The pain of E. coli O157: Walkerton survivor ends his life

On Sunday, May 21, 2000, at 1:30 p.m., the Bruce Grey Owen Sound Health Unit in Ontario, Canada, posted a notice to hospitals and physicians on their web site to make them aware of a boil water advisory and that a suspected agent in the increase of diarrheal cases was E. coli O157:H7.

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.

Sounds like Walkerton: More than 750,000 in NZ exposed to potentially unsafe drinking water

Same old, same old.

Tracy Watkins of Stuff writes complacency, inept officials – a Government inquiry paints a frightening picture of the state of New Zealand’s drinking water, with at least 750,000 of New Zealanders drinking from supplies that are “not demonstrably safe” – a figure described as likely to be a “significant underestimate.”

The inquiry was sparked by the 2016 Havelock North gastro outbreak, which has now been linked to four deaths, and calls for a major overhaul of water supplies, including mandatory treatment.

The Government has now written urgently to all mayors and district health boards asking to check the water they are supplying meets current standards after the inquiry revealed 20 per cent of water supplies were not up to standard.

That 20 per cent affects 759,000 people, of which 92,000 are at risk of bacterial infection, 681,000 of protozoal infection and 59,000 at risk from the long term effects of exposure to chemicals through their water supply.

But that figure was likely to understate the problem, as it did not include more than 600,000 people who drink water from self-suppliers or temporary suppliers, or tourists to places like Punakaiki on the West Coast, which is under a permanent “boil water” notice.

The inquiry found that complacency about the state of New Zealand’s drinking water was common, yet the evidence showed that in many cases it was safer to drink tap water overseas than here.

But its most damning findings related to the Ministry of Health, which it described as inept and negligent in its oversight of a system in which non-compliance with safe standards was high.

The risks for contamination of the water supplies were detailed by the inquiry including damaged pipes, a huge number of private and unknown bores, and the close proximity of sewerage to drinking water assets, a factor that caused surprise among overseas experts.

The second part of the inquiry looked at broader water quality issues.

It found that lessons from Havelock North appeared not to have been learned – compliance figures in the 2016-17 period were still “alarmingly low” and “do not appear to reflect any increased vigilance by suppliers in the aftermath of [that] outbreak”.

“The inquiry found the falling compliance levels with the bacteriological and chemical standards particularly concerning. The decrease in compliance with the bacteriological standards results from an increased number of transgressions, an increased number of supplies with ineffective, delayed or unknown remedial action following transgressions, and an increased number of supplies with inadequate monitoring.

“Twenty-seven supplies failed entirely to take any remedial action after a transgression. In the aftermath of the bacteriological outbreak in Havelock North, these failures to respond effectively to transgressions or to monitor adequately are surprising and unacceptable.”

It’s only water safety but I like it: Chlorine is a friend, multiple failings in NZ campy-in-water outbreak that sickened 5500 and killed 3

On Sunday, May 21, 2000, at 1:30 p.m., the Bruce Grey Owen Sound Health Unit in Ontario (that’s in Canada) posted a notice to hospitals and physicians on their web site to make them aware of a boil water advisory for Walkerton, and that a suspected agent in the increase of diarrheal cases was E. coli O157:H7.

Walkerton Water Tower

Not a lot of people were using RSS feeds, and I don’t know if the health unit web site had must-visit status in 2000. But Walkerton, a town of 5,000, was already rife with rumors that something was making residents sick, and many suspected

the water supply. The first public announcement was also the Sunday of the Victoria Day or May 24 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 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.

The E. coli was thought to originate on a farm owned by a veterinarian and his family at the edge of town, a cow-calf operation that was the poster farm for Environmental Farm Plans. Heavy rains washed cattle manure into a long discarded well-head which was apparently still connected to the municipal system. The brothers in charge of the municipal water system for Walkerton were found to add chlorine based on smell rather than something like test strips, and were criminally convicted.

Ultimately, 2,300 people were sickened and seven died. All the gory details and mistakes and steps for improvement were outlined in the report of the Walkerton inquiry, available at http://www.attorneygeneral.jus.gov.on.ca/english/about/pubs/walkerton/.

In Aug. 2016, some 5,500 people in a New Zealand town of 14,000 were sickened with Campylobacter linked to the water supply and three died.

Didn’t chlorinate.

Just like Walkerton, where a drunk employee was found to adjust chlorine levels based on smell, Hawke’s Bay, New Zealand also had some lax procedures.

A panel looking into last year’s outbreak made the first stage of its findings public at Hastings District Court on Wednesday.

It identified several failings by the Hastings District Council, Hawke’s Bay Regional Council and drinking water assessors.

The outbreak in August last year made some 5500 of the town’s 14,000 residents ill with campylobacteriosis. It put 45 in hospital and was linked to three deaths.

The contamination was later found to have entered the town’s drinking water bores. Panel chair Lyn Stevens QC said the outbreak “shook public confidence” in this fundamental service of providing safe drinking water and it raised “serious questions” about the safety and security of New Zealand’s drinking water.

The district and regional councils did not directly cause the outbreak, but their “dysfunctional relationship” and their lack of co-operation resulted in a number of missed opportunities that may have prevented it from occurring.

Knowledge and awareness of aquifer and contamination risks near Brookvale Rd fell below “required standards” and it failed to take effective steps to assess the risk, including the management of the many uncapped or disused bores in the vicinity, and the monitoring of the district council’s resource consent to take the water.

Walkerton redux.

The district council “failed to embrace or implement the high standard of care required of a public drinking-water supplier,” particularly in light of a similar outbreak in the district in 1998, from which it appeared to have learned nothing.

The council’s mid-level managers especially failed, Stevens said. They delegated tasks but did not adequately supervise or ensure implementation of requirements. This led to unacceptable delays in developing the council’s water safety plan which would have been “fundamental in addressing the risks of the outbreak.”

That’s a polite way of saying, people care more about their retirement than others, and often fuck up.

Drinking Water Assessors were also at fault, with Stevens finding they were “too hands off” in applying the drinking water standards.

Sounds like food safety auditors.

They should have been stricter in requiring the district council to comply with responsibilities with its water safety plan, he said.

“They failed to address the [council] sufficiently about the lack of risk assessment and the link between the bores and the nearby pond.”

Nicki Harper of Hawkes Bay Today wrote a high number of positive E. coli readings in the Havelock North and Hastings water supplies over the years, dating back to a 1998 water contamination event similar to last year’s Havelock North campylobacter outbreak, caused bureau-types to do, nothing.

It was confirmed yesterday that the most likely source of the contamination was sheep feces that ran off a paddock following heavy rain on August 5 and 6 into the Mangateretere pond near Brookvale Bore 1.

Water from the pond then entered into the aquifer and flowed across to Bore 1 where it was pumped into the reticulation, Mr Stevens said.

The son of an elderly woman who died shortly after contracting Campylobacter during the Havelock North gastro crisis says she had “good innings” despite her death.

Jean Sparksman, 89, was one of three elderly people whose deaths were linked to the outbreak and had been living in the Mary Doyle retirement village at the time of the crisis.

Speaking from the Whangaparaoa Peninsula in Auckland yesterday, Mrs Sparksman’s son, Keith, said her death shouldn’t have happened the way it did.

“She contracted this bug but there were no steps taken to help. That’s probably why she died in the first place.”

The failures are all too familiar: space shuttle Challenger, Bhopal, BP in the Gulf, Listeria in Maple Leaf cold cuts, Walkerton: the tests said things were not good. But a human condition kicked in: Nothing bad happened yesterday so there is a greater chance of nothing bad happening today.

All these people fucked up, and others got sick.

Yet government, industry and academia will trod along, piling up retirement savings, until the next shitfest comes along.

So just watch this stupid Stones video with Keith out of his mind.

Nothing bad will really happen.

Jim, maple syrup and anxiety

My friend Jim calms me down almost as much as my puppy, Ted.

I’ve known Jim since about 1996. We collaborated to shut down emotion-not-evidence-based rules on genetically engineered foods in Canada, and he has always brought a practical sense of what a farmer goes through to make a buck.

He also used to terrorize my then young girls by telling them how he shot stray cats left at his dairy farm, because cats carry toxoplasmosis, and it impacted his money-making side.

We were grateful for the three cats from Walkerton.

Jim and Donna’s Walkerton farm is across the road from the source of the E. coli O157 outbreak in 2000 that killed seven and sickened thousands, and I still get chills when Jim recalls another chopper going over the farm, probably another dead person.

Media outlets were broadcasting live from Walkerton, like it was a dam about to collapse.

Or as I said at the time (Jim had to remind me), media wanted cows, manure, river, and townhouses all in one photo.

I spoke with Jim the other day, primarily to balance myself against the most moderate person I know.

Jim has gotten into the maple syrup biz in Ontario (that’s in Canada), he’s got grandkids, like I do, and a seemingly stable situation, running his B&B with Donna, substitute teaching, and new farming ventures.

I admire that.

 

Chlorine works, focus on public health: NZ campy-in-water inquiry wraps up with 16 draft recommendations

I served on one of those water inquires, back in Canada after the 2000 outbreak of E. coli O157:H7 that killed seven and sickened 2,300 residents in Walkerton, Ontario, Canada, a town of about 5,000.

Walkerton Water Tower

Walkerton Water Tower

It was decent work, but what surprised me most was the actions taken by various social actors in the aftermath of the outbreak: protect themselves, public health be damned.

The number of higher-ups who wanted to meet with me to express why they did what they did, in a private chat, had absolutely no influence on my conclusions, and was sorta repulsive.

Maybe I was naïve.

Still am (I’m the full professor from Kansas State University who got fired for bad attendance with  — nothing, except my family, and that makes a good Hollywood tale).

In August, 2016, about 5,530 or 39 per cent of Havelock North, New Zealand’s population reported gastroenteritis from Camplylobacter in the water supply, 1,072 of those confirmed cases.

Nicki Harper of the New Zealand Herald reports a government inquiry into contamination of a Hawke’s Bay water supply has made 16 draft recommendations.

The inquiry into the Hastings District Council’s request to re-activate a Brookvale Road bore to augment Havelock North’s peak summer water supply retired today with a set of draft recommendations.

Before wrapping up proceedings, inquiry panel chair Lyn Stevens QC thanked the Hawke’s Bay Regional Council (HBRC) and Hastings District Council (HDC) for the efforts they made that resulted in the regional council dropping its prosecution of the Hastings council.

This agreement came after the first day of hearings on Monday, when pressure was applied by the panel to re-consider the charges.

After extensive questioning on Monday, the regional council agreed to withdraw the charges relating to breaches of the Hastings District Council’s resource consent conditions for taking water from Brookvale bores 1 and 2 – opting to instead consider issuing infringement notices.

Mr Stevens said, “The panel has noted a level of defensiveness in some of the evidence filed to date.

“I’m not being critical of any organisation or witness but wish to emphasise the overriding interest with this inquiry is the public interest, while we look to fulfil the terms of reference to determine the possible causes of contamination.”

A set of 16 draft recommendations were issued and Mr Stevens said the joint working group would be an important conduit to implement them.

The aim was to have the bore re-opened at the end of January before Havelock North water use reached peak demand in February.

Among the recommendations was a directive that the working group – comprising representation from HDC, HBRC, the DHB and drinking water assessors – meet regularly and share information of any potential drinking water safety risk.

For at least 12 months from December 12, the bore would receive cartridge filtration, UV and chlorine treatment, and a regime of regular montioring be implemented.

It was also recommended that the HDC draft an Emergency Response Plan before Bore 3 was brought on line.

Hundreds sickened with Campylobacter in NZ town’s water supply

At least 200 people have been stricken by what appears to be Campylobacter in Havelock North, New Zealand, and residents say Hastings District Council knew the town’s water supply was contaminated hours before they told people to stop drinking it.

Havelock North, New ZealandCassandra Heke said she was angry she heard about the contaminated water from her friends before the council made the issue public.

“The council knew about it on Friday morning but didn’t tell anyone.”

She had chosen to keep her child home for the day, but had called in for some voluntary work at Havelock North Primary School. “I think it’s dreadful, especially the elderly, it’s hurt the community.”

She commended the school’s ability to communicate with them as parents and update them as the saga worsened.

The outbreak has been linked to an underground bore which tested positive for E. coli.

Hastings District Council was unable to be reached for comment this morning.

Colleen Pascoe had just done the school run for her grandchildren while their mother lay sick at home.

“It’s disgusting the council didn’t tell us.”

She said her daughter, not knowing the sickness was waterborne, had focussed on keeping her fluids up drinking lots of water. Catherine Wedd, who had just dropped her child off at school, said she was angry about the lack of communication.

Hastings District Council issued a full page apology this morning for the contaminated water.

Hawke’s Bay Hospital confirmed two older people were critically ill in the intensive care unit. A death at a Havelock North rest home may also be linked to the illness.

Hawke’s Bay District Health Board today said 183 people went to their local doctor and 11 people went to hospital for treatment on Sunday.

Today a leading researcher of infectious diseases said it was likely faecal run-off from sheep and cattle was the cause of this latest outbreak.

walkerton“Groundwater is much less likely to be contaminated than surface water, but if it is campylobacter, based on previous experiences, it is most likely to have come from cattle and sheep and run-off of effluent or faeces,” said Massey University Infectious Diseases Research Centre director professor Nigel French.

He said the outbreak demonstrated even secure groundwater could become contaminated and testing and treatment was advised to ensure the best public health outcomes particularly if there had been a high-risk event such as heavy rainfall.

Hawke’s Bay District Health Board medical officer of health Dr Nicholas Jones said gastroenteritis affected older and younger people much more severely and older people needed to seek medical help early on if they weren’t getting better or couldn’t keep fluids down. The same applied to young children.

He said they encouraged the community to keep an eye out for older people living alone.

“The boil notice will remain until we are confident there is no other bug resistant to chlorination in the water, which is expected to take several days,” he said.

Hands needed to be washed thoroughly by using plenty of soap, cleaning under fingernails, rinsing hands well and drying on a clean towel: before and after preparing food, after going to the toilet or changing a baby’s nappy, after caring for sick people and after touching animals.

What water are the residents supposed to use?

NC petting zoo, weather blamed for deadly E. coli outbreak at fair

State and county health officials have concluded the petting zoo at the Cleveland Co. Fair is the cause of E. coli outbreak across the North Carolina region in late September.

WBTV reports that “N.C. Department of Health and Human Services have determined that the petting zoo at the Cleveland County Fair was the initial source of exposure to E. coli,” the statement released on Friday said.

More than 100 people were infected from the bacteria and a 2-year-old died as a result of the infection that spread into neighboring counties in the early weeks of October. 

According to test results, weather may be one of the factors that played a role in widespread contamination of the area surrounding the petting zoo exhibit.

Two specific strains of E. coli on cases from the outbreak were matched to environmental samples taken from fair grounds. Heavy rains during the run of the fair, from 9/29 to 10/8 resulted in runoff that may have spread contamination from petting zoo into nearby areas.

So why didn’t anyone predict the potential problem when the rain was coming down?

Germany’s E. coli nightmare: Too often, politics trumps safety

The Aug/Sept. issue of Food Quality magazine contains a package of articles about lessons learned from this year’s E. coli O104 outbreak in Germany linked to raw sprouts grown from seeds produced in Egypt.

My own contribution was an attempt, at the editor’s request, to capture the uncertainty and vagaries that characterize outbreaks of food- or waterborne illness.

My friend Jim called on a Friday afternoon. Jim is a dairy farmer located on the edge of a town in Ontario, Canada, called Walkerton, and he said a lot of people were getting sick. The community knew there was a problem several days before health types went public.

On Sunday, May 21, 2000, at 1:30 p.m., the Grey Bruce Health Unit in Owen Sound, Ontario posted a notice on its website to hospitals and physicians to make them aware of a boil water advisory and inform them that a suspected agent in the increase of diarrheal cases was E. coli O157:H7.

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 because the first public announcement was also the Sunday of the Victoria Day long weekend, it 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 a.m. on Tuesday, May 23, the Walkerton hospital held a media conference jointly with the health unit to inform the public of the outbreak, to make people aware of the potential complications of the E. coli O157:H7 infection, and to warn them 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.

These public outreach efforts were neither speedy nor sufficient. Ultimately, 2,300 people were sickened and seven died—in a town of 5,000. All the gory details and mistakes and steps for improvement were outlined in the report of the Walkerton inquiry
(www.attorneygeneral.jus.gov.on.ca/english/about/pubs/walkerton).

The E. coli O157:H7 was thought to have originated on a farm owned by a veterinarian and his family at the edge of town, someone my friend Jim knew well, a cow-calf operation that was the poster farm for Environmental Farm Plans. Heavy rains washed cattle manure into a long abandoned well-head, which was apparently still connected to the municipal system. The brothers in charge of the municipal water system for Walkerton, who were found to have been adding chlorine based on smell rather than something minimally scientific like test strips, were criminally convicted.

But the government-mandated reports don’t capture the day-to-day drama and stress that people like my friend experienced. Jim and his family knew many of the sick and dead. This was a small community. News organizations from around the province descended on Walkerton for weeks. They had their own helicopters, but the worst was the medical helicopters flying patients with hemolytic uremic syndrome to the hospital in London. Every time Jim saw one of those, he wondered if it was someone he knew.

I’m not an epidemiologist, but as a scientist and journalist with 20 years of contacts, I usually find out when something is going on in the world of foodborne outbreaks.

The uncertainties in any outbreak are enormous, and the pressures to get it right when going public are tremendous.

The public health folks in Walkerton may have been slow by a couple of days while piecing together the puzzle; what happened in Germany this summer in the sprout-related outbreak of E. coli O104, a relative of O157, was a travesty.
Worse, bureaucrats seemed more concerned about the fate of farmers than that of citizens. By at least one count, 53 have died, and more than 4,200 have been sickened.

Raw sprouts are one of the few foods I won’t eat, and as many epidemiologists have pointed out, sprouts top the list of any investigation involving foodborne illness.

We at bites count at least 55 outbreaks related to raw sprouts beginning in the U.K. in 1988, sickening thousands.

The first consumer warning about sprouts was issued by the U.S. Centers for Disease Control and Prevention (CDC) in 1997. By July 9, 1999, the U.S. Food and Drug Administration (FDA) had advised all Americans to be aware of the risks associated with eating raw sprouts. Consumers were informed that the best way to control the risk was to not eat raw sprouts. The FDA stated that it would monitor the situation and take any further actions required to protect consumers.

At the time, several Canadian media accounts depicted the U.S. response as panic, quoting Health Canada officials as saying that, while perhaps some were at risk, sprouts were generally a low-risk product.

That attitude changed in late 2005, as I was flying back to reunite with a girl I had met in Kansas and 750 people in Ontario became sick from eating raw bean sprouts.

Unfortunately, what food safety types think passes for common knowledge—don’t eat raw sprouts—barely registers as public knowledge. It’s hard to compete against food porn.

Sprouts present a special food safety challenge because the way they are grown, with high moisture at high temperature, also happens to be an ideal environment for bacterial growth.

Because of continued outbreaks, the sprout industry, regulatory agencies, and the academic community in the U.S. pooled their efforts in the late 1990s to improve the safety of the product, implementing good manufacturing practices, establishing guidelines for safe sprout production, and beginning chemical disinfection of seeds prior to sprouting.

But are such guidelines being followed? And is anyone checking?

Doubtful.

This was demonstrated by two sprout-related outbreaks earlier this year linked to sandwiches served by Jimmy John’s, a chain of gourmet sandwich shops based in Champaign, Ill.

Sprouts served on Jimmy John’s sandwiches supplied by a farm called Tiny Greens sickened 140 people with Salmonella, primarily in Indiana. In January, Jimmy John’s owner Jimmy John Liautaud said his restaurants would replace alfalfa sprouts, effective immediately, with allegedly easier-to-clean clover sprouts. This was one week after a separate outbreak of Salmonella sickened eight people in the U.S. Northwest who had eaten at a Jimmy John’s that used clover sprouts.

If the head of a national franchise is that clueless about food safety, can we really expect more from others?

Sprout grower Bill Bagby, who owns Tiny Greens Sprout Farm, said in the context of the German outbreak that, for many like him, the nutritional benefits outweigh the risk:

“Sprouts are kind of a magical thing. That’s why I would advise people to only buy sprouts from someone who has a (food safety) program in place (that includes outside auditors). We did not have (independent auditors) for about one year, and that was the time the problems happened. The FDA determined that unsanitary conditions could have been a potential source of cross-contamination and so we have made a lot of changes since then.”

Independent auditors? Like the ones who said everything was cool, everything was OK, at Peanut Corporation of America (nine dead, 700 sick in 2008-09) and Wright County Egg (2,000 sick in 2010)?

Like the Walkerton E. coli O157:H7 outbreak in 2000, too many are using the filters of their politics to advance their own causes and saying too many dumb things in light of the sprout outbreak of 2011.

It’s really about biology and paying attention to food safety basics—no matter how much that interferes with personal politics.

Walkerton 11 years later; E. coli O157:H7 in a municipal water supply

On Sunday, May 21, 2000, at 1:30 p.m., the Bruce Grey Owen Sound Health Unit in Ontario, Canada, posted a notice to hospitals and physicians on their web site to make them aware of a boil water advisory for Walkerton, and that a suspected agent in the increase of diarrheal cases was E. coli O157:H7.

Not a lot of people were using RSS feeds, and I don’t know if the health unit web site had must-visit status in 2000. But Walkerton, a town of 5,000, was already rife with rumors that something was making residents sick, and many suspected the water supply. The first public announcement was also the Sunday of the Victoria Day long weekend (which happens this weekend in Canada) 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 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.

The E. coli was thought to originate on a farm owned by a veterinarian and his family at the edge of town, a cow-calf operation that was the poster farm for Environmental Farm Plans. Heavy rains washed cattle manure into a long discarded well-head which was apparently still connected to the municipal system. The brothers in charge of the municipal water system for Walkerton were found to add chlorine based on smell rather than something like test strips, and were criminally convicted.

Ultimately, 2,300 people were sickened and seven died. All the gory details and mistakes and steps for improvement were outlined in the report of the Walkerton inquiry, available at http://www.attorneygeneral.jus.gov.on.ca/english/about/pubs/walkerton/.

Today, as the 11th anniversary of the Walkerton outbreak approaches, Canadian Press reports the Ontario government has paid out more than $72 million in compensation to victims of Walkerton’s tainted water tragedy and their families.

Ontario Attorney General Chris Bentley says over 99 per cent of the more than 10,000 compensation claims have been resolved, and the remainder are supposed to be resolved by the end of this year.

A total of 10,189 claims were made, with 9,275 qualifying for compensation.
Bentley says while nothing will ever make up for the tragedy experienced in Walkerton, he hopes the compensation plan has helped all those who suffered continue along the path to healing.

Among the 121 recommendations on an inquiry aimed at preventing a recurrence of the public-health disaster were ones geared toward mandatory training and certification for water-system operators.

10 years after E. coli O157:H7 in Walkerton, Ontario water

On Sunday, May 21, 2000, at 1:30 p.m., the Bruce Grey Owen Sound Health Unit in Ontario, Canada, posted a notice to hospitals and physicians on their web site to make them aware of a boil water advisory and that a suspected agent in the increase of diarrheal cases was E. coli O157:H7.

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 were sickened and seven died. All the gory details and mistakes and steps for improvement were outlined in the report of the Walkerton inquiry.