E. coli O157 is always tragic, but probably not because of the last thing you ate

McDonald’s is a big, semi-popular fast-food chain in the way Semi-Tough (the movie) depicted American professional football as big and semi-popular.

When Shiga-toxin producing E.coli were discovered in 1977 (named verotoxigenic E. coli) and then the first outbreaks were linked to human illness in 1982 at McDonald’s in White City, Ore., and Traverse City, Mich., McDonald’s completely revamped its beef sourcing and cooking procedures.

Over the past three decades, I’ve heard everyone blame McDonald’s for everything, especially on food safety, and especially what used to be known as hamburger disease.

South Korean lawyers are apparently catching up to where North Americans were 25 years ago, but perpetuate semi-stereotypes.

According to The Korea Herald, a mother on Wednesday filed a complaint against McDonalds Korea, claiming her daughter was diagnosed with the “hamburger disease” after eating a burger with an undercooked patty in one of its outlets.

“The 4-year-old victim had no health problems, but caught hemolytic uremic syndrome after eating a McDonald’s hamburger,” lawyer Hwang Da-yeon said at a press conference held in front of the Seoul District Prosecutors Office, before submitting the complaint. 

HUS is serious shit.

McDonald’s has known about it for a long time.

The complaint claims McDonald’s violated local food safety rules by serving contaminated meat that was not fully cooked.

The plaintiff also made a tearful plea, asking state prosecutors to investigate and hold McDonald’s Korea responsible for her daughter, who has suffered irreversible damage to her kidneys and must undergo eight to 10 hours of peritoneal dialysis on a daily basis.

According to the mother, the child ate a hamburger at a McDonald’s outlet in Gyeonggi Province in September and fell ill about three hours afterwards.

HUS is always tragic, and I wouldn’t wish it on anyone.

She was brought to an intensive care unit three days later, where she was diagnosed with HUS, a food-borne disease that can cause acute kidney failure. The child was discharged from the hospital two months later, but had lost 90 percent of her kidney function.

The McDonald’s outlet denied any link between its product and the child’s illness, saying the meat is machined-cooked, eliminating human error.

I’m not sure who’s right, but Shiga-toxin producing E. coli – the kind that lead to HUS – take 2-4 days to develop – not 3 hours.

As Kate Murphy of The New York Times explained last week, when you’re fine one minute and barfing the next – what the U.S. Centers for Disease Control and Prevention calls an acute gastrointestinal event — happens to all of us at least once a year. The bouts, while extremely unpleasant, usually don’t occasion a trip to the doctor or require any medication.

But such events tend to make us spin our gears trying to pinpoint what made us so miserably sick. While it’s hard to know for sure, there are clues that might help you determine the source and reduce your risk in the future.

“People tend to blame the last thing they ate, but it’s probably the thing before the last thing they ate,” said Dr. Deborah Fisher, a gastroenterologist and associate professor at Duke University School of Medicine.

It takes the stomach around four to six hours to empty a full meal, and then the small intestine takes about six to eight hours to squeeze out all the nutrients and empty into the colon. The remains linger there for another one to three days, fermenting and being formed into what ultimately is flushed down the toilet. So-called bowel transit time varies significantly from person to person, but gastroenterologists said you can easily find out what’s normal for you by eating corn and watching for when the indigestible kernels appear in your stool.

Gross, perhaps, but with that baseline, the next time you get sick, you’ll be better able to estimate when you might have eaten the offending meal. For example, if you throw up something and don’t have diarrhea or roiling further down, it could be that what made you ill was something you ate within the last four to six hours. If you wake up in the middle of the night with cramps and diarrhea, it’s more likely something you consumed a good 18 to 48 hours earlier, depending on the results of your corn test.

We stopped at a McDonald’s on the way home from the Glass Mountains yesterday. Quality was semi-OK, but safety was there.

(No McDonald’s money was involved in this blog post; there was no money at all; I just like to write).

Food safety is not simple

Winnipeg, Manitoba, Canada correspondent, Rob Mancini, writes:

I’ve been told many times from various sources that Mancini’s always a cheerful guy, you can’t upset him… this is only because I find happiness with my family. I have an amazing wife and 2 incredible kids (6 years old and 19 months), all healthy.  What more can I ask for: nothing.

But when I read stories of kids dying from hemolytic uremic syndrome due to an E. coli infection, in particular when it could have been prevented, I get mad.

“We can’t hold him. We can’t love on him. All we can do is just stand at the bedside,” Lindsey Montgomery, Huston’s mom, told WFAA.

Heartbreaking.

Fox News reports A 2-year-old boy is on life support after contracting an E. coli infection from an unknown source while on vacation in Oklahoma with his family. Landon Huston, of Ennis, Texas, was experiencing stomach virus-like symptoms when a fecal sample tested positive for E. coli, WFAA reported.

Huston was taken to Children’s Medical Center Dallas where doctors discovered the infection had progressed to Hemolytic Uremic Syndrome (HUS), an abnormal destruction of red blood cells that leads to kidney failure, WFAA reported.

Huston underwent the first of two surgeries on June 14 and has had a blood transfusion. He was placed on life support after doctors discovered fluid in his lungs, a post on the family’s GoFundMe page said.

The Texas Department of Health Services is investigating any potential source of the bacteria. E. coli can be found in the environment, foods, and intestines of people and animals, according to the Centers for Disease Control and Prevention (CDC).

“Most parents like us had no idea, you know, the dangers of something like this,” Montgomery told WFAA. “And it’s everywhere. E. coli is something that’s everywhere.”

While most strains of the bacteria are harmless, others can cause diarrhea, urinary tract infections, respiratory illness and pneumonia. About 5-10 percent of patients who contract E. coli will develop (HUS), which could present as decreased frequency of urination, feeling tired and losing color in cheeks and inside the lower eyelids. Patients can recover in a few weeks but others may suffer permanent damage or die.

“I have faith he’s going to come out on top,” John Huston, the toddler’s dad, told WFAA.

I’ve taught many food safety courses and have lectured on the importance of food safety to many. I’ve used different techniques in teaching, heavily based on behavioral science amongst other antics, to stress the importance of certain food safety principles. Even did a TV show on the subject.  All of this doesn’t matter if your inherent belief system is contrary to the information provided.  Need to be compelling and understand how human behavior operates. At times I wish I know more psychology but it’s never too late.

Food safety is not simple, it is hard and anyone who says otherwise is clueless.

I always try to share personal stories and current relevant food safety stories in an attempt to connect with my audience or readers and gauge their interest. Doug taught me this and it works.

 

Petting zoo: Minnesota 10-year-old awarded $7.55 million in E. coli settlement

Maury Glover of Fo 9 reports a jury awarded $7.5 million to a Rosemount, Minnesota family after a young girl contracted E. coli from a petting zoo at Dehn’s Pumpkins in Dayton.

emma-rosemount-girl-e-coli_1479962267763_2325612_ver1-0_640_360In 2013, Emma Heidish spent a month overcoming a potentially deadly form of kidney disease which cause her kidneys to shut down and required surgery and near constant dialysis.

On Tuesday, a Hennepin County jury found the owners of the farm where she got E. coli, Dehn’s Pumpkins in Dayton, negligent for not taking steps to prevent their animals from transmitting diseases and awarded Emma $7.5 million.

Emma was one of seven people sickened in an October 2013 E. coli O157:H7 outbreak linked by the Minnesota Department of Health to cows in the animal attraction  at Dehn’s Pumpkins, LLC, a business located in Dayton, MN.

The bulk of the money is for future medical bills and pain and suffering.

“It is one of the largest verdicts in the country for an E. coli outbreak for a condition like this one and its one of the largest involving a petting zoo case,” Emma’s attorney, Fred Pritzker, said. “The people who run the pumpkin patch are decent people. It’s not that they were mean spirited. But, what they didn’t know caused a great deal of pain and suffering for my clients.”

Since the outbreak, the popular pumpkin patch no longer operates a petting zoo, but Pritzker sais animal attractions like it are not regulated or inspected.

His firm will push for a new law, named after Emma, requiring petting zoos to follow safety precautions, like having hand washing stations nearby to help prevent the spread of the disease.

“There have been 150 to 200 cases of outbreaks involving animals in public settings in the last 15 years, Pritzker said

Pritzker says Emma probably won’t see all the money because the farm’s insurance doesn’t have that much coverage.

A table of petting zoo outbreaks (which needs to be updatd) is available at http://barfblog.com/wp-content/uploads/2014/04/Petting-Zoo-Outbreaks-Table-4-8-14.xlsx

Toddler contracts serious E. coli infection on NZ family farm

Eight months on from a rescue helicopter dash to Starship children’s hospital, two-year-old Grace Dheda is enjoying being back on her family’s farm – even though it nearly killed her.

grace-dhedaIn March, Grace and her family were savouring rural life in Wellsford.

Mum Megan and Dad Kirin were planning their up-coming wedding. 

That all came to a sudden halt when their daughter began to show signs of illness.

After two days of vomiting and diarrhea, a doctor diagnosed a tummy bug.

Grace was sent home and prescribed plenty of fluids, Megan says.

At home Grace played on the deck like her normal self, but collapsed at bedtime.

Grace was rushed back to the doctors.

“They put her on oxygen straight away. She’d been unconscious for about 45 minutes and they were starting to worry about potential brain damage.”

Given the severity of the situation and the closest ambulance an hour away, the Auckland Westpac Rescue Helicopter was called.

Grace and Megan were ferried to a helipad and arrived to see the chopper landing.

“It was such a relief to see the helicopter,” Megan says.

Megan recalls, “At first nobody knew what was wrong with her and why she was having these seizures. It wasn’t until a few days before we left the hospital that we found out she had contracted E. coli and HUS (Hemolytic Uremic Syndrome).”

HUS is a severe complication of the E. coli infection that can lead to kidney failure.

At first it was thought that Grace had contracted the bacterial infection through the water supply, however this was later tested and found to be normal.

It is now believed that she contracted it via the farm animals.

Megan says, “We’ve got cows here on the farm and I don’t like Grace going anywhere near them. The doctor told me I have ‘parental anxiety.’ ‘I love the farm life, but I’m a bit paranoid now and have about 20 bottles of sanitiser around the place.”

The Helicopter Trust is actively fundraising at present in order to purchase three new ventilators for use on their helicopters and in their Rapid Response Vehicle.

Raw sprouts and sausage: There’s some hot STECs out there

In 2011, one of the world’s largest outbreaks of hemolytic-uremic syndrome (HUS) occurred, caused by a rare Escherichia coli serotype, O104:H4, that shared the virulence profiles of Shiga toxin-producing E. coli (STEC)/enterohemorrhagic E. coli (EHEC) and enteroaggregative E. coli (EAEC).

sprout-santa_-barf_-xmas__0-featuredThe persistence and fitness factors of the highly virulent EHEC/EAEC O104:H4 strain, grown either in food or in vitro, were compared with those of E. coli O157 outbreak-associated strains.

The log reduction rates of the different EHEC strains during the maturation of fermented sausages were not significantly different. Both the O157:NM and O104:H4 serotypes could be shown by qualitative enrichment to be present after 60 days of sausage storage. Moreover, the EHEC/EAEC O104:H4 strain appeared to be more viable than E. coli O157:H7 under conditions of decreased pH and in the presence of sodium nitrite. Analysis of specific EHEC strains in experiments with an EHEC inoculation cocktail showed a dominance of EHEC/EAEC O104:H4, which could be isolated from fermented sausages for 60 days. Inhibitory activities of EHEC/EAEC O104:H4 toward several E. coli strains, including serotype O157 strains, could be determined. Our study suggests that EHEC/EAEC O104:H4 is well adapted to the multiple adverse conditions occurring in fermented raw sausages. Therefore, it is strongly recommended that STEC strain cocktails composed of several serotypes, instead of E. coli O157:H7 alone, be used in food risk assessments.

The enhanced persistence of EHEC/EAEC O104:H4 as a result of its robustness, as well as the production of bacteriocins, may account for its extraordinary virulence potential.

sproutssprouts-batzIMPORTANCE In 2011, a severe outbreak caused by an EHEC/EAEC serovar O104:H4 strain led to many HUS sequelae. In this study, the persistence of the O104:H4 strain was compared with those of other outbreak-relevant STEC strains under conditions of fermented raw sausage production. Both O157:NM and O104:H4 strains could survive longer during the production of fermented sausages than E. coli O157:H7 strains. E. coli O104:H4 was also shown to be well adapted to the multiple adverse conditions encountered in fermented sausages, and the secretion of a bacteriocin may explain the competitive advantage of this strain in an EHEC strain cocktail.

Consequently, this study strongly suggests that enhanced survival and persistence, and the presumptive production of a bacteriocin, may explain the increased virulence of the O104:H4 outbreak strain. Furthermore, this strain appears to be capable of surviving in a meat product, suggesting that meat should not be excluded as a source of potential E. coli O104:H4 infection.

Fitness of Enterohemorrhagic Escherichia coli (EHEC)/Enteroaggregative E. coli O104:H4 in comparison to that of EHEC O157: Survival studies in food and in vitro

Applied and Environmental Microbiology; November 2016 vol. 82 no. 21 6326-6334

Christina Böhnlein, Jan Kabisch, Diana Meske, Charles M. A. P. Franz and Rohtraud Pichner

http://aem.asm.org/content/82/21/6326.abstract?etoc

Avoid pigeon poop, possible source of bad E. coli

Verotoxigenic Escherichia coli infections in humans cause disease ranging from uncomplicated intestinal illnesses to bloody diarrhea and systemic sequelae, such as hemolytic uremic syndrome (HUS).

pigeon-poop-shamelessPrevious research indicated that pigeons may be a reservoir for a population of verotoxigenic E. coli producing the VT2f variant. We used whole-genome sequencing to characterize a set of VT2f-producing E. coli strains from human patients with diarrhea or HUS and from healthy pigeons. We describe a phage conveying the vtx2f genes and provide evidence that the strains causing milder diarrheal disease may be transmitted to humans from pigeons.

The strains causing HUS could derive from VT2f phage acquisition by E. coli strains with a virulence genes asset resembling that of typical HUS-associated verotoxigenic E. coli.

Whole-Genome characterization and strain comparison of VT2f- producing Eschericha coli causing hemolytic uremic syndrome

Emerging Infectious Dieseaes, Volume 22, Number 12- December 2016,  DOI: 10.3201/eid2212.160017

http://wwwnc.cdc.gov/eid/article/22/12/16-0017_article#suggestedcitation

$1.6 M lawsuit claims Calgary siblings infected with E. coli after eating at Vietnamese restaurant

Kevin Martin of the Calgary Herald reports a $1.6-million lawsuit has been filed on behalf of a Calgary brother and sister who were infected with E. coli, allegedly from eating tainted food at a Vietnamese restaurant.

Chi Lan Vietnamese RestaurantThe lawsuit filed on behalf of minors Hunter and Julia Aloisio said both were infected with E. coli after dining at the Chi Lan Vietnamese Restaurant on July 31, 2014.

It says Hunter Aloisio was impacted most by the infection, developing hemolytic uremic syndrome.

The boy required dialysis to treat the illness and is now susceptible to kidney failure, the lawsuit says.

The claim names the restaurant, as well as its suppliers and “upstream defendants,” unidentified companies “involved in the livestock slaughter and dressing industry, the farming industry and/or the secondary processing industry.”

“The defendants were negligent and breached the standard of care owed to the plaintiffs,” the statement of claim filed on behalf of the siblings says.

“The defendants owed the plaintiffs a duty of care to ensure that their products, including the restaurant food, were safe for consumption and would not expose the plaintiffs to contaminants such as E. coli bacteria,” it says.

Utah girl, 8, dies from Shiga-toxin producing E. coli

A family in American Fork is receiving an outpouring of support after an 8-year-old girl became sick last week, was rushed to a hospital but died five days later.

hannah.jolley.e.coliBrian and Melissa Jolley never imagined they would be making funeral plans for their daughter, Hannah.

“She always wanted to play with her friends, loved playing with friends,” Melissa Jolley said.

On the morning of July 14, she started showing symptoms typical of the flu. But her condition quickly deteriorated.

“Come Thursday night she had a really, really hard night. And Friday morning we could tell she was in a lot of pain,” Brian Jolley said.

Doctors at Utah Valley Hospital quickly diagnosed her with E. coli. She was later flown to Primary Children’s Hospital. Last Monday she had a seizure, and doctors determined Hannah had hemolytic uremic syndrome, a disease that destroys red blood cells.

The most common cause of HUS, particularly in children, is E. coli infection.

“We have no idea how she got the E. coli. At this point it’s not important,” Brian Jolley said. “We want answers someday. Of course, we want to know where it came from.”

Hannah died Tuesday night, and since then the show of support from the community has been non-stop. Hand-made decorations, chalk art and ribbons decorate the Jolleys’ home in American Fork. Complete strangers have phoned and emailed the family to offer support.

Shiga-toxin producing E. coli: Montessori school closed after 2 students hospitalized

The Washington, Monroe Montessori School was closed Wednesday after two young children were hospitalized with E. coli.

The girls are both under the age of 5 and were hospitalized. Only one of the girls has a confirmed kidney issue called HUS, which indicates a more serious case of E. coli. Her condition has not been released.

Sixty other preschoolers and 10 staff members may have been exposed. Everyone who has been at the school since July 11 is being tested.  Test Kits will be sent to parents Thursday, and results can take about five days.

Although it is not the source of the E. coli, the school is also being sanitized.

“The exact source of contamination in E. coli can be very difficult to identify, but at this point we believe the children were likely exposed to livestock near their home,” said Dr. Gary Goldbaum, health officer and director of the Health District.

Cottage cheese positive: More clues in Romanian HUS outbreak

The Romanian Institute of Hygiene and Veterinary Public Health (BIP) received, until 29 February 2016 a total of 337 samples of food samples taken from the Ministry of Health indicated and notified through the Rapid Alert System for Food and Feed

UnknownTo these are added a total of 59 samples , received until March 3, 2016 in samples of joint teams DSV – DSP ​​of water, dairy products and raw material milk and 15 samples from samples of dairy products, required to be analyzed by the owner of the milk processing in Arges county, under the program of self-control.

By that date, the total of 411 samples received , 312 have been completed (two with positive results) and 99 samples are in progress .

Data from ANSVSA checks indicate that there is a direct causal link between the cottage cheese product from the lot on 22.02.2016 and illnesses of children diagnosed with HUS.

Please note that pasteurization of raw milk from the group ensures the bacteria Escherichia coli (including O26) , and the resulting products are safe for consumption.

Regarding the positive sample detected in poultry meat (if Bacau), clarified that the appropriate heat treatment and compliance with hygiene prevents transmission of bacteria from the group Escherichia coli.