85 sick with shiga-toxin E. coli at Marines base

About 85 U.S. Marines-in-training remained ill last week after an apparent shiga-toxin producing E. coli outbreak at Marine Corps Recruit Depot San Diego and Camp Pendleton amid a week-old outbreak of diarrheal illnesses at the military installations, authorities reported.

Among the medical cases were 19 new ones diagnosed since Oct. 31, 2017, according to MCRD public affairs. In all, 16 recruits were receiving treatment at an off-base hospital, with the remainder being cared for at military medical facilities.

Base officials initially announced a total of about 300 cases of intestinal ailments at the 2 San Diego-area installations on Oct. 30, 2017.

 That tally was down to roughly 215 a day later. The cause or causes of the debilitating bacterial exposure remain under investigation.

12-year-old Oklahoma girl lives with constant reminder of E. coli outbreak nine years ago

In Aug. 2008, 26-year-old Chad Ingle had a meal at the Country Cottage in Locust Grove, Oklahoma, a popular family-owned buffet-style restaurant.

Nine days later, Chad was dead from E. coli O111.

By the end of the outbreak, 341 people had been sickened with E. coli O111, all from eating at the country diner in a town of 1,423 people.

A paper describing the investigation was published in 2011 in Epidemiology and Infection and concluded from epidemiological evidence the outbreak resulted from cross-contamination of restaurant food from food preparation equipment or surfaces, or from an unidentified infected food handler.

Ethan Hutchins of ABC News writes that at first glance Machaela Ybarra is a typical 12-year-old going through the struggles any pre-teen faces. But like the words on the pages of her textbooks, Machaela has a story to tell, a story she only wishes was fiction.

“Whenever I understood what happened to me, I couldn’t believe it,” said Ybarra.

Machaela was just 2 when she contracted E. coli. It happened at Country Cottage restaurant in Locust Grove.

A Sunday afternoon lunch nine years ago changed Machaela’s life forever.

“It sounds scary even though I don’t remember much,” said Ybarra.

Her mother will never forget that day. Christina Ybarra still knows what her daughter ate: Fried chicken, meatloaf, green beans, mashed potatoes and gravy.

“It was a buffet so we went and got one plate, her and I both ate off of it and I didn’t get sick at all,” said Christina Ybarra.

It’s a miracle, she says, since Christina was seven months pregnant at the time with Machaela’s little sister.

Of the hundreds who got sick from E. coli, one person died. The restaurant closed, but was back in business two months later, and now years later Country Cottage remains open. Folks here in town say they still eat here, not blaming the restaurant for those dark days years ago.

No one in Locust Grove at the restaurant or even with the city likes to talk about the outbreak. It’s fair to say, it’s a bad time most people there would like to forget.

But for Machaela, there are daily reminders.

“I’m on seizure medication because I can just stare sometimes and just be unconscious,” said Ybarra.

 

UK woman critically ill with E.coli O55

A young woman from Guildford has been left in a critical condition in hospital after she contracted E.coli O55.

Alexander Brock of Get Surrey writes the victim and her sister, whose family have asked us not to name, both fell ill within hours of each other on Saturday September 16.

Public Health England (PHE) confirmed it was investigating “a confirmed case of E.coli O55 in Surrey.”

The eldest of the two sisters, aged 22, recovered after a few days of having symptoms such as diarrhoea and abdominal pain.

However, the health of the younger sister, 19, quickly deteriorated and she was rushed to Royal Surrey County Hospital in Guildford a few days after becoming ill.

She then suffered kidney failure, which developed into hemolytic uremic syndrome.

This led to several of her organs failing, including her heart. The woman has been in critical condition at St Bartholomew’s Hospital in London since September 27.

The strain has been confirmed as E.coli O55, which 31 people contracted in an outbreak in Dorset between July 2014 and November 2015.

In a statement, PHE added there had been other recorded E.coli cases in children in neighbouring areas which have been “identified as being potentially linked.”

 

South Korea McDonald’s offices raided after outbreak of HUS

The UK Daily Mail reports investigators have raided McDonald’s offices in Seoul, South Korea after allegations that several children fell ill after eating the U.S. chain.

At least five children have allegedly suffered life-threatening kidney disease as a result of an infection, after being served under-cooked hamburger patties at McDonald’s.

The raid on Wednesday saw the Seoul central district prosecutors’ office confiscated documents and evidence local news reports said.

Investigators also carried out raids at three other companies, including an ingredient supplier.

A spokeswoman at McDonald’s Seoul office confirmed the raid to Reuters, but gave no reason or further details.

In July, a consumer filed a complaint against the U.S. firm, saying her daughter was diagnosed with hemolytic uremic syndrome – also known as hamburger disease – following the consumption of a McDonald’s hamburger last year.

The parent said that the four-year-old girl had been left with irreversible kidney damage.

Complaints were also filed by parents of four more children who became sick after eating McDonald’s burgers.

Fancy food ain’t safe food: UK E. coli cheesemaker edition

Jane Bradley of the Scotsman reports an artisan cheesemaker which is embroiled in a court case with food hygiene authorities after being forced to withdraw its products amid an outbreak of E.coli which killed a three year old girl, has been named one of Britain’s top cheese producers in an industry awards ceremony.

Errington Cheeses, which is awaiting a court date against South Lanarkshire Council, which ordered the manufacturer to stop production of its raw milk cheeses amid an investigation following the outbreak of the food poisoning bug last summer, was given runner up in the Best Artisan Producer category at the Great British Cheese Awards. The Lanarkshire-based business also came runner up in the category of Best Blue Cheese for its Lanark Blue cheese, at the awards at Marcus Wareing’s Gilbert Scott restaurant in London, hosted by food website Great British Chefs.

The company is currently only making one type of cheese – made from ewe’s milk – pending its court case against South Lanarkshire Council. Owner Humphrey Errington, who launched the firm in 1985, has insisted that his cheese is not the source of the food poisoning outbreak – which saw 19 people hospitalised – and has claimed that the authorities, including Food Standards Scotland, are trying to curb production of raw milk cheese. A Just Giving campaign launched to help Errington cover its legal costs, raised £34,000 from supporters. Twitter user Artisan Food wrote: “Chefs vote of confidence @ErringtonCheese Resilience in face of harassment/bias/ignorance.” In March, an official report from Health Protection Scotland into the E.coli outbreak claimed that Errington’s Dunsyre Blue was the source of the bacteria.

Was it the bulgogi burger? HUS outbreak in S. Korea linked to McDonald’s

Bulgogi is literally “fire meat,” a Korean-style grilled or roasted dish made of thin, marinated slices of beef or pork, grilled on a barbecue or on a stove-top griddle. It is also often stir-fried in a pan in home cooking

A Bulgogi burger is the same idea.

Korea Centers for Disease Control and Prevention is conducting an epidemiological investigation into a case of 7 children and 1 adult who showed symptoms of food poisoning with vomiting and diarrhea after eating McDonald’s hamburgers on 25 Aug 2017 at a Jeonju branch in North Jeolla.

Authorities are not ruling out the possibility that the 8 individuals contracted hemolytic-uremic syndrome (HUS), widely known as “hamburger disease,” a bacterial infection that can leave the renal system severely damaged.

On 25 Aug 2017, a group of 15 adults and elementary school students from the same church in Jeonju visited McDonald’s Jeonju branch and ate bulgogi burgers together. A day later, 7 children and 1 adult experienced diarrhea and vomiting. The authorities declared an epidemiological probe into the case on Sat 2 Sep 2017.

As the case was publicized, McDonald’s Korea halted selling bulgogi burgers nationwide starting on Sat 2 Sep 2017. On its website, a notice says, “We have decided to stop selling bulgogi burgers pending the outcome of the ongoing investigation by authorities,” adding that the multinational company’s Korean branch was taking the issue seriously. It also said the company will do its best to help patients recover, though without elaborating on how or when.

The outcome of the ongoing probe is expected to be made public around Wed 6 Sep 2017.

ProMED-mail reports classic bulgogi recipes use a marinade of soy, ginger, garlic, and gochujang (Korean chili paste) to flavor and tenderize strips of meat. Because combining a marinade into ground beef would change the consistency of the hamburger, making it more of a “sloppy-joe”, usually a bulgogi inspired sauce is used on top of the burger although a Korean inspired spice combination can be added to the ground beef.

31 sickened by E. coli O55 in Dorset: Almost 4 years later, health-types’ report is public

In Dec. 2014, an outbreak of E. coli O55 was identified in Dorset, UK with at least 31 sickened. Public Health England (PHE) and local environmental health officials investigated and found nothing, other than cats were also being affected.

There was a protracted battle between local residents affected by the outbreak, and the lack of disclosure by PHE, documented in June, 2017.

But now, the health-types have gone public, in a report in the current issue of Eurosurveillance.

The first documented British outbreak of Shiga toxin-producing Escherichia coli (STEC) O55:H7 began in the county of Dorset, England, in July 2014. Since then, there have been a total of 31 cases of which 13 presented with haemolytic uraemic syndrome (HUS). The outbreak strain had Shiga toxin (Stx) subtype 2a associated with an elevated risk of HUS. This strain had not previously been isolated from humans or animals in England. The only epidemiological link was living in or having close links to two areas in Dorset.

Extensive investigations included testing of animals and household pets. Control measures included extended screening, iterative interviewing and exclusion of cases and high-risk contacts. Whole genome sequencing (WGS) confirmed that all the cases were infected with similar strains. A specific source could not be identified. The combination of epidemiological investigation and WGS indicated, however, that this outbreak was possibly caused by recurrent introductions from a local endemic zoonotic source, that a highly similar endemic reservoir appears to exist in the Republic of Ireland but has not been identified elsewhere, and that a subset of cases was associated with human-to-human transmission in a nursery.

Recurrent seasonal outbreak of an emerging serotype of shiga toxin producing Escherichia coli (STEC O55:H7 STX2A) in the South West of England, July 2014 to September 2015

Eurosurveillance, vol 22, issue 36, 07 September 2017, N McFarland, N Bundle, C Jenkins, G Godbole, A Mikhail, T Dallman, C O’Connor, N McCarthy, E O’Connell, J Treacy, G Dabke, J Mapstone, Y Landy, J Moore, R Partridge, F Jorgensen, C Willis, P Mook, C Rawlings, R Acornley, C Featherstone, S Gayle, J Edge, E McNamara, J Hawker, Balasegaram, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.36.30610,

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22872

Going public: Early disclosure of food risks for the benefit of public health

Mar.17

NEHA, Volume 79.7, Pages 8-14

Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell

http://www.neha.org/node/58904

Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public. Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough.

Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.

E. coli O91 in food and environmental samples

Shiga toxin-producing Escherichia coli (STEC) strains of the O91:H21 serotype have caused severe infections, including hemolytic-uremic syndrome. Strains of the O91 serogroup have been isolated from food, animals, and the environment worldwide but are not well characterized. We used a microarray and other molecular assays to examine 49 serogroup O91 strains (environmental, food, and clinical strains) for their virulence potential and phylogenetic relationships.

Most of the isolates were identified to be strains of the O91:H21 and O91:H14 serotypes, with a few O91:H10 strains and one O91:H9 strain being identified. None of the strains had the eae gene, which codes for the intimin adherence protein, and many did not have some of the genetic markers that are common in other STEC strains. The genetic profiles of the strains within each serotype were similar but differed greatly between strains of different serotypes.

The genetic profiles of the O91:H21 strains that we tested were identical or nearly identical to those of the clinical O91:H21 strains that have caused severe diseases. Multilocus sequence typing and clustered regularly interspaced short palindromic repeat analyses showed that the O91:H21 strains clustered within the STEC 1 clonal group but the other O91 serotype strains were phylogenetically diverse.

IMPORTANCE This study showed that food and environmental O91:H21 strains have similar genotypic profiles and Shiga toxin subtypes and are phylogenetically related to the O91:H21 strains that have caused hemolytic-uremic syndrome, suggesting that these strains may also have the potential to cause severe illness.

Shiga toxin-producing serogroup O91 Escherichia coli strains isolated from food and environmental samples

7.july.2017

Applied and Environmental Microbiology

Feng et al.

http://aem.asm.org/content/83/18/e01231-17.abstract?etoc

 

8 sick with E. coli from Colorado fair

At least eight people are sick with Shiga toxin-producing E. coli after spending time at the Mesa County Fair, which ran from July 25-29 in Grand Junction.

The Post Independent reports Mesa County Public Health officials have been working with representatives from the fair and those who became sick to find the source of the illness.

Shiga toxin-producing E. coli is common in cattle, sheep and goats. It can be contracted through direct contact with these animals or contact with things in close proximity to the animals that may have been cross contaminated.

Mesa County Public Health officials have also been in close communication with child-care providers and health-care providers to determine the magnitude of the outbreak, and to prevent further spread of the illness.

People can become sick between two and 10 days after being infected with Shiga toxin-producing E. coli.