In May 2018, five children at Pam Walker’s day care in Tenn. were stricken with E. coli O157.
Kristi L Nelson of Knox News reports that science, public health officials said, sleuthed out the source of the E. coli infection: a goat farm across the road.
But for Walker, there’s been no closure — and she may never get the answers to exactly how a microorganism turned her dream of a bucolic child care center in a farm setting to a weeks-long nightmare.
Meanwhile, the health department was already investigating an E. coli outbreak among 10 children who’d consumed raw milk from a nearby dairy, French Broad Farms. Because it would be so unusual for two different E. coli O157 outbreaks to occur in the same area simultaneously, the health department, in the course of extensive interviews, looked for a link between Kids Place and the dairy. Did any children at the day care drink raw milk? Socialize or swim with anyone in the other group of infected children? Did any person or animal go back and forth between the dairy and the day care? The answers, they found, were no.
“Finding a bacteria that is microscopic, not visible to the naked eye, is really, really challenging,” said health department Director Dr. Martha Buchanan. “You have got to get the right sample at the right spot. And environmental cleaning did happen — the environment had changed when they went back” to sample.
With the positive culture from goat feces, the health department’s investigators determined that bacteria from the goats had somehow gotten into the baby house — and probably would have been present there before cleaning. When the specimens were sent back to the Tennessee Department of Health for DNA comparison with stool samples from the sick children, the DNA “fingerprint” from the goat samples and the Kids Place children were an exact match — but different from the DNA “fingerprint” of the cow feces from the dairy and the children who’d consumed raw milk, which matched each other. That meant, though unusual, that Knox County had two separate E. coli outbreaks in young children happening at the same time.
Finding it in goat feces, however, wasn’t a surprise. Goats, cows, sheep and other “ruminant” animals — animals that have a multichambered stomach and regurgitate and rechew food before digesting it — often carry E. coli in their digestive tracts. They can carry the bacteria, and shed it through their feces, but it typically doesn’t make them sick.
“Given that some of these illnesses have been linked to the goats at your facility, I recommend you no longer keep goats or other ruminant animals on your property, or that those who interact with the goats do not have contact with the children in your care,” Buchanan told Walker in a July 6 letter.
After the outbreak, Walker gave the goat herd to a friend. But the week after the health department informed her of the test results, she and her husband contacted the University of Tennessee College of Veterinary Medicine to have the goats tested again for E. coli. Dr. Marc Caldwell, assistant professor in large animal clinical sciences, remembers the test being requested merely to see if the goats were healthy, but Steve Walker said he wanted to see if this second test also would find a DNA fingerprint match between his goats and the children’s stool samples.
Techs from UTVM swabbed the goats themselves for fecal samples, rather than collecting feces from the ground as the health department did, and sent them to the Nebraska lab for culture. None of the goats tested positive for E. coli, but both herd dogs — also swabbed — did, while the health department’s dog feces samples were negative. It’s unusual, but possible, for dogs to carry E. coli, Caldwell said.
Caldwell said the test doesn’t prove the animals didn’t have E. coli O157 when the health department tested the feces. In fact, it doesn’t prove they didn’t have it that week, since the amount of bacteria shed from an infected animal can depend on heat, stress and other factors, and a certain amount has to be present for the antigen test — which is what the lab used — to show positive.
Stourbridge News reports that Harriet Homer suffered kidney failure after contracting E. coli O157 during the school summer holiday and her parents Dave and Laura were left fearing the worst.
But the plucky tot from Norton pulled through after undergoing dialysis at Birmingham Children’s Hospital and her family told the News this week that she has been recovering well since being discharged.
The family believed the youngster may have picked up the infection after visiting a petting farm but Public Health England chiefs have stressed they have found nothing to link the incidence of E. coli with locations visited by the family.
Since early July, the number of cases of ehec infection has increased in Sweden. Analyzes show that the majority are of the same type and cases have been reported from several counties, mainly Uppsala and Västra Götaland. According to the investigation, it is a national ehec outbreak that has one or more common sources of infection.
So far, the ehec infection of some fifty people who fell in July could have been linked by molecular biologic analyzes of the genetic engineering of the bacteria. Another fifty-one people were also suspected of being affected. Among the infected are both children and adults.
Since the current type of ehec, O157: H7, has spread to different parts of the country, it is probably about a foodborne infection. Locally, the infection can also be spread from person to person via bathing water.
– This appears to be one of the biggest outbreaks of ehec we have had in Sweden. The germ strain spread may cause serious disease, especially in children. Together with the affected infected units and municipalities, the Swedish Food Administration and the State Veterinary Office, we are working to investigate the outbreak and, above all, try to identify the source of infection and prevent further spread of infection, “says microbiologist Cecilia Jernberg.
Elizabeth Shogren and Susie Neilson of Reveal write that William Whitt suffered violent diarrhea for days. But once he began vomiting blood, he knew it was time to rush to the hospital. His body swelled up so much that his wife thought he looked like the Michelin Man, and on the inside, his intestines were inflamed and bleeding.
For four days last spring, doctors struggled to control the infection that was ravaging Whitt, a father of three in western Idaho. The pain was excruciating, even though he was given opioid painkillers intravenously every 10 minutes for days.
His family feared they would lose him.
“I was terrified. I wouldn’t leave the hospital because I wasn’t sure he was still going to be there when I got back,” said Whitt’s wife, Melinda.
Whitt and his family were baffled: How could a healthy 37-year-old suddenly get so sick? While he was fighting for his life, the U.S. Centers for Disease Control and Prevention quizzed Whitt, seeking information about what had sickened him.
Finally, the agency’s second call offered a clue: “They kept drilling me about salad,” Whitt recalled. Before he fell ill, he had eaten two salads from a pizza shop.
William Whitt and wife Melinda say it is irresponsible for the Food and Drug Administration to postpone water-testing requirements for produce growers. “People should be able to know that the food they’re buying is not going to harm them and their loved ones,” Melinda Whitt said.
The culprit turned out to be E. coli, a powerful pathogen that had contaminated romaine lettuce grown in Yuma, Arizona, and distributed nationwide. At least 210 people in 36 states were sickened. Five died and 27 suffered kidney failure. The same strain of E. coli that sickened them was detected in a Yuma canal used to irrigate some crops.
For more than a decade, it’s been clear that there’s a gaping hole in American food safety: Growers aren’t required to test their irrigation water for pathogens such as E. coli. As a result, contaminated water can end up on fruits and vegetables.
After several high-profile disease outbreaks linked to food, Congress in 2011 ordered a fix, and produce growers this year would have begun testing their water under rules crafted by the Obama administration’s Food and Drug Administration.
But six months before people were sickened by the contaminated romaine, President Donald Trump’s FDA – responding to pressure from the farm industry and Trump’s order to eliminate regulations – shelved the water-testing rules for at least four years.
Despite this deadly outbreak, the FDA has shown no sign of reconsidering its plan to postpone the rules. The agency also is considering major changes, such as allowing some produce growers to test less frequently or find alternatives to water testing to ensure the safety of their crops.
“Mystifying, isn’t it?” said Trevor Suslow, a food safety expert at the University of California, Davis. “If the risk factor associated with agricultural water use is that closely tied to contamination and outbreaks, there needs to be something now. … I can’t think of a reason to justify waiting four to six to eight years to get started.”
The deadly Yuma outbreak underscores that irrigation water is a prime source of foodborne illnesses. In some cases, the feces of livestock or wild animals flow into a creek. Then the tainted water seeps into wells or is sprayed onto produce, which is then harvested, processed and sold at stores and restaurants. Salad greens are particularly vulnerable because they often are eaten raw and can harbor bacteria when torn.
After an E. coli outbreak killed three people who ate spinach grown in California’s Salinas Valley in 2006, most California and Arizona growers of leafy greens signed agreements to voluntarily test their irrigation water.
Whitt’s lettuce would have been covered by those agreements. But his story illustrates the limits of a voluntary safety program and how lethal E. coli can be even when precautions are taken by farms and processors.
Farm groups contend that water testing is too expensive and should not apply to produce such as apples or onions, which are less likely to carry pathogens.
“I think the whole thing is an overblown attempt to exert government power over us,” said Bob Allen, a Washington state apple farmer.
While postponing the water-testing rules would save growers $12 million per year, it also would cost consumers $108 million per year in medical expenses, according to an FDA analysis.
“The Yuma outbreak does indeed emphasize the urgency of putting agricultural water standards in place, but it is important that they be the right standards, ones that both meet our public health mission and are feasible for growers to meet,” FDA spokeswoman Juli Putnam said in response to written questions.
In addition, the FDA did not sample water in a Yuma irrigation canal until seven weeks after the area’s lettuce was identified as the cause of last spring’s outbreak. And university scientists trying to learn from the outbreak say farmers have not shared water data with them as they try to figure out how it occurred and avoid future ones.
The statement by Prosecutor Nabil Sadek came a week after travel company Thomas Cook said that there was a “high level of e. coli and staphylococcus bacteria” at the Steigenberger Aqua Magic Hotel where John and Susan Cooper died Aug. 21 after falling ill in their room in the five-star hotel.
Forensic tests showed that John Cooper, 69, suffered acute intestinal dysentery caused by E.coli, and Susan Cooper, 64, suffered Hemolytic-uremic syndrome (HUS), likely because of E .coli, Sadek said.
He said that tests also showed no links between the couples’ death and the spraying of their neighboring room with lambda-cyhalothrin 5 per cent. The insecticide is safe to use, according to the statement.
The couple’s bodies showed “no criminal violence” and other tests showed no toxic or harmful gas emissions or leaks in their room and tests on air and water at the hotel found nothing unusual, the statement said.
There was not an immediate comment from the Steigenberger Aqua Magic Hotel. Thomas Cook meanwhile said it needs time for their own experts to review the prosecutor’s statement.
My former dean was known as Dr. Clorox while serving in Vietnam.
I used to give training sessions to food types headed for Iraq and Afghanistan from Fort Riley (in Manhattan, Kansas) and would sheepishly say, I have no idea what you’re going to face in terms of potable water, but bleach is your friend.
I reported in Nov. 2017 that a bunch of Marines training in San Diego got sick from Shiga-toxin producing E. coli.
The eventual number would be about 220.
Food safety lawyer Bill Marler wrote the other day that the outbreak “seemed to fall a bit below the radar.”
That means below his litigation radar, not the public awareness radar. Yesterday he filed a lawsuit in the Southern District Court of California against Sodexo Inc. on behalf of Illinois resident, Vincent Grano who developed an E. coli O157:H7 infection from food served at the cafeteria and mess hall at a Marine Corps Recruit Depot in San Diego.
Sodexo, a Delaware company, provides food and facility management services for the United States Marine Corps Depot in San Diego. Mr. Grano is represented by Marler Clark, the food safety law firm, and Gordon and Holmes, a local San Diego firm.
There is so much I want to write about, to get the daily buzz of the blog, but blogs don’t last, and don’t pay the bills.
What’s important to me is the pic, below, and everything I can do to help them succeed.
I’ll work on books (which also don’t pay the bills, but may last longer).
Julian Kolsut of Chek reports that a Parksville family is at the B.C. Children’s Hospital in Vancouver this weekend after their two-year-old toddler contracted an E. coli Infection — that his father Aaron Hughes says was not diagnosed until it was almost too late.
“Be persistent… if we didn’t stick to our guns and react, he would be dead right now,” said Hughes.
It all started when 2-year-old Jaxon starting to act “off” on Tuesday, both of his parents thought he may have had heatstroke and made sure to take him out of the sun and keep him hydrated.
“He was out in the sun and he became really lethargic really fast, didn’t have an appetite, a fever kicked in quickly and then the diarrhea started,” said Aarons wife Jolene Secord.
After contacting the nurse’s line, they were given the same advice, but eventually Jaxon started vomiting. A visit to the walk-in clinic resulted in a different diagnosis, a possible bacterial infection, but while at the clinic they noticed blood in his diaper.
“They did take a swab of his green bowl movements but sent us home,” said Secord.
They were told to continue keeping an eye on him and taking care of him.
The parents say on Wednesday the vomiting and bleeding got worse, and after rushing Jaxon to the Nanaimo Regional General Hospital they were told again it may be a bacterial infection, and that he may have had a torn fissure. After speaking to a nutritionist they were sent home.
Aaron says he couldn’t see the fissure, and was confused the mucus coming out of his toddler’s behind was also bloody.
When his 18-year-old daughter called him when he was shopping for vaseline for his son in Nanaimo on Thursday and was told Jackson’s symptoms were worse, he told them to call and ambulance at that he would meet them at the hospital.
“We weren’t wasting any time… but they couldn’t find his stools [that were sent in for testing]” said Hughes.
“The doctor then came into the room [the next day] and said, “I think we found the source” and he didn’t look too happy, [the doctor] tracked down the stools and said the test came back positive for E. coli O157:H7.”
He was immediately airlifted to the B.C. Children’s Hospital in Vancouver and currently, among many other issues with his health, does not have any functioning kidneys and has a damaged pancreas.
Jaxon is undergoing dialysis, transfusion and other treatments, and his mom says his state changes by the hour.
“At this point, they don’t see the kidneys waking up… it could be a long-term thing… every hour seems to change for Jaxon,” said Secord. “We will see a positive, we will see a negative, we will see a positive.”
The exact cause is unknown, but the family says they suspect it came from deer feces, as the animal can carry the O157:H7 strain. They think Jackson may have come in contact with it outside. Contaminated food is also a possibility.
“We almost have a family of deer living [on our property]” said Hughes. “We have apple trees on our property and they [the deers] live off that stuff, and that can transport diseases.”
Both parents also say the unfortunate incident is a reminder to always listen to your gut.
“If we would have stuck to what they were telling us then we would have lost him… and if we waited he could have had brain damage, heart failure,” said Hughes.
The ecology of Escherichia coli O157:H7 is not well understood. The aims of this study were to determine the prevalence of and characterize E. coli O157:H7 associated with houseflies (HF).
Musca domestica L. HF (n = 3,440) were collected from two sites on a cattle farm over a 4-month period and processed individually for E. coli O157:H7 isolation and quantification. The prevalence of E. coli O157:H7 was 2.9 and 1.4% in HF collected from feed bunks and a cattle feed storage shed, respectively. E. coli O157:H7 counts ranged from 3.0 × 101 to 1.5 × 105 CFU among the positive HF. PCR analysis of the E. coli O157:H7 isolates revealed that 90.4, 99.2, 99.2, and 100% of them (n = 125) possessed the stx1, stx2, eaeA, and fliC genes, respectively.
Large populations of HF on cattle farms may play a role in the dissemination of E. coli O157:H7 among animals and to the surrounding environment.
Association of Escherichia coli O157:H7 with houseflies on a cattle farm
Applied and Environmental Microbiology vol. 84 no. 14