The ecology of Escherichia coli O157:H7 is not well understood. The aims of this study were to determine the prevalence of and characterize E. coli O157:H7 associated with houseflies (HF).
Musca domestica L. HF (n = 3,440) were collected from two sites on a cattle farm over a 4-month period and processed individually for E. coli O157:H7 isolation and quantification. The prevalence of E. coli O157:H7 was 2.9 and 1.4% in HF collected from feed bunks and a cattle feed storage shed, respectively. E. coli O157:H7 counts ranged from 3.0 × 101 to 1.5 × 105 CFU among the positive HF. PCR analysis of the E. coli O157:H7 isolates revealed that 90.4, 99.2, 99.2, and 100% of them (n = 125) possessed the stx1, stx2, eaeA, and fliC genes, respectively.
Large populations of HF on cattle farms may play a role in the dissemination of E. coli O157:H7 among animals and to the surrounding environment.
Association of Escherichia coli O157:H7 with houseflies on a cattle farm
Applied and Environmental Microbiology vol. 84 no. 14
I started the Food Safety Network (the original FSN) as an incoming graduate student in 1993 in the wake of the Jack-in-the-Box outbreak, combining my science and journalism learnings, and because a constant refrain I observed was, I never knew foodborne illness could be so serious.
That’s why I continue to do it as a form of community service (I haven’t been paid since 2016).
That’s the reason the Schidings, two months ago, signed up for a local cow-share program after they read about the health benefits of unpasteurized milk.
Instead, 18-month-old Genevieve and 3-year-old Anthony contracted an illness caused by E. coli bacteria and ended up with kidney failure in the pediatric intensive care unit at East Tennessee Children’s Hospital — two of 12 local children hospitalized with E. coli since the end of May.
Knox County Health Department staff told the Schidings the E. coli infection was likely linked to the consumption of raw milk from French Broad Farm. On Thursday, the health department lifted its directive that requested French Broad Farm temporarily cease operations. But health department Director Dr. Martha Buchanan reiterated that consuming raw milk is always risky and health officials recommend the public consume only pasteurized milk and dairy products.
Jordan Schiding said he and his wife knew there was “potential” for food poisoning from unpasteurized milk, which both adults drank with seemingly no serious effects, but “we were definitely not aware that anything like this was remotely possible.”
The Schiding children seem to have turned a corner, he said, with Anthony discharged Friday afternoon and Genevieve still hospitalized but out of intensive care.
But what started as a supposed stomach bug May 31 turned into a terrifying experience that traumatized both the children and their parents, who had to watch them suffer.
Schiding said the family brought Genevieve to the emergency room at Children’s Hospital May 31 after she became seriously dehydrated with diarrhea and vomiting. As she was being admitted, Anthony also began vomiting.
The hospital rehydrated the children and discharged them a few hours later. Schiding believes they were among the first children related to the current cluster of E. coli cases to come to Children’s Hospital.
Two days later, after both children continued to get sicker, the Schidings brought them back to the hospital. This time, hospital staff took a stool sample from Genevieve, which tested positive for E. coli, and then from Anthony, who also tested positive. Both children were admitted, and Knox County Health Department contacted the couple the next day, he said.
The Schidings knew little about E. coli; certain strains produce a toxin, Shiga, that can cause a chain of reactions in the body — hemolytic uremic syndrome — resulting in clots in the small blood vessels in the kidneys that cause kidney failure. The very young, the very old and people whose immune systems are already compromised are more susceptible to HUS.
Four children admitted to Children’s so far have had HUS, including Genevieve and Anthony. Though Anthony wasn’t quite as sick as his sister, both had surgery to implant central lines so they could get fluids, dialysis and blood transfusions, Schiding said. Anthony had three days of dialysis, Genevieve seven.
In addition, Anthony’s central lines became infected with staph, Schiding said, but the antibiotics typically prescribed to treat staph are too hard on the kidneys to give a child with HUS, so doctors had to use a less common medication, which has seemed to work.
“Obviously, we were freaked out a little bit,” Schiding said. “It seemed like he had started turning the corner” until he spiked a fever of 104.9 and tested positive for staph.
Schiding said his family no longer will consume raw milk.
Several outbreaks of foodborne illness traced to leafy greens and culinary herbs have been hypothesized to involve cross-contamination during washing and processing. This study aimed to assess the redistribution of Salmonella Typhimurium LT2 during pilot-scale production of baby spinach and cilantro and redistribution of Escherichia coli O157:H7 during pilot-scale production of romaine lettuce.
Four inoculated surrogate: uninoculated product weight ratios (10:100, 5:100, 1:100, and 0.5:100) and three inoculation levels (103, 101, and 10−1 CFU/g) were used for the three commodities. For each of three trials per condition, 5-kg batches containing uninoculated product and spot-inoculated surrogate products at each ratio and inoculation level were washed for 90 s in a 3.6-m-long flume tank through which 890 L of sanitizer-free, filtered tap water was circulated. After washing and removing the inoculated surrogate products, washed product (∼23, 225-g samples per trial) was analyzed for presence or absence of Salmonella Typhimurium or E. coli O157:H7 by using the GeneQuence Assay.
For baby spinach, cilantro, and romaine lettuce, no significant differences (P > 0.05) in the percentage of positive samples were observed at the same inoculation level and inoculated: uninoculated weight ratio. For each pathogen product evaluated (triplicate trials), inoculation level had a significant impact on the percentage of positive samples after processing, with the percentage of positive samples decreasing, as the initial surrogate inoculation level decreased.
The weight ratio of contaminated: noncontaminated product plays an important role: positive samples ranged from 0% to 11.6% ± 2.05% and from 68.1% ± 33.6% to 100% among the four ratios at inoculation of 10−1 and 101 CFU/g, respectively.
To our knowledge, this study is the first to assess the redistribution of low levels of pathogens from incoming product to leafy greens during processing and should provide important data for microbial risk assessments and other types of food safety analyses related to fresh-cut leafy greens.
Transfer and redistribution of Salmonella typhimurium LT2 and Escherichia coli O157:H7 during pilot-scale processing of baby spinach, cilantro, and romaine lettuce
Journal of food Protection vol.81 no. 6 June 2018
HALEY S. SMOLINSKI,1 SIYI WANG,1 LIN REN,1 YUHUAN CHEN,2 BARBARA KOWALCYK,3 ELLEN THOMAS,3 JANE VAN DOREN,2 and ELLIOT T. RYSER1*
It takes two to three weeks between when a person becomes ill with E. coli and when the illness is reported to CDC. Most of the people who recently became ill ate romaine lettuce when lettuce from the Yuma, Arizona, growing region was likely still available in stores, restaurants, or in peoples’ homes. Some people who became sick did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce.
According to the U.S. Food and Drug Administration, the last shipments of romaine lettuce from the Yuma growing region were harvested on April 16, 2018, and the harvest season is over. It is unlikely that any romaine lettuce from the Yuma growing region is still available in people’s homes, stores, or restaurants due to its 21-day shelf life.
The traceback investigation indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor. While traceback continues, the FDA will focus on trying to identify factors that contributed to contamination of romaine across multiple supply chains. The agency is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching consumers.
The FDA has identified Harrison Farms of Yuma, Arizona, as the grower and sole source of the whole-head romaine lettuce that sickened several people in an Alaskan correctional facility, but has not determined where in the supply chain the contamination occurred.
There had been a marked increase in illness in the town of about 5,000 people, and many were already saying the water was suspect. But the first public announcement was also the Sunday of the Victoria Day long weekend and received scant media coverage.
It wasn’t until Monday evening that local television and radio began reporting illnesses, stating that at least 300 people in Walkerton were ill.
At 11:00 a.m., on Tuesday May 23, the Walkerton hospital jointly held a media conference with the health unit to inform the public of outbreak, make the public aware of the potential complications of the E. coli O157:H7 infection, and to tell the public to take the necessary precautions. This generated a print report in the local paper the next day, which was picked up by the national wire service Tuesday evening, and subsequently appeared in papers across Canada on May 24.
Ultimately, 2,300 people in a town of 5,000 were sickened and seven died. All the gory details and mistakes and steps for improvement were outlined in the report of the Walkerton inquiry.
Paul Hunter of the Toronto Star writes it was a glorious, sun-warmed afternoon after a long winter. Robbie Schnurr’s blinds were closed. He was finalizing his plans to die.
“Pretty much where I’m laying right now, where I’ve been for years,” he said, reflexively patting the bedsheet between him and the half-finished bottles of water kept within easy reach.
“What does a person do when they know they’re going to die within hours? I mean, do you walk over and look out the window? I can’t walk anyways. I guess you just wait for the time to pass and then you miss the hors d’oeuvres.”
It’s been 18 years since a deadly E. coli outbreak devastated the rural town of Walkerton, 150 kilometres northwest of Toronto. Seven people perished. A further 2,500, half the population, took ill. Most eventually got better. Schnurr never did.
Poisoned like the others, his health declined slowly and painfully until he lived in a sort of limbo: a prisoner in his own body, in his own bed, here in his 11th-floor Mississauga condo, a 71-year-old alone and feeling largely forgotten.
The former OPP officer and investigator with Ontario’s Office of the Fire Marshal was in constant pain from a degenerative nerve disease. Doctors, he said, told him he would continue to decline. There was no hope of improvement.
His legs had wasted away. Numbness in his fingers made it impossible for him to write or button a shirt; he opened bottles of painkillers with his mouth. He was losing sight in his right eye; the hearing in one ear was already gone. He’d leave his home only every two weeks, strapped on a gurney to be transported to the Queensway Health Centre for an intravenous immunoglobulin treatment. He went for the last time in late April.
On May 1, a doctor came to him.
In the company of his younger sister, Barbara Ribey, her husband, Norm, and two friends, Schnurr fulfilled his wish for a physician-assisted death.
“I just won’t live like this anymore,” he explained the day before that final moment. “There’s nothing to look forward to, there’s no goals in life. There’s nothing.”
Before he took ill, Schnurr said he “had the world by the ass.” He wanted people to know that. He also didn’t want forgotten what happened at Walkerton and how it cheated him, and others from his hometown, in life and left a heartbreaking legacy.
Schnurr said he also recently spoke to two old friends from the OPP who’d had no idea of what became of him.
He wanted everyone to know. So he invited the Star to his home to share his story and explain his decision.
Schnurr was, as it would have been described in another era, a man’s man, living like he was the lead in a 1970s action movie.
Mustachioed and handsome, he drove fast cars (the last a black Corvette), lived for long stretches on his 35-foot boat (where the parties were frequent) and had a closet full of Armani and Hugo Boss suits and silk ties. He owned a condo in Mexico and, befitting a Hollywood star, he always seemed to have a beautiful date on his arm.
“Women loved Robbie,” said Ribey.
Schnurr skied, he rollerbladed, he had a black belt in karate. As a teen, he played every sport he could. He excelled at hockey and was never afraid to drop the gloves. In baseball, a fastball in the low to mid-90s caught a scout’s eye, and he went off to pitch in the minors in North Carolina.
“I know I could have made the big leagues, but I didn’t know how long it would take,” he said. “And there was this girl that wanted me to get married. When I got home she handed me an application for the OPP.”
The policing job idea stuck, but the thought of marriage didn’t. Schnurr became a cadet at 19, was sworn in and got his gun at 21. He said he was shot twice and stabbed twice. He lost hearing in one ear because of target shooting practice. He investigated motorcycle gangs — “We didn’t get along real well, the bikers and I” — and major crimes.
He moved from Owen Sound to Kenora to Manaki before landing in Orillia in the early 1980s shortly before a train derailed in nearby Medonte. The fire marshal’s office was impressed with how he handled that case and suggested he apply. Schnurr said he beat out 800 other candidates for the job and was soon sent off to train with the FBI to become an expert in explosions.
In newspapers during the ’80s and ’90s, Schnurr was frequently quoted standing among the ashes at one fire or another. He figured he investigated some 2,000 fires. At one point, he helped profile and hunt down an arsonist who was terrorizing Toronto’s west end. On another case, the torching of a church, he received death threats.
Through his working life, sports remained important, as he coached youth baseball and organized instructional clinics around the province.
Though single at the end, he had married twice, had a daughter, Samantha, whom he adored and a grandson, Kaiden, born in January.
Tough as he was, through a twist of fate Schnurr was exiled from the world he embraced so enthusiastically.
“Now, I can’t even get down the goddamned hall,” he said. “To make a long story short, I was screwed.”
Schnurr didn’t even live in Walkerton when he encountered his kryptonite there. He’d gone to his hometown for his mother’s memorial in mid-May of 2000. When he returned to Mississauga, he realized he’d forgotten his suit jacket. With Victoria Day weekend coming, he decided to make a quick return trip to Walkerton to pick it up and see a couple of friends on the Friday before the holiday traffic got heavy.
“It was a really hot and muggy day and when I got there, I took a pitcher of water and chugalugged it,” he said.
That began a weekend of hell that lasted 18 years.
“I had blood coming out of both ends,” he said of the next 48 hours, spent feeling groggy and on the floor of his condo. “It was almost two days before I could get any help because I wasn’t strong enough.”
Walkerton’s water supply had been contaminated. A heavy rainstorm washed cow manure carrying a strain of E. coli O157:H7 into a vulnerable town well and, because of improper chlorination, the lethal bacteria was not destroyed.
The poison was passed on through tainted tap water and made thousands sick with severe gastrointestinal issues, including bloody diarrhea, in one of the worst public health disasters in Canadian history. A landmark, seven-year study of those who fell ill, released in 2008, determined there were legacy illnesses from the tragedy. Patients who had confirmed gastroenteritis had a 30 per cent higher risk of high blood pressure or kidney damage.
The study found that 22 children who became sick in 2000 had permanent kidney damage, but treatment had stopped that illness from getting worse.
Dr. William Clark, a kidney specialist at London Health Sciences Centre who led the study, looked again three years ago at the victims of Walkerton, and found that although “there is no doubt some people have had significant long-term problems” when compared with similar small towns, Walkerton is actually doing “somewhat better” when it comes to kidney and heart issues.
That, he suggests, could be related to a post-crisis medical screening program involving about 4,000 residents. It not only identified health issues related to the contamination, but also picked up ailments such as diabetes and hypertension, allowing physicians to get those patients on proper medication.
Clark said the kidney and heart issues of Walkerton residents have improved, but “there’s no doubt they’re on more medication” than comparable groups.
Schnurr had no idea others were also poisoned as he floundered on his condominium floor in 2000. He didn’t know why he was sick, even as an ambulance eventually took him, in blood-soaked clothes, to the hospital. He also wondered why all the medical staff took such keen interest in his Walkerton roots. Then, on one of the muted televisions at the hospital, he started to see familiar faces from his hometown.
“I’m going, ‘What’s going on?’ (A hospital worker) said to me, ‘You haven’t heard about the E. coli epidemic in Walkerton?’ Bang. It all came together.”
Schnurr returned to work until 2002, but he got progressively weaker. His retirement plan had been to take a lucrative position investigating insurance fraud in the U.S., or set up his own business. Instead, he struggled with balance, falling often, and forgot things. At 55, he could no longer work.
Schnurr said the bacterial infection destroyed his immune system and that led to his current neurological disorder. Press reports, years after the Walkerton disaster, chronicled Schnurr’s struggles as a lingering victim.
Doctors eventually diagnosed Schnurr with chronic inflammatory demyelinating polyneuropathy (CIDP), a neurological disorder that causes the body’s immune system to attack and destroy the myelin sheath that envelops nerves. It’s comparable to stripping the insulation off electrical wires. Symptoms include tingling in the feet and hands as well as progressive weakness in the legs and arms. For Schnurr, it also brought debilitating pain.
“Anything too hot or too cold on him would almost be like tinfoil on a tooth filling,” Ribey said.
CIDP, a rare disorder, typically follows an infection in the body that messes up the immune system. There is always a suspected trigger, but the exact cause can’t be pinned down.
Clark, the lead health investigator at Walkerton, said research hasn’t shown a good correlation between E. coli O157:H7 and CIDP.
“But I’m not excluding it because the reality is any inflammatory event may … contribute to the onset of an autoimmune disorder, which CIDP really is,” he said.
At first, Schnurr could “furniture walk” around his condo, using a cane and clutching at various items to keep his balance. But there were too many tumbles, too many sutures and too many broken bones. Five times, he ended up in the hospital. Once he fell into his television, pushing it through the drywall.
“When I could get out of bed, I’d go down into the living room and sit there and stare,” he said. “I wouldn’t even answer the phone.”`
When his legs got weaker, Schnurr would crawl around his home, sometimes till his knees bled. For the past decade, even that was too much.
“I would often hope and pray I would get some kind of something to make me well,” he said. “I know now that’s not going to happen and …”
The rest of that thought preoccupied his mind, he said, for almost 10 years. He wanted out of a life that hurt to live. Before assisted death became legal in Canada in 2016, he considered going to Switzerland, where it was available.
“I’m not afraid. I’m not scared. I’m almost looking … I am looking forward to it because I’ll be gone,” he said.
“I think most people, well, I know most people, they don’t want to die. They want to live, but life is no fun for me. I can’t go anywhere. I can’t do anything. My body is breaking down more and more. So I discussed it with doctors and family. They agreed with me. So here I am.”
Schnurr was resolute in his decision, approaching his own death with an almost clinical detachment — “There was never a tear,” Ribey said — as he wondered about timing and process. He said he cleaned up any debts and other paperwork so his sister wouldn’t be burdened. He got someone to throw away all his pills and he said goodbye to those who mattered.
“I’m rational. I’m in pain, but I’m always in pain,” he said. “I gave it a lot of thought. It’s not something you decide overnight.”
On his birthday on July 14, 2017, he posted on Facebook that it would be his last.
“Going back a month ago up till present, I was ticking the days off,” he said. “I just didn’t want to suffer anymore. The pain and suffering and lack of friends, you know. I’m basically here alone with the exception of the people that come in and clean.”
On the first day of May, in the afternoon, Ribey lay down next to her brother. It was time. A doctor administered three injections.
“I was lying beside him and holding his hand and he just put his head down on mine and said, ‘How’s my little sister?’ And that’s when I started to cry. Then I said something like, thank you for being such a kind brother and a good brother to me. I’m going to miss you … I told him I loved him.”
She said it was “very, very peaceful and very quick.”
For Schnurr, a man broken beyond repair, the pain stopped.
Since the outbreak began in late March, 40 cases of E. coli infection have been confirmed; 12 people have been hospitalized and one person has died.
The outbreak began when several people who visited the same restaurant in Edmonton become ill. Alberta Health Services soon traced the illnesses to pork products distributed by The Meat Shop in Pine Haven, Alb.
Edmonton’s Real Deal Meats says her family-run business has had to throw away thousands of dollars worth of meat.
That prompted a recall that has since expanded to include raw and frozen meat, ground pork, sausages and more. The products have only been distributed in Alberta.
An Edmonton law firm has already begun a $15-million lawsuit against The Meat Shop, on behalf of those who have become ill. But more than half a dozen businesses whose names have been caught up in the recall say their reputations are taking a hit too.
Alicia Boisvert of Edmonton’s Real Deal Meats says her family-run business has had to throw away thousands of dollars worth of meat — much of it returned by customers.
“We have to remove all the packaging… before the truck picks it up,” she told CTV Edmonton. “And then we have to pay for that (removal). Obviously, we’re going to have to figure that out as well.”
Another business whose reputation has taken a hit in this outbreak is Mama Nita’s Filipino Cuisine in southeast Edmonton – the restaurant where the outbreak began.
A full 21 of the 40 lab-confirmed cases have been linked to Mama Nita’s. The restaurant is still open but would not speak to CTV Edmonton about how their business is doing.
The other 19 illnesses — including the one involving the patient who died — have been linked to pork sold by Pine Haven’s retail partners.
Real Deal Meats’ Boisvert says, just being associated with an E. coli outbreak has led to many sleepless night for her and her family.
At K&K Foodliner — another food retailer caught up in the recall — business is slower. Even though Pine Haven pork is no longer sold at the store, general manager Kevin Krause says some customers are avoiding pork altogether.
“This is our first recall in 62 years,” he told CTV Edmonton. “Regardless if it’s Pine Haven’s fault, it’s still our reputation on the line as well.”