Father of Tennessee E. coli victim ‘Nutritionist recommended raw milk’

James Zenker never imagined his young son would battle for his life at just two-years-old.

“It’s affected his kidneys; they shut down,” Zenker said. “It affected his intestines; he couldn’t digest any of his food and its affected his brain — he has a substantial brain injury.”

His son William got E. coli after drinking raw milk linked to French Broad Farm. Zenker said a nutritionist recommended the raw milk to help William fight allergies.

“He’s not able to speak and not able to do the same activities as before he was ill,” Zenker said.

The vast majority of nutritionists, dieticians and physicians I encounter – and it’s frequent with my brain status and trips to emergency – know shit about microbial food safety.

The odd ones do, and they are food safety heros.

But when hospitals continue to serve raw sprouts to immunocompromised people, when they won’t be sold at WalMart in the U.S., I gotta question their food safety credibility.

To reiterate, I stared the Food Safety Network (the original FSN) over 25 years ago 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).

Of the 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk and contact with ruminants from French Broad Farm, William is the last one left in the hospital. His father said East Tennessee Children’s Hospital saved his son’s life.

The Knox County Health Department said an investigation concluded that the outbreak was caused by two separate sources, the exposure to farm animals and exposure to raw milk.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan.

William has had several blood transfusions during his recovery and still needs more. His home church Temple Baptist in Powell (no relation – dp) hosted a replacement drive Tuesday for William and the community.

“It’s so encouraging to see people take time out of their busy day and donate from their own life to help Will and others affected by E. coli,” Zenker said.

If you would like more information about future blood drives click here: 
Blood drives scheduled to help children infected with E. coli.

4 confirmed sick with Shiga-toxin E. coli associated with I Love Sushi and Sodexo’s Café Mario in Washington state

Seattle’s King County public health is investigating an outbreak of Shiga toxin-producing E. coli (STEC) associated with I Love Sushi and Sodexo’s Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. At this time, the source of the illnesses has not been identified.

Since July 2, 2018, we have learned that four people (two King and two Snohomish County residents) have tested positive for STEC. All four consumed food from Café Mario in King County and work at the Nintendo of America campus in Redmond. Symptoms included abdominal cramps and bloody diarrhea. Illness onsets occurred during June 25–28, 2018. The four ill people consumed food from Café Mario on multiple days during June 18–22, 2018; one ill person also ate at I Love Sushi on June 19 and June 26, 2018, which is a food establishment that operates out of Café Mario once a week.\

On July 3, 2018, Public Health – Seattle & King County Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.

At Café Mario, potential risk factors were identified and corrective actions discussed with Café Mario’s management, including inadequate hand washing practices and improper cold holding temperatures of food. At I Love Sushi, potential risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on July 4 due to it being a holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Both restaurants will remain closed until approved to reopen by Public Health. Both food establishments will be required to complete a thorough cleaning and disinfection before reopening. Remaining food products are being held and environmental swabs were collected for laboratory testing. We are currently investigating whether any employees of these restaurants had a recent diarrheal illness. Investigators also reviewed with Café Mario’s management the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

Raw isn’t rad, it’s risky: Radagast Pet Food, Inc. voluntarily recalls three lots of rad cat raw diet free-range chicken recipe and one lot of pasture-raised venison recipe because of possible health risk

Radagast Pet Food, Inc. of Portland, OR is recalling three lots of Rad Cat Raw Diet Free-Range Chicken Recipe because testing results indicate they have the potential to be contaminated with Listeria monocytogenes.

The Company is also recalling one lot of Rad Cat Raw Diet Pasture-Raised Venison Recipe because testing results indicate it has the potential to be contaminated with Shiga Toxin producing E. coli O121.  This recall is being conducted out of an abundance of caution.  Due to Radagast Pet Food’s commitment to food safety and quality, The Company is conducting this voluntary recall.

Uh-huh.

Petting zoos as a source of shiga-toxin producing E. coli in Austria

Hey Gonzo, they cited us.

Too bad your soccer teams suck, and I don’t care.

But I do care when others cite the gumshoe work we put into our research activities.

And I especially care when every year, I tell our public school or the local shopping mall that petting farms around kids can lead to heartache.

They call me crazy, just like they continue to top salads with raw alfalfa sprouts at Brisbane Private Hospital, despite my protestations.

I do what I can.

These others are microbiological idiots.

There, I’m done.

Despite their general low incidence, Shiga toxin-producing Escherichia (E.) coli (STEC) infections are considered an important public health issue due to the severity of illness that can develop, particularly in young children.

 We report on two Austrian petting zoos, one in Tyrol (2015) and one in Vorarlberg (2016), which were identified as highly likely infection sources of STEC infections. The petting zoo related cases involved a case of hemolytic uremic syndrome (HUS) due to STEC O157:HNM in 2015 and an outbreak of STEC O157:H7 infections affecting five young children and two adults in 2016. The HUS case accounted for 2.8% of the 36 STEC O157:HNM/H7 infections notified in Austria in 2015 (5,9% of 17 HUS cases). The seven cases described for 2016 accounted for 4.0% of the 177 human STEC infections documented for Austria in 2016, and for 19% of the 36 STEC O157:HNM/H7 infections notified that year.

The evaluation of the STEC infections described here clearly underlines the potential of sequence-based typing methods to offer suitable resolutions for public health applications. Furthermore, we give a state-of-the-art mini-review on the risks of petting zoos concerning exposure to the zoonotic hazard STEC and on proper measures of risk-prevention.

A table of petting zoo outbreaks is available at http://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.xlsx

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos.

Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact.

Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Petting zoos as sources of shiga toxin-producing Escherichia coli (STEC) infections

27.june.18

International Journal of Medical Microbiology, DOI: 10.1016/j.ijmm.2018.06.008 

Sabine Schlager, Sarah Lepuschitz, Werner Ruppitsch, Oksana Ableitner, Ariane Pietzka, Sabine Neubauer, Anna Stöger, Heimo Lassnig, Claudia Mikula, Burkhard Springer, Franz Allerberger
http://www.x-mol.com/paper/721663

Doesn’t matter if your kid has E. coli, US privileged want playground taken down

Tim Sanders claims his family’s neighborhood association wants him to take down the playground he installed for his daughter, who is fighting kidney failure.

“It’s important to have this playground when my daughter gets home from the hospital, because it’s hope,” Sanders said. E. coli led to kidney failure for 6-year-old Ashlin three years ago.

The Sanders family moved to Oconomowoc to be closer to family and Ashlin’s doctors in Madison.

She had a kidney transplant on Father’s Day and is expected to return home soon.

“Today they pulled out a pic-line in her chest where they administer fluids and things of that nature,” Sanders said.

Sanders says the former neighborhood president approved the playground and trees. An email says “permission was granted for the rainbow playground set.” It goes on to say trees were also allowed.

“We are not breaking codes. Everything was permitted,” Sanders said.

Sanders said the new HOA board wants him to take everything down “in order to obtain and maintain harmony in appearance,” according to a letter.

Suburbia, I smile and wave.

Beware the canal waters (I’m looking at you Holland Marsh, Ontario, that’s in Canada): Canal irrigation water likely source of E. coli O157 outbreak linked to romaine lettuce 5 dead, 218 sick

The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local partners, are investigating a multistate outbreak of E. coli O157:H7 illnesses linked to romaine lettuce from the Yuma, Arizona, growing region.

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak.

Samples have been collected from environmental sources in the region, including water, soil, and cow manure. Evaluation of these samples is ongoing.

To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of Shiga-toxin producing E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.

Analysis of additional samples is still ongoing, and any new matches to the outbreak strain will be communicated publicly and with industry in the region.

Identification of the outbreak strain in the environment should prove valuable in our analysis of potential routes of contamination, and we are continuing our investigation in an effort to learn more about how the outbreak strain could have entered the water and ways that this water could have come into contact with and contaminated romaine lettuce in the region.

As of June 27, the CDC reports that 218 people in 36 states and Canada have become ill. These people reported becoming ill in the time period of March 13, 2018 to June 6, 2018. There have been 96 hospitalizations and five deaths.

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, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak. To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.

The FDA is continuing to investigate this outbreak and will share more information as it becomes available.

“More work needs to be done to determine just how and why this strain of E. coli O157:H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms,” said Dr. Scott Gottlieb, commissioner of the U.S. Food and Drug Administration, in a statement.

Yes E. coli is natural: Texas Natural Meats recalls frozen raw ground beef products for E. coli O103

Texas Natural Meats, a Lott, Texas establishment, is recalling approximately 489 pounds of frozen raw, ground beef products that may be contaminated with Shiga toxin-producing E. coli (STEC) O103, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The frozen raw, ground beef items were produced on Aug. 8, 2017.  The following products are subject to recall:  [View Label (PDF only)]
1.00-lb. bags of “Green Field Farms Rogers Texas Ground Beef.”  The bags display the “PRODUCTION DATE 08.08.2017” and also display the “EXPIRATION DATE 08.08.2020.”  The bags are labeled “COOK USE ONLY” with the instruction “DO NOT refreeze after defrosting.”  
The products subject to recall bear establishment number “EST. 34449” inside the USDA mark of inspection. These items were shipped to a retailer who sold the product at a farmer’s market in Roger, Texas.
The problem was discovered on June 19, 2018 by FSIS during routine inspection activities. The product was tested by the establishment and found to be positive for STEC O103 under their sampling program. …

The only way to confirm that ground beef is cooked to a temperature high enough to kill harmful bacteria is to use a food thermometer that measures internal temperature, http://1.usa.gov/1cDxcDQ.

Raw is risky: ‘Not aware this was remotely possible’ Father of toddlers critically sickened by E. coli linked to raw milk in Tenn.

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).

There are now at least 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk from French Broad Farm.

According to Kristi L Nelson of Knox News, Jordan and Stephanie Schiding wanted to give their children every health advantage.

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.

Shiga-toxin E. coli in dairy cattle near Brisbane

Sure it’s almost 20 years old. But a reminder.

Over a 12-month period, 588 cattle faecal samples and 147 farm environmental samples from three dairy farms in southeast Queensland were examined for the presence of Shiga-toxigenic Escherichia coli (STEC). Samples were screened for Shiga toxin gene (stx) using PCR.

Samples positive for stx were filtered onto hydrophobic grid membrane filters and STEC identified and isolated using colony hybridisation with a stx-specific DNA probe. Serotyping was performed to identify serogroups commonly associated with human infection or enterohaemorrhagic Escherichia coli (EHEC). Shiga-toxigenic Escherichia coli were isolated from 16.7% of cattle faecal samples and 4.1% of environmental samples. Of cattle STEC isolates, 10.2% serotyped as E. coli O26:H11 and 11.2% serotyped as E. coli O157:H7, and the E. coli O26:H11 and E. coli O157:H7 prevalences in the cattle samples were 1.7 and 1.9%, respectively.

Prevalences for STEC and EHEC in dairy cattle faeces were similar to those derived in surveys within the northern and southern hemispheres. Calves at weaning were identified as the cattle group most likely to be shedding STEC, E. coli O26 or E. coli O157. In concurrence with previous studies, it appears that cattle, and in particular 1-14-week-old weanling calves, are the primary reservoir for STEC and EHEC on the dairy farm.

A longitudinal study of Shiga-toxigenic Escherichia coli (STEC) prevalence in three Australian diary herds

Veterinary microbiology, Volume 71, Issue 1-2, Pages 125-37, Jan 1, 2000

https://espace.library.uq.edu.au/view/UQ:a5186cb

Raw is risky: Netherlands study finds STEC and Campylobacter in dairy goats and dairy sheep, shows importance of pasteurization

Researchers with the Dutch National Institute for Public Health and the Environment (RIVM) and the Dutch Food and Consumer Product Safety Authority (NVWA) shows that two types of bacteria that can cause diarrhea in humans ( STEC and Campylobacter) are common in dairy goat farms and dairy sheep farms, according to a RIVM press release (computer translated).

According to Outbreak News Today, in the animal study, 181 dairy goat farms and 24 dairy sheep farms were examined. STEC (Shiga-toxin-producing E. coli) and Campylobacter was found on most. STEC appeared on virtually all the farms studied. Campylobacter has been demonstrated in one out of three goat farms (33 percent) and almost all sheep farms (96 percent). These bacteria have found much less among cattle farmers and family members.

Listeria was less common, at about 9 percent of the goat and about 17 percent of the sheep farms. The bacteria was not found in the people studied. People run the risk of becoming infected with the listeria bacteria by eating raw milk soft cheese. The study also looked at Salmonella and ESBL-producing bacteria. These were not very common on the farms surveyed.

The results show that pasteurization of milk and hygiene after visiting a dairy goat farm or dairy sheep farm is important to prevent disease.

The bacteria found are in the intestines of the animals and thus enter the manure. A small amount of manure can contaminate raw milk or raw milk cheese. Contamination can be prevented by drinking only pasteurized milk or using it in other foods. In addition, people at a farm can become infected if they have contact with the animals or their environment. Visitors can reduce the risk of illness by washing their hands after contact with the animals or their environment.

In unrelated but related news, Brandon Macz of the Monroe Monitor reports that St. John Creamery in Monroe, Washington, announced on Thursday it is voluntarily recalling raw goat milk that may be contaminated with Escherichia coli (E.coli) bacteria.

A June 14 news release states the recall was initiated after “the presence of toxin-producing E.coli in retail raw goal milk dated 6/17” was discovered during routine sampling by the Washington State Department of Agriculture.

Included in the recall are half-gallon and one-pint containers of raw goat milk marked best by June 17-21.