Monday, June 11, 2012

CDC: Investigating Multi-State Outbreak Of Shiga-Toxin Producing E. coli

 

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E. coli – Photo Credit CDC

 

# 6380

 

Last year at this time you may recall that much of Europe’s public health system was embroiled in containing a massive outbreak of STEC (Shiga-toxin Producing Escherichia coli) that over a couple of months sickened more than 4,000 people and contributed to the deaths of more than 45 individuals (see Shiga toxin-producing E. coli (STEC): Update on outbreak in the EU (27 July 2011, 11:00)).

 

After more than a month of investigation the European Food Safety Authority (EFSA) zeroed in on a specific lot of imported fenugreek seeds (used for sprouting) imported from Egypt as the source of infection, although some person-to-person transmission was also suspected.

 

STEC (sometimes referred to as verocytotoxic E. coli (VTEC) or enterohemorrhagic E. coli (EHEC)) infections can produce serious illness, particularly among the very young and the elderly.

 

A particularly serious, but fairly rare complication is called HUS (hemolytic uremic syndrome) which is a type of kidney failure.  Not everyone who consumes Shiga-toxin producing strains of E. coli will develop symptoms, however, and far fewer still will go on to experience HUS.

 

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E. Coli is believed responsible for more than 250,000 illnesses each year in the United States.  The CDC explains about STEC on their E. coli page.

 

 

What are Shiga toxin-producing E. coli?

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 for short. You might hear them called verocytotoxic E. coli (VTEC) or enterohemorrhagic E. coli (EHEC); these all refer generally to the same group of bacteria. The most commonly identified STEC in North America is E. coli O157:H7 (often shortened to E. coli O157 or even just “O157”). When you hear news reports about outbreaks of “E. coli” infections, they are usually talking about E. coli O157.

 

In addition to E. coli O157, many other kinds (called serogroups) of STEC cause disease. These other kinds are sometimes called “non-O157 STEC.” E. coli serogroups O26, O111, and O103 are the non-O157 serogroups that most often cause illness in people in the United States.

 

Some recent outbreaks that have been investigated by the CDC over the past 18 months include:

 

2012

2011

 


The CDC is currently investigating a multi-state outbreak of STEC which has sickened 14 people across 6 states.  A common source for the infections has not yet been identified.

 

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Multistate Outbreak of Shiga Toxin-producing Escherichia coli O145 Infections

Posted June 10, 2012 01:00 AM ET

Highlights
  • Read the Advice to Consumers »
  • A total of 14 persons infected with the outbreak strain of STEC O145 infection have been identified in 6 states.
    • The number of ill persons identified in each state is as follows: Alabama (2), California (1), Florida (1), Georgia (5), Louisiana (4), and Tennessee (1).
    • Three ill persons have been hospitalized; one death has been reported in Louisiana.
  • Based on interviews conducted to date, a source for these infections has not been identified. If a specific source is identified, public health officials will advise the public and take steps to prevent additional illnesses.
  • Dates for patients' onset of illness range from April 15 to May 12, 2012. It has been approximately 4 weeks since the last illness onset among reported cases. Although this indicates that this outbreak could be over, CDC continues to work with state public health officials to identify additional cases and the source of these STEC O145 infections.

 

 

Despite our modern technology, foodborne illnesses pose a heavy burden to Americans, with the CDC estimating that 1 in 6 of us (48 million) fall victim to food poisoning each year, and that 128,000 are hospitalized, and as many as 3,000 die.

 

While we await news of the source of this outbreak, the CDC’s advice to consumers is valid and should be heeded 365 days a year, regardless of whether an outbreak of E. coli is being investigated or not:

 

Multistate Outbreak of Shiga Toxin-producing Escherichia coli O145 Infections

Advice to Consumers

  • No source has been identified for this outbreak, and therefore we do not have specific consumer advice at this time.  Recommendations for protecting against STEC infections are provided below.  If a specific source is identified for this outbreak, public health officials will advise the public and take steps to prevent additional illnesses.
  • Practice proper hygiene, especially good hand washing
    • 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 backyard).
    • Always wash your hands before preparing and feeding bottles or foods to  your infant, before touching your infant's mouth, and before touching pacifiers or other things that go into your infant's mouth.
    • If soap and water aren't available, use an alcohol-based hand sanitizer. These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and water.
  • It is also important to keep all objects that enter infants' mouths (such as pacifiers and teethers) clean.
  • Know your risk for food poisoning.  People at higher-risk for foodborne illness are pregnant women and newborns, children, older adults and those with weak immune systems.
  • Cook meats thoroughly. Ground beef and meat that has been needle-tenderized should be cooked to a temperature of at least 160°F/70˚C. It’s best to use a thermometer, as color is not a very reliable indicator of how thoroughly meat has been cooked.
  • Avoid consuming 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. 
  • Please see the FoodSafety.govExternal Web Site Icon E.coli web site for information on what you can to  prevent from getting infected with STEC.
  • Persons who think they might be ill with STEC should consult their healthcare providers.

The good news is that no new cases have been reported to local health departments since the middle of May, suggesting that this outbreak may all ready be winding down.