare provider know of your possible exposure to assist in your diagnosis and treatment.

E. Coli Symptoms

Symptoms of E. coli illness usually start two to four days after exposure, but can occur as late as 12 hours later, or as long as 10 days after exposure. Symptoms of STEC may include:

  • Diarrhea with stomach cramps
  • Blood may also be present in the stool
  • Vomiting
  • Fever
  • Chills

In a very small percentage of cases (approximately 2% to 7%) particularly higher risk groups such as children under the age of 5, the immunocompromised, and the elderly, a more severe complication known as HUS (Hemolytic Uremic Syndrome) may occur. That complication includes kidney failure and anemia, and often results in prolonged hospitalization. However, the large majority of people exposed to STEC do not develop HUS and recover completely from their diarrhea within 5 to 10 days. More specific information on E. coli, including STEC, is available from the Centers for Disease Control and Prevention here.

Prevention

Health officials remind everyone that there are steps they can take to help prevent contracting illnesses from animals, which sometimes carry germs that can make people sick. Animals that look clean and healthy can carry harmful germs, and even areas where animals live, or roam can contain germs that can make people sick. Having contact with the animals’ environment can also be a risk factor for illness. Every year, many people get sick after visiting animal exhibits, such as petting zoos, aquariums, farms, or fairs. Preventive steps to take include:

  • Wash your hands right after touching animals or anything in the areas where they live, roam or eat. Even if you didn’t touch the animals or wore gloves, wash your hands when you leave animal areas.
  • Running water and soap are best, but if they are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol and wash your hands with soap and running water as soon as you can.
  • Don’t eat or drink around animals and keep food and drinks away from animal areas.
  • Children 5 years of age and younger, people with weakened immune systems and adults over 65 years of age are more likely to get sick from the germs animals can carry and should take extra precautions at animal exhibits.

Take these extra precautions for children:

  • Always supervise children around animals.
  • Leave items such as strollers, pacifiers, cups, or toys outside the exhibit.
  • Don’t let children put their thumbs, fingers, or objects such as pacifiers in their mouths when they’re around animals or in an animal area.
  • Don’t let children sit or play on the ground in animal areas.
  • Teach children to approach animals with caution and follow the rules provided on signs or verbally by the staff.
  • Children 5 years of age and younger should not have contact with reptiles, amphibians, or live poultry because these animals are more likely to make them sick. Parents of children in this age group should also consider not letting the children have direct contact with other types of livestock.

See also www.fair-safety.com

The Alabama Department of Public Health (ADPH) is investigating four cases of E. coli O157:H7 and two cases of Rotavirus in younger children in Northeastern Alabama. ADPH regularly investigates clusters and outbreaks of communicable diseases as required by Notifiable Disease Rules in Alabama.

In 2021, ADPH investigated 113 cases of E. coli, shiga toxin-producing illness (includes O157:H7). People of any age can become infected with this germ, but very young children and the elderly are more likely to develop severe illness and kidney problems than others.

The symptoms of E. coli O157 and similar E. coli infections can vary. Symptoms frequently include severe stomach cramps, diarrhea (often bloody) and vomiting. Fever up to 101 degrees F may occur, but is not the most common symptom. While most people improve in 5-7 days of illness, it is important that persons who have symptoms talk to their healthcare provider, especially if the persons are having bloody diarrhea or are very young or elderly.

To reduce the risk of E. coli O157:H7 and other gastrointestinal illnesses, the Centers for Disease Control and Prevention (CDC) recommends:

  • WASH YOUR HANDS thoroughly after using the bathroom or changing diapers, and before preparing or eating food.
  • WASH YOUR HANDS after contact with animals or their environments (at farms, petting zoos, fairs, even your own back yard).
  • COOK meats thoroughly. Ground beef and meat that has been needle-tenderized should be cooked to a temperature of at least 160 degrees F/70 degrees C. It is best to use a thermometer as color is not a very reliable indicator of “doneness.”
  • AVOID raw milk, unpasteurized dairy products and unpasteurized juices (like fresh apple cider).
  • AVOID swallowing water when swimming or playing in lakes, ponds, streams, swimming pools and backyard “kiddie” pools.
  • PREVENT cross contamination in food preparation areas by thoroughly washing hands, counters, cutting boards and utensils after they touch raw meat.

French health officials have confirmed 50 cases of E. coli linked to a type of Nestlé frozen pizza.

Of these infections, 48 were caused by E. coli O26 and two by E. coli O103, according to Santé publique France, the French public health agency.

Another 25 cases of hemolytic uremic syndrome (HUS) and Shiga toxin-producing E. coli (STEC) infections are still being investigated. HUS is a type of kidney failure associated with E. coli infections that can result in lifelong, serious health problems and death.

Buitoni brand Fraîch’Up pizzas sold since June 2021 were withdrawn and recalled in mid-March after Nestlé was warned about the potential presence of E. coli O26 in dough used to make them.

Of the 50 patients, 48 are children and two are adults. They fell ill between Jan. 18 and March 14. The two adults are older than 90, with one having developed HUS.

Sick children are between 1 and 17 years old with a median age of 7. Twenty are females and 28 are males. Two youngsters died but it is not known if they ate the pizzas and their deaths are under investigation.

Eleven patients live in Hauts-de-France, eight in Nouvelle Aquitaine, seven in Pays de la Loire, six in Bretagne and Ile-de-France, three in Auvergne-Rhône-Alpes, two each in Bourgogne Franche-Comté, Grand Est, Occitanie and Provence-Alpes-Côte d’Azur and one in Centre Val-de-Loire.

Viiworks Blog tells the story:

Little Marceau, 4 and a half years old, came close to death. The child, poisoned by the E.coli bacterium after having eaten a contaminated pizza, was finally able to be treated by doctors at the Lille hospital. Extremely shocked, her mother testifies to La Dépêche of the days of anguish that the family has spent.

Marceau returned to school just ten days ago with strict recommendations: not to eat salty foods. And, if he hurts himself, do not take anti-inflammatories. “He will never be able to get stung in the arm again either, breathes his mother, still tested by the seven weeks she has just spent. We must keep his veins intact for a transfusion in case he has another kidney problem. .” All that for having eaten a piece of Fraîch’up pizza without knowing that it was contaminated with E. coli bacteria, the weekend of February 12…

Coralie is determined to file a complaint against Buitoni so that all responsibilities are established concerning the ordeal experienced by her family. “And again, it could have been worse,” sighs this 8 and a half month pregnant mother, who remembers her reaction when her partner told her that the doctors did not know if Marceau was going to live or die. “When I arrived at Lille hospital, he greeted me, telling me that the next 72 hours were going to be decisive. That the bacteria was attacking the heart, the kidneys and the brain. I was devastated.”

According to French health authorities, as part of the investigations carried out on the cases of serious haemolytic and uraemic syndromes (HUS) reported since January 1, 2022, the analyzes (epidemiological, microbiological and traceability) carried out suggest, at this stage, a possible link with the consumption of frozen pizzas from the Fraîch’Up range of the Buitoni brand. Investigations are continuing to determine the origin of the contamination, including for other products, as well as epidemiological investigations in order to establish potential links with all the cases detected in the territory since the beginning of January 2022.

Consequently, as a precautionary measure, and pending additional analyses, the company is proceeding today with the withdrawal-recall of all the pizzas in the Fraîch’Up range, of the Buitoni brand, marketed on this day.

As of March 17, 2022, 27 cases of HUS or serious infection, linked to E. coli bacteria with similar characteristics, have been identified, and 31 additional cases are under investigation. These 58 cases occurred in 12 regions of metropolitan France: Hauts-de-France (13 cases), New Aquitaine (9 cases), Pays de la Loire (9 cases), Brittany (6 cases), Ile-de-France ( 6 cases), Grand Est (5 cases), Auvergne-Rhône-Alpes (3 cases), Bourgogne Franche-Comté (2 cases), Center Val-de-Loire (2 cases) Normandy (1 case), Occitanie (1 case ) and Provence-Alpes-Côte d’Azur (1 case). The sick children, aged 1 to 18 years with a median age of 5 ½ years, presented symptoms between 10/01/2022 and 10/03/2022. Two children died.

Public Health France, in conjunction with the National Reference Centers for E. coli, the General Directorate for Food, the General Directorate for Competition, Consumption and the Repression of Fraud, and in coordination with the General Directorate for Health, is continuing to investigate all cases of pediatric HUS reported since January 1, 2022.