E. Coli O157

  • Posted: January 21st, 2012 - 4:10am by Doug Powell

     On-going outbreaks and recalls in Washington State, the same E. coli O157:H7 scattered throughout a California dairy that sickened five children, and now a man who drank raw milk produced at a Western Massachusetts dairy farm is suspected of being infected with brucellosis, raising concerns about the emergence of a germ that has not been seen in New England livestock in at least two decades.

    Brucellosis is an infectious disease passed primarily between animals, but it can be acquired by humans through the consumption of raw milk.

    Officials from the state Department of Public Health said they are investigating Twin Rivers Farm in Ashley Falls as the possible source of the infection, because the infected man purchased raw milk there. The dairy sells raw milk only at the facility, not in retail stores, and officials urged anyone who bought raw milk there to discard it.

    The owners of Twin Rivers Farm could not be reached for comment.

    Dr. Alfred DeMaria, the state’s top disease tracker, said the man has believed to have consumed the milk in late December. But because the illness often starts with flu-like symptoms, it was difficult to pinpoint at first, adding, “It’s an astute physician that worked it out.”

    A table of raw-milk related outbreaks is available at http://bites.ksu.edu/rawmilk.

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  • Posted: January 13th, 2012 - 8:01pm by Doug Powell

    The Western Upper Peninsula Health Department in Michigan is, according to the Minning Gazette, investigating a cluster of E. coli O157 cases that originated at a Houghton restaurant.

    Dr. Terry Frankovich, WUPHD medical director, told the Mining Gazette the incidence of E. coli O157:H7 occurred at the Ambassador Restaurant on Shelden Avenue during Christmas. Seven people became ill and four were hospitalized with no deaths occurring. The seven people who became ill were not sitting together. Two of the people were from Dickinson County and Wisconsin, with the rest from the Copper Country.

    Frankovich said the O157:H7 strain when found in laboratory testing is reportable to the health department.

    Frankovich said after getting the information about the E. coli illnesses, health department environmental health staff went to the Ambassador Restaurant to talk to the managers and to determine whether the source was food or an employee.

    "What we identified as a source was an ill food handler," Frankovich said.
    The restaurant is open for business, and there is no anticipated risk for further exposure, she said.

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  • Posted: January 12th, 2012 - 9:47pm by Doug Powell

    In Nov. 2011, raw milk produced by Cozy Vale Creamery in Tenino, Washington, sickened at least three children and environmental swabs found E. coli O157 at the dairy.

    Today, the owner and armchair epidemiologist says the publicity and lawsuit for making people barf is ruining his business and it’s "hanging on by it's fingernails."

    Duh.

    In a statement posted on the Cozy Valley (or Vale, they seem to be used interchangeably) Dairy website, the owner says the lawsuit, bad press and community gossip have "nearly ruined" the business.

    "Cows still giving lots of good milk...do I use it as fertilizer and hope that business will pick up, or should I send the girls to the slaughter house," the statement reads.

    “I'd like to let you know that recent publicity and gossip foisted upon Cozy Vale has nearly ruined us. Cozy Vale is hanging on by it's fingernails. If you'd like to see us continue our small farming enterprise, please let us know. Most of you know how important local products are to our local economy. I mean it's tough enough already being a Raw Milk Dairy Producer and add to it a lawsuit, bad press, and community gossip. My God!

    “I've learned that no good comes from talking to the press. I've learned that no good comes from not talking to the press. I've learned that if someone sues you, you become guilty instantly...and you know what? They know that. I've learned that facts can be presented in a way that can be damaging or helpful and the choice is always for damaging, its just more delicious that way! I've learned that gossip in a small community always divides it and destroys....um...I really thought better of my small community.

    “There never was any ecoli found in our milk product. They did not find any ecoli in any of the milk samples taken. And the WSDA sampled over 36 seperate containers of milk (that I counted anyway). They tested the milk that the sick person drank from, no ecoli found. When my facility was swabbed down, they did not find ecoli anywhere that the milk would be. They tried really hard to find it too...even went so far as to stick a swab up the ass of my cows! (Well not really, but thats what it felt like). They did stick the swabs in old poop, steaming hot fresh poop, cows tails and udders. I was horrified!

    In 3 sample swabs, one in the milking room floor, the sponge mop head, and processing room floor ecoli was found. It looks as if the mop had spread it around. I am told that the strain of ecoli found on my dairy room floor was a common type...I do not understand all of that, and am still looking into that.

    Luckily, floor cleaning was an easy fix...it was fixed the very next day with a simple bleach solution.”

    Would you buy raw milk or any food from this local producer?

     

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  • Posted: December 28th, 2011 - 2:04pm by Doug Powell

    Joan Hunt, 64, of Brixton, spent three weeks in hospital and needed treatment in intensive care after being infected with E. coli O157 in a UK outbreak linked to crab meat – or its preparation.

    She has been left with only 35 per cent kidney function after developing the potentially deadly complication HUS.

    Hunt recently told her story to the Plymouth Herald to raise awareness of symptoms and thank the hospital team who saved her life.

    She is recovering after becoming dangerously ill in August – the month of a reported Plymouth E. coli outbreak believed to be linked to crab meat.

    Joan does not know the source of her poisoning as she had not eaten crab. None of her family became sick.

    "I felt I was going to die. I wasn't in control of my body, my body was controlling me. It was frightening.”

    As reported in The Herald earlier this month, there is an ongoing investigation into an E. coli outbreak in Plymouth with a possible link to an unapproved crab supplier.

    Investigators took action after nine cases emerged in August. There have been no further reports of illness linked to crab since.

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  • Posted: December 15th, 2011 - 2:53am by Doug Powell

    The Japanese health ministry said Thursday it has detected E. coli O157 inside beef liver for the first time, raising the likelihood that raw liver -- considered a delicacy in Japan -- may soon be banned from the dining table.

    The findings, to be discussed by a ministry council next Tuesday, come as the Ministry of Health, Labor and Welfare has been considering whether to prohibit butchers and restaurants from selling raw beef liver, in the wake of food poisoning deaths from raw beef served at barbeque restaurants earlier this year.

    The ministry found live E. coli bacteria of the strain in the livers of two of the about 150 cattle it has examined at meat inspection centers nationwide since summer.

    The ministry said the outcome of genetic testing has also shown that the bacteria existed inside beef livers of more than one cow examined.

    So far, the bacteria have been found only on the surface of beef livers and the ministry had been warning consumers to be careful when eating raw livers.

    Restaurants have already been asked by the government to refrain from serving raw beef liver since July while the ministry considered the safety of consuming raw beef and raw liver.

    Of the 116 cases of food poisoning from eating raw beef liver confirmed between 1998 and 2010, 20 were caused by enterohemorrhagic E. coli bacteria, according to the ministry.

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  • Posted: December 12th, 2011 - 5:21am by Doug Powell

    krusty.krab_.spongebob.jpg

    In yet another example of prompt public alerts by UK health types, nine people were sickened with E. coli O157 in Plymouth in August and it’s now being made public (see E. coli O157 linked to leeks sickens 250 and kills 1 in UK; 8-month outbreak only now being made public).

    A 3-month delay is, sortof, an improvement on an 8-month delay in public notification.

    The Plymouth Herald reports this morning that environmental health officers and the Health Protection Agency (HPA) launched an inquiry after nine cases were confirmed in the city – in August.

    It is believed to be the first reported outbreak of the E.coli O157 strain associated with the consumption of crab meat.

    The investigation is continuing but there is a suspected link with an unapproved crab supplier.

    Investigators revealed they took action after nine cases emerged in August. There have been no further reports of illness linked to crab since.

    The South West HPA and Plymouth City Council said in a joint statement: "A wider investigation is still ongoing following on from the outbreak, so we are not in a position to give full details but we suspect a link to an unapproved crab supplier.

    "Environmental health officers from the council acted swiftly to identify crab meat as a possible source and removed all potentially affected crab meat from food establishments as a precautionary measure.

    "The team worked closely with the SW (North) Health Protection Unit to investigate the cases and ensure that GPs in Plymouth and beyond were aware of the issue, if anyone presented with symptoms."

    The team also alerted food outlets in the city about the importance of only buying food or ingredients from approved or registered suppliers.

    A study into the outbreak showed a 'statistically significant' association between cases and the consumption of crab meat away from home.

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  • Posted: November 29th, 2011 - 4:06am by Doug Powell

    Elizabeth Weise in USA Today doesn’t really answer the who-should-pay question, but does ask, what if it were possible to almost entirely do away with E. coli in ground beef and it would cost only about a penny a burger?

    Food-safety experts say it's entirely feasible with new technologies that have become available. One is a vaccine, the other a feed additive, which, given early enough, could bring down potential E. coli contamination to negligible levels.

    The problem, experts in beef safety say, is that the economics are backward. The new interventions have to be administered long before the cattle are slaughtered, when the calves are young or in feedlots where they're growing.

    It's hard to figure out who should pay for steps that would take place months and possibly years before the grill starts sizzling. The people who'd have to pay for them aren't the ones who would reap the direct benefits.’’’

    These interventions aren't perfect, but they're very good, says Guy Loneragan, a professor of food safety at Texas Tech University in Lubbock. "The question is no longer, 'Can we get the technologies?' We've got them, or they're soon to arrive. The question is 'How do we implement?' "

    So far only two small companies appear to be embracing them. One is a tiny feed lot cooperative in Kansas that's looking to vaccinate all its cattle "soon." The other is a Meade, Kan., cooperative that's staking its economic life on calling for retailers nationally to demand these interventions from the packers that supply their meat.

    The regulatory landscape "is confusing," says Elisabeth Hagen, USDA's undersecretary for food safety. "But we're realizing that there's an issue here and somehow we have to bring everybody together and focus on the end product, the result of which is the safety of the food that goes to the American consumer."

    Loneragan says they've gone as far as they can after the animal is slaughtered. Now the focus needs to be on ridding the animals of E. coli O157:H7 before they get to the slaughterhouse. The new methods to do that involve:

    •A vaccine. The biggest and potentially most game-changing treatment is a vaccine introduced by Pfizer Animal Health in 2010 and given in a three-shot series starting when the calf is just 6 months old. This gets rid of the E. coli O157:H7 bacteria in 85% of the cattle, says Brad Morgan, a senior food-safety specialist at Pfizer Animal Health in Stillwater, Okla. Not only that, but even among the ones that still have the bacteria in the gut, the injections reduce the amount the animals shed in their manure by 98%, he says.

    It's not all or nothing. Pfizer has done studies showing that if only 50% or even 25% of cattle are vaccinated, rates of E. coli are strongly reduced in the feed yard, and therefore in the packing plant. And Harvard's Hammitt says his research shows that Americans understand that food can't be "perfectly safe," but they want safer.

    The vaccine costs $4 to $6 per animal for the full series, says Loneragan. There are several other vaccines in the regulatory pipeline here and overseas.

    •The probiotic. The other intervention is a probiotic added to feed. These are beneficial bacteria cultures that out-compete the more dangerous forms of E. coli in the cattles' guts, much as yogurt is said to seed the gut with good bacteria to keep out the bad. Many studies have found that using "the right strain at the right dose you can get a fairly predictable 40% to 50% reduction in E. coli O157:H7," says Loneragan.

    The American Meat Institute Foundation, the research arm of the meat industry trade group, says there just isn't enough data yet to know if these treatments work. While there's been a tremendous amount of research and it looks promising, "We're right at the cusp of understanding the technology," says Betsy Booren, the institute's director of scientific affairs.

    Last year Cargill, one of the nation's largest beef producers, conducted a trial of the E. coli vaccine on 85,000 head of cattle at its Fort Morgan, Colo., beef-processing facility, says spokesman Mike Martin at Cargill's Wichita headquarters.

    The trial's results were "inconclusive," Martin says, in part because the levels of O157:H7 they found on the cattle in general "were the lowest in years . …" There was "very little difference" in rates between the vaccinated and the unvaccinated cattle, he says.

    Loneragan says in the studies he's done, E. coli O157:H7 levels were indeed low but dropped lower in meat from vaccinated cattle.

    In the end, it's going to take movement by the biggest companies to move the industry. There are two that could make this happen in a second, McDonald's and Wal-Mart, says Chuck Jolley, a meat industry marketing company executive.

    "If either decides to require it, the industry will turn around on a dime," he says.

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  • Posted: November 27th, 2011 - 12:18am by Doug Powell

     Woe is the California lettuce and spinach grower.

    "It was just more regulations. More inspections. More paperwork. More filings. More fees," said Chris Bunn, part of a four-generation Salinas Valley farming family. Now in his 60s, he quit two years after the 2006 outbreak. "I miss it terribly," Bunn said. "It was a wonderful business."

    Deborah Schoch, a senior writer at the California HealthCare Foundation Center for Health Reporting, writes in the Mercury News today that five years after their healthy-looking green fields became the epicenter of a national food disaster, farmers in the Salinas Valley are still working to regain something even the most bountiful harvest can't ensure: the public's trust.

    They are doing their best to rebound after investigators linked spinach grown and bagged here to a deadly E. coli strain that would kill three people, sicken 206 more and shake the nation's faith in California leafy greens. So far, they have succeeded in avoiding another major outbreak.

    Last year, Monterey County produced spinach worth $127.5 million, down from $188.2 million in 2005, according to reports from the county agricultural commissioner's office.

    Salinas Valley growers and processors have retooled nearly every step in their industry -- from planting seedlings to harvesting and washing greens. They have rallied to create a state-industry pact on how to protect 14 types of leafy greens that is being held up as a national model.

    "It was the watershed moment for the produce industry," said Joe Pezzini, chief operating officer of Ocean Mist Farms in Castroville.

    Too bad it didn’t happen 10 years earlier.

    In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider -- and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been insufficiently washed after falling to the ground and coming into contact with deer feces.

    Almost 10 years later, on Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others (United States Food and Drug Administration, 2006). The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause.

    In the decade between these two watershed outbreaks, almost 500 outbreaks of foodborne illness involving fresh produce were documented, publicized and led to some changes within the industry, yet what author Malcolm Gladwell would call a tipping point -- "a point at which a slow gradual change becomes irreversible and then proceeds with gathering pace"(http://en.wikipedia.org/wiki/Tipping_Point) -- in public awareness about produce-associated risks did not happen until the spinach E. coli O157:H7 outbreak in the fall of 2006. At what point did sufficient evidence exist to compel the fresh produce industry to embrace the kind of change the sector has heralded since 2007? And at what point will future evidence be deemed sufficient to initiate change within an industry?

    In 1996, following extensive public and political discussions about microbial food safety in meat, the focus shifted to fresh fruits and vegetables, following an outbreak of Cyclospora cayetanesis ultimately linked to Guatemalan raspberries that sickened 1,465 in 21 U.S. states and two Canadian provinces (U.S. Centers for Disease Control and Prevention, 1997), and subsequently Odwalla. That same year, Beuchat (1996) published a review on pathogenic microorganisms in fresh fruits and vegetables and identified numerous pathways of contamination.

    By 1997, researchers at CDC were stating that pathogens could contaminate at any point along the fresh produce food chain -- at the farm, processing plant, transportation vehicle, retail store or foodservice operation and the home -- and that by understanding where potential problems existed, it was possible to develop strategies to reduce risks of contamination. Researchers also reported that the use of pathogen-free water for washing would minimize risk of contamination.

    Yet it would take a decade and some 29 leafy green-related outbreaks before spinach in 2006 became a tipping point.

    What was absent in this decade of outbreaks, letters from regulators, plans from industry associations and media accounts, was verification that farmers and others in the farm-to-fork food safety system were seriously internalizing the messages about risk, the numbers of sick people, and translating such information into front-line food safety behavioral change.

    Today, according to  Schochmajor food and retail chains, from McDonald's to Walmart, want proof that their lettuce is as clean as any natural product can be.

    That means no cattle grazing uphill from a spinach farm, no roaming wild pigs, no farm crews without hairnets or gloves, no missing reports.

    Some food chains even send inspectors unannounced.

    "They'll be the Toyota Camry with the Hertz sticker on the edge of the field, looking with binoculars," said Mike Dobler, 50, a third-generation grower who works with his family on a large-scale vegetable farm based in Watsonville.

    "They're looking to see if you're doing what you say you're doing," Dobler said.

    Before September 2006, he said, "we were taken at our word, and nobody asked."

    Actually, lots of people asked, including FDA, state public health types, journalists, lawyers and academics. Growers apparently just didn’t pay attention.

    A table of leafy green related outbreaks is available at http://bites.ksu.edu/leafy-greens-related-outbreaks (they didn’t all originate with California produce, but lots did).

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  • Posted: November 15th, 2011 - 8:02pm by Doug Powell

    Raw milk products produced by Organic Pastures of Fresno County are the subject of a statewide recall and quarantine order announced by California State Veterinarian Dr. Annette Whiteford.

    Under the recall, all Organic Pastures raw dairy products with the exception of cheese aged a minimum of 60 days are to be pulled immediately from retail shelves and consumers are strongly urged to dispose of any products remaining in their refrigerators. Until further notice, Organic Pastures may not produce raw milk products for the retail market. The order also affects Organic Pastures raw butter, raw cream, raw colostrum, and a raw product labeled “Qephor.”

    The quarantine order came following a notification from the California Department of Public Health of a cluster of five children who were infected, from August through October, with the same strain of E. coli O157:H7. These children are residents of Contra Costa, Kings, Sacramento, and San Diego counties. Interviews with the families indicate that the only common reported food exposure is unpasteurized (raw) milk from Organic Pastures dairy. Three of the five children were hospitalized with hemolytic uremic syndrome, a serious condition that may lead to kidney failure.

    Surveys indicate that only about three percent of the public report drinking raw milk in any given week so finding 100% of these children drank raw milk and the absence of other common foods or animal exposures indicates the Organic Pastures raw milk is the likely source of their infection.

    While laboratory samples of Organic Pastures raw milk have not detected E. coli 0157:H7 contamination, epidemiologic data collected by the California Department of Public Health link the illnesses with Organic Pastures raw milk.

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  • Posted: November 10th, 2011 - 11:12am by Doug Powell

    NBC17 reports state health officials have determined that the source of the E. coli O157:H7 outbreak came from the Kelley Building at the North Carolina State Fair.

    The Kelley Building is one of the permanent buildings where sheep, goats, and pigs were housed and competed in livestock show.

    NBC-17 was the first to report a direct link to goats at the State Fair and the E. coli outbreak. A family of six in Sampson County who was diagnosed with E. coli reported they visited the goats while attending the State Fair.

    The N.C. Division of Public Health says 27 individuals were identified as having contracted E. coli after attending the State Fair in October.

    State Epidemiologist Megan Davies said the illness is likely related to animal contact, however the study did not implicate any specific animal or breed. Health officials say no other exhibits, foods or activities were linked to the E. coli infections.

    In 2004, 108 cases of E. coli were reported, all linked to the petting zoo at the State Fair. After the 2004 outbreak, Fair officials installed handwashing stations with sinks, soap and water around the petting zoo and near animal exhibits.

    A table of petting zoo related outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

     

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