30 sick: Salmonella linked to tuna

Marissa Harshman of the Spokesman-Review writes Clark County Public Health officials in Washington state were among the first to identify a nationwide salmonella outbreak linked to tuna loins and tuna steaks.

Locally, the case began with five reports of illness to Clark County Public Health in late August. Since then, the outbreak has grown to 30 cases in seven states and led to a recall of a California-based company’s tuna products.

The outbreak includes six confirmed and two presumed cases in Clark County, said Dr. Alan Melnick, Clark County health officer.

The investigation is continuing at the national level by the Food and Drug Administration and the Centers for Disease Control and Prevention.

“The fact that little, old Clark County was able to be one of the first people to pick up on this ongoing outbreak really highlights the strengths of this system we’ve developed,” said Madison Riethman, an applied epidemiology fellow at Clark County Public Health, during a county health board meeting Wednesday.

And what did little old Clark County do to publicize the outbreak, go public to try and prevent others getting sick.

The first rule of public health is, as encapsulated by Riethman, make public health look good.

Local health officials first learned of a possible outbreak on Aug. 29, when local laboratories reported five cases of salmonella, a bacteria that causes illness with symptoms such as diarrhea, fever and abdominal cramps. Typically, the department gets three to eight reports each month, Riethman said.

“The fact that we got five in one day was a big red flag,” she said.

Aunt of E. coli victim wants answers from county about lousy response

The Columbian reported today that the aunt of 4-year-old Ronan Wilson (right), who died April 8 after contracting E. coli at his Hazel Dell in-home day care in Washington state, wants to know why the Clark County Department of Health did not let the public know about the outbreak until the day after Ronan died.

Savenia Falquist also questions why the day care children and their siblings continued attending school, possibly putting other children at risk, and why the health department did not at least alert health care providers about the outbreak.

When Ronan’s mother first took him to a doctor on March 29, the doctor did not think it was necessary to test for E. coli and diagnosed Ronan with the flu. Other parents of children at the day care have said they initially had difficulty getting doctors to approve a stool test, the only way to test for E. coli.

Falquist told Clark County commissioners at their monthly Board of Health meeting Wednesday that she’s trying to educate herself on the county’s policies for informing the public about communicable diseases, adding after the meeting,

“The intention is not to go after a county department that’s funded by the public. What I really want to do is rule out complacency.”

John Wiesman, the director of the health department, said the county typically only issues public health warnings when health officials can’t personally contact those potentially affected by a health threat. For example, a news release would be issued if a food services worker tested positive for hepatitis A and the county would have to warn people who ate at the worker’s restaurant.

A provider alert was not sent out about the E. coli outbreak at the day care because owners Larry and Dianne Fletch had contact information for all of the parents whose children attended the center, Wiesman said.

Wow. That’s terrible accountability. Alerts also raise awareness and provide lessons for others – oh, and may prevent people from getting sick. Maybe not directly, but it could enhance the conversations and culture surrounding food safety if others knew, oh, kids can get E. coli O157:H7 at day care.

A total of 14 people at the day care tested positive for E. coli O157:H7 bacteria. Three were hospitalized and 10 people had mild symptoms.

Children who tested positive were not allowed to go to a day care until they had two negative stool samples, 24 hours apart, Melnick said Wednesday. He said older children at the center or older siblings of children at the day care were still allowed to go to school because there aren’t the same concerns about transmitting the bacteria with older children. There aren’t diapers being changed, for example.

“The kids are older, and their hygiene is better,” Melnick said.

Any evidence to back up that statement?