E. coli Lawyer

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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.

Eighteen people infected with the outbreak strain of Shiga toxin-producing E. coli O26 were reported from four states.

Illnesses started on dates ranging from July 5, 2018 to July 25, 2018.

Six people were hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. One person in Florida died.

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

On September 19, 2018, Cargill Meat Solutions recalled ground beef products that were produced and packaged on June 21, 2018 and shipped to retailers[PDF – 240 KB] nationwide. Visit the USDA-FSIS website for a list of recalled products[PDF – 40.2 KB]

As of September 19, 2018, 18 people infected with the outbreak strain of E. coli O26 were reported from 4 states – Colorado (10), Florida (15), Massachusetts (1) and Tennessee (1). 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.

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, including Publix Super Markets, Inc.

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.

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.

Cargill Meat Solutions, a Fort Morgan, Colo. establishment, is recalling approximately 132,606 pounds of ground beef products made from the chuck portion of the carcass that may be contaminated with Escherichia coli O26, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The ground beef items were produced and packaged on June 21, 2018. The following products are subject to recall: (Products List) [View Labels (PDF only)]

The products subject to recall bear establishment number “EST. 86R” inside the USDA mark of inspection. These items were shipped to retail locations nationwide.

On Aug. 16, 2018, FSIS was notified of an investigation of E. coli O26 illnesses. FSIS, the Centers for Disease Control and Prevention, and state public health and agriculture partners determined that raw ground beef was the probable source of the reported illnesses. The epidemiological investigation identified 17 illnesses and one death with illness onset dates ranging from July 5 to July 25, 2018.

The Cargill Meat Solutions’ ground beef products were identified following further investigation related to Recall 072-2018, conducted on Aug. 30, 2018, where ground beef products were recalled in connection with the E. coli O26 outbreak. FSIS’ traceback information indicated that case-patients consumed ground beef products purchased at various retail stores that were supplied by Cargill Meat Solutions.

Cargill Meat Solutions, a Fort Morgan, Colo. establishment, is recalling approximately 25,288 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 ground beef items were produced on Aug. 16, 2018. The following products are subject to recall:

  • 10-lb. chubs of “EXCEL 93/7 FINE GRIND GROUND BEEF” with “Use/Frz. By Sep 05” on the chub label and a “PACK DATE 08/16/2018” on the box label.

The products subject to recall bear establishment number “EST. 86R” inside the USDA mark of inspection. These items were shipped to warehouses in California and Colorado.

The problem was discovered on Aug. 22 by the establishment when they reviewed their records and determined that the product may be associated with product that was presumptive positive for E. coli O157:H7. The company then notified FSIS. 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. 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 frozen and in consumers’ refrigerators or freezers. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase.

The Knox County Health Department (KCHD) is concluding its investigation into a cluster of Escherichia coli (E. coli) O157 infections. Fifteen confirmed cases of E. coli O157 were reported to KCHD recently. All cases were among children, nine were hospitalized and seven developed a complication of the infection called Hemolytic Uremic Syndrome (HUS). Of the children who were hospitalized, one remains in fair condition at East Tennessee Children’s Hospital. Lab results from the Tennessee Department of Health have confirmed two different strains of E. coli O157 caused the children to become ill.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan. “The investigation revealed no definitive connections between the two sources or the two groups of ill children. And this is now supported by the state’s lab results confirming it was two different strains of E. coli O157.”

Ten of the 15 children consumed raw milk from French Broad Farm, Knox County, Tenn., the only common link among all ten children. The lab results have confirmed these children had the same strain of E. coli O157. The lab also confirmed that this strain is a DNA fingerprint match to the E. coli O157 found in cow manure samples collected from French Broad Farm.

To date, the lab did not find E. coli O157 in the raw milk samples. This is not uncommon, and it does not mean the milk consumed was free of contamination. E. coli bacterium do not distribute themselves uniformly in milk, meaning a portion of even the same glass of milk can be contaminated while another portion is not. This is one reason why raw milk is inherently risky. Due to the nature of E. coli and other pathogens that can be present, and even with the strictest safety precautions in place at a dairy, including testing the milk, there is no way to guarantee raw milk is safe for consumption. This is why health officials recommend the public consume only pasteurized milk and dairy products. Based on the dates when the children became ill (i.e., onset of symptoms) and allowing time for the milk to be distributed and time for incubation of the illness, officials believe the contamination event occurred in mid-May.

The only common link among the other five ill children was attending the same child care facility, Kids Place, Inc., Mascot, Tenn., where goats, a type of ruminant animal, are present. The lab results confirmed these five children had the same strain of E. coli O157. Additionally, the lab results showed this strain was a DNA fingerprint match to the E. coli O157 found in the goat fecal samples and one hay sample collected from the child care facility. To date, the lab did not find E. coli O157 in the other environmental samples from inside the facility. Again, this is not uncommon, and one reason testing environmental samples is only part of the disease investigation process.

E. coli O157 is naturally found in the intestinal tracts of many farm animals (ruminants), including healthy cattle, sheep and goats. Animals can carry E. coli O157 and shed it in their stool while still appearing healthy and clean. E. coli can contaminate the animals’ skin, fur, and the areas where they live and roam.

Both Kids Place, Inc. and French Broad Farm have fully cooperated throughout KCHD’s investigation, including sharing contact information of those who may be at risk, supporting sample collection and ceasing operations as requested. KCHD lifted the directive for Kids Place, Inc. on June 8, 2018, by following existing state and national procedures for infection control and mitigation at a permitted, regulated facility. KCHD lifted the health directive requesting French Broad Farm temporarily cease operations on June 14, 2018. While the investigation thus far has revealed no specific problems with French Broad Farm, the risk in consuming raw milk cannot be mitigated. The E. coli outbreak appears to be over as KCHD is not seeing ongoing transmission.

Following national epidemiological standards and methodology, the health department’s investigation included standardized and in-depth interviews; examination of all potential sources; analysis of symptom onset and incubation to aid in determining the timeline, potential exposures and the type of outbreak; and testing samples.

Most people become infected with E. coli O157 from contaminated food, such as undercooked ground beef, but E. coli O157 can also be passed directly to people from the stool of ruminant animals. Historically, the major source for human illness is cattle, which can carry E. coli O157 but show no signs of illness. E. coli O157 can also be spread from person to person via a fecal-to-oral route as these bacteria are invisible to the human eye.

While it is possible to get sick from many other foods, raw milk is one of the riskiest. As stated in the American Academy of Pediatrics policy statement on unpasteurized dairy, only an estimated 1 to 3 percent of dairy products consumed in the U.S. are unpasteurized. Yet between 1973 and 2009, these products accounted for 82 percent of the milk- or milk product-associated foodborne outbreaks reported to the Centers for Disease Control and Prevention. Health officials recommend the public consume only pasteurized milk, dairy products, juices and ciders.

Symptoms of E. coli infection vary for each person, but often include severe stomach cramps, diarrhea (often bloody) and vomiting. Some may have a low fever (less than 101˚F). Some infections are mild, but others can be severe. E. coli O157 can cause disease by making a Shiga toxin; these are referred to as Shiga toxin-producing E. coli or STEC. This can cause severe diarrhea and even life-threatening complications, especially in children, older adults, pregnant women and those with compromised immune systems. Approximately 5 to 10 percent of those diagnosed with a STEC infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS).