E. coli outbreak at childcare facility in mid-west Ireland

The Department of Public Health in the Mid-West is handling an E.coli outbreak at a childcare facility and is reminding the public of the danger this bacteria can pose. 

Verotoxigenic E. coli (VTec) is a powerful strain of E.coli bacterium that lives in the gut of healthy cattle and sheep and can cause serious illness in the elderly and in children aged under five. 

The Mid-West public health department said the outbreak was under control but the incidence highlights the importance of hand hygiene and proper water treatment. 

VTec can be a source of food poisoning and can cause bowel inflammation leading to bloody diarrhea and severe stomach cramps. 

A specialist in public health said Ireland had one of the highest incidence rates of VTec in Europe and that the Mid-West region has one of the highest reported rates in the country. 

It underpins the importance of hand hygiene before and after preparing food, after contact with farm animals and their environment, and effective treatment and rehabilitation of private wells. 

STEC on dairy farms

One of my best friends used to be a dairy farmer, and he would always say, I’m not eating at McDonald’s, could be one of my former cows.

Shiga toxin-producing Escherichia coli (STEC) are foodborne bacterial pathogens, with cattle a significant reservoir for human infection. This study evaluated environmental reservoirs, intermediate hosts and key pathways that could drive the presence of Top 7 STEC (O157:H7, O26, O45, O103, O111, O121 and O145) on pasture-based dairy herds, using molecular and culture-based methods.

A total of 235 composite environmental samples (including soil, bedding, pasture, stock drinking water, bird droppings and flies and faecal samples of dairy animals) were collected from two dairy farms, with four sampling events on each farm. Molecular detection revealed O26, O45, O103 and O121 as the most common O-serogroups, with the greatest occurrence in dairy animal faeces (> 91%), environments freshly contaminated with faeces (> 73%) and birds and flies (> 71%). STEC (79 isolates) were a minor population within the target O-serogroups in all sample types but were widespread in the farm environment in the summer samplings.

Phylogenetic analysis of whole genome sequence data targeting single nucleotide polymorphisms revealed the presence of several clonal strains on a farm; a single STEC clonal strain could be found in several sample types concurrently, indicating the existence of more than one possible route for transmission to dairy animals and a high rate of transmission of STEC between dairy animals and wildlife.

Overall, the findings improved the understanding of the ecology of the Top 7 STEC in open farm environments, which is required to develop on-farm intervention strategies controlling these zoonoses.

Investigation of on-farm transmission routes for contamination of dairy cows with top 7 Escherichia coli O-serogroups

Environmental Microbiology

Rapp & C. M. Ross & P. Maclean & V. M. Cave & G. Brightwell

https://link.springer.com/article/10.1007/s00248-020-01542-5

The continuing prevalence of shiga-toxin producing E. coli in produce

Chris Koger of The Packer writes the U.S. Centers for Disease Control and Prevention has added 16 more people to an E. coli outbreak investigation of unknown origin, bringing the total to 39. Cases have been reported in 18 states; there have been no deaths.

According to the CDC’s Nov. 23 update, “Of the 22 ill people interviewed to date, all reported eating a variety of leafy greens, like spinach (16), romaine lettuce (15), iceberg lettuce (12), and mixed bag lettuce (8). No single type or brand of leafy greens or other food item has been identified as the source of this outbreak. CDC is not advising people avoid any particular food at this time.

Dole Fresh Vegetables, Inc. is voluntarily recalling a limited number of cases of organic romaine hearts. The products being recalled are Dole™ Organic Romaine Hearts 3pk (UPC 0-71430-90061-1), combined English/French packaging, with Harvested-On dates of 10-23-20 and 10-26-20, and Wild Harvest Organic Romaine Hearts (UPC 7-11535-50201-2), with Harvested-On dates of 10-23-20 and 10-26-20.  The recall is being conducted due to a possible health risk from E. coli in the two products.  Dole Fresh Vegetables is coordinating closely with regulatory officials. No illnesses have been reported to date in association with the recall. 

Pathogenic E. coli can cause diarrhea, severe stomach cramps and vomiting.  Most people recover within a week, but some illnesses can last longer and can be more severe.

This precautionary recall notification is being issued due to an isolated instance in which a package of Dole™ Organic Romaine Hearts – 3pk yielded a positive result for pathogenic non-O157 E.coli STEC in a routine sample collected at a retail store by the Michigan Department of Agriculture and Rural Development. There is no indication at this time that this positive result is related to any illnesses nor consumer complaints and it is not associated with the strains connected to the ongoing outbreaks currently under regulatory investigation. 

Spice risk: Cilantro and dangerous E. coli

I tell people that spices like cilantro are a significant source of dangerous E. coli and they look at me like I just fell off the turnip truck.

This study sought to model the growth and die-off of Escherichia coli (E. coli) O157:H7 along the cilantro supply chain from farm-to-fork to investigate its risk to public health. Contributing factors included in the model were on farm contamination from irrigation water and soil, solar radiation, harvesting, and transportation and storage times and temperatures.

The developed risk model estimated the microbiological risks associated with E. coli O157:H7 in cilantro and determined parameters with the most effect on the final concentration per serving for future mitigation strategies. Results showed a similar decrease in the E. coli O157:H7 (median values) concentrations along the supply chain for cilantro grown in both winter and summer weather conditions. With an estimated 0.1% prevalence of E. coli O157:H7 contamination for cilantro post-harvest used for illustration, the model predicted the probability of illness from consuming fresh cilantro as very low with fewer than two illnesses per every one billion servings of cilantro (1.6 x 10-9; 95th percentile). Although rare, 3.7% and 1.6% of scenarios run in this model for summer and winter grown cilantro, respectively, result in over 10 cases per year in the United States.

This is reflected in real life where illnesses from cilantro are seen rarely but outbreaks have occurred. Sensitivity analysis and scenario testing demonstrated that ensuring clean and high quality irrigation water and preventing temperature abuse during transportation from farm to retail, are key to reducing overall risk of illness.

Evaluation of public health risk for Escherichia coli O157:H7 in cilantro, 16 July 2020

Food Research International

eTaryn Horr and Abani Pradhan

https://doi.org/10.1016/j.foodres.2020.109545

https://www.sciencedirect.com/science/article/abs/pii/S0963996920305706

E. coli in tea

In this study, the persistence of toxigenic Escherichia coli (E. coli ) on dried chamomile, peppermint, ginger, cinnamon, black and green teas stored under 4, 10, and 25°C was determined.

 The E. coli survival rate in ginger and cinnamon teas decreased below 0 on Day 5. In the other tested teas, E. coli survivability showed a downward trend over time, but never dropped to 0. Chamomile tea retained the greatest population of viable E. coli . Meanwhile, die‐off of E. coli was higher at 25°C compared to lower temperatures. Additionally, fate of E. coli during brewing at 60, 70 and 80°C was evaluated.

The E. coli population was reduced to below 2 Log colony forming units (CFU)/g after 1 min at 80°C, At the same time, the E. coli survival at 60°C was higher than that at 70°C in all tested teas. The data indicated that if E. coli survives after storage of prepared teas, it may also survive and grow after the brewing process, especially if performed using temperatures <80°C. Finally, we analyzed the correlations between temperature, time, tea varieties and E. coli survival, and successfully constructed a random forest regression model. The results of this study can be used to predict changes in E. coli during storage and fate during the brewing process. Results will form the basis of undertaking a risk assessment.

Survival of toxigenic Escherichia coli on chamomile, peppermint, green, black, ginger, and cinnamon teas during storage and brewing, 23 June 2020

Journal of Food Safety

Yanan Liu, Fan Wu, Yan Zhu, Yirui Chen, Kayla Murray, Zhaoxin Lu, Keith Warriner

https://doi.org/10.1111/jfs.12831

https://onlinelibrary.wiley.com/doi/abs/10.1111/jfs.12831

And the tea lady is featured here.

The Crimson Permanent Assurance (Monty Python’s) from EpicFilmsGlobal on Vimeo.

Brits like their tea – it’s not local

In this study, the persistence of toxigenic Escherichia coli (E. coli ) on dried chamomile, peppermint, ginger, cinnamon, black and green teas stored under 4, 10, and 25°C was determined.

The E. coli survival rate in ginger and cinnamon teas decreased below 0 on Day 5. In the other tested teas, E. coli survivability showed a downward trend over time, but never dropped to 0. Chamomile tea retained the greatest population of viable E. coli . Meanwhile, die‐off of E. coli was higher at 25°C compared to lower temperatures. Additionally, fate of E. coli during brewing at 60, 70 and 80°C was evaluated.

The E. coli population was reduced to below 2 Log colony forming units (CFU)/g after 1 min at 80°C, At the same time, the E. coli survival at 60°C was higher than that at 70°C in all tested teas. The data indicated that if E. coli survives after storage of prepared teas, it may also survive and grow after the brewing process, especially if performed using temperatures <80°C. Finally, we analyzed the correlations between temperature, time, tea varieties and E. coli survival, and successfully constructed a random forest regression model. The results of this study can be used to predict changes in E. coli during storage and fate during the brewing process. Results will form the basis of undertaking a risk assessment.

Survival of toxigenic Escherichia coli on chamomile, peppermint, green, black, ginger, and cinnamon teas during storage and brewing, 23 June 2020

Journal of Food Safety

Yanan Liu, Fan Wu, Yan Zhu, Yirui Chen, Kayla Murray, Zhaoxin Lu, Keith Warriner

https://doi.org/10.1111/jfs.12831

https://onlinelibrary.wiley.com/doi/abs/10.1111/jfs.12831

Raw is still risky: Six years after a toddler died, Australian advocates want raw milk back on the table

In late 2014, three children in the Australian state of Victoria developed hemolytic uremic syndrome linked to Shiga-toxin toxin producing E. coli in unpasteurized bath milk produced by Mountain View Dairy Farm. One child died, and two others developed cryptosporidiosis.

The Victorian government quickly banned the sale of so-called bath milk, which although labeled as not fit for human consumption, was a widely recognized way for Australian consumers to access raw milk.

What followed was a despicable whisper campaign that the child who died had an underlying medical condition, it wasn’t Shiga-toxin producing E. coli (STEC), farmers were losing access to lucrative markets – anything but the basic and sometimes deadly biology of STECs and everything involving fantasy and fairytales.

Victorian Dairy farmer Vicki Jones was told in 2014 by the coroner that raw milk was the likely cause of death of a three-year-old boy in 2014.

The milk was ‘raw’, or unpasteurised, and Ms Jones’ Mountain View Dairy Farm had been selling it as bath milk — a cosmetic product labelled ‘not fit for drinking’. 

Ms Jones said she told the officer she would immediately remove the milk from the shelves of local stores. 

“And he said to me, ‘No, no, no, don’t do that. You’ve done nothing wrong and all your labelling is right’.”

In hindsight, Ms Jones said this response “was really bizarre” — as was the decision to wait months before telling her about the cases.

But then the health officer told her a three-year-old boy had died after drinking the bath milk. 

“It was the most devastating news that you could possibly imagine ever getting,” she said.

“I was mortified, we were doing the raw milk because people wanted it.”

Or because you contributed to promoting BS.

A Gippsland MP, the father of the child who died, and evidence presented to the coroner have all questioned how the cases were managed and suggested other contributing factors were overlooked.

Mark Wahlqvist, an Emeritus professor of medicine at Monash University and former president of the international union of nutrition sciences, said, “Raw milk, unpasteurised milk, is not safe enough to be in the public domain.”

Professor Wahlqvist said he was open to new research but at present, found campaigners for raw milk to be more than unconvincing.

“When people for conspiratorial reasons rather than scientific reasons, think that vaccination is a problem or that pasteurisation is a problem,” he said.

“We have a science communication problem in this country and it needs science leaders.”

Jimmy Johns: The E. coli gift that keeps on giving

The U.S. Centers for Disease Control reports that as of April 22, 2020, this outbreak linked to clover sprouts appears to be over.

51 people infected with the outbreak strain of E. coli O103 were reported from 10 states.

3 people were hospitalized. No deaths were reported.

Epidemiologic, traceback, and laboratory evidence indicated that clover sprouts were the source of this outbreak.

On March 16, 2020, Chicago Indoor Garden recalled external icon all products containing red clover sprouts. More information about this recall is available on the FDA website.external icon

Jimmy John’s LLC reported that all of its restaurants stopped serving clover sprouts on February 24, 2020.

People usually get sick from Shiga toxin-producing E. coli (STEC) 1 to 10 days (average of 3 to 4 days) after swallowing the germ.

Symptoms vary, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may have a fever, which usually is not very high (less than 101˚F/38.5˚C).

Some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS).

Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing HUS, and a benefit of treatment has not been clearly demonstrated.

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of E. coli O103 infections linked to clover sprouts.

Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on E. coli bacteria isolated from ill people by using a standardized laboratory and data analysis method called whole genome sequencing (WGS). CDC PulseNet manages a national database of these sequences that are used to identify possible outbreaks. WGS gives investigators detailed information about the bacteria causing illness. In this investigation, WGS showed that bacteria isolated from ill people were closely related genetically. This means that people in this outbreak were likely to share a common source of infection.

A total of 51 people infected with the outbreak strain of E. coli O103 were reported from 10 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases.

Illnesses started on dates ranging from January 6, 2020, to March 15, 2020. Ill people ranged in age from 1 to 79 years, with a median age of 29 years. Fifty-five percent of ill people were female. Of 41 ill people with information available, 3 were hospitalized and no deaths were reported.

WGS analysis of isolates from 39 ill people was performed; the isolate from 1 ill person predicted antibiotic resistance to streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole, and 38 isolates from ill people did not show evidence of antibiotic resistance. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently underway. These findings do not affect treatment guidance since antibiotics are not recommended for patients with STEC O103 infections.

Investigation of the Outbreak

Epidemiologic, traceback, and laboratory evidence indicated that clover sprouts were the source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures they had in the week before their illness started. Eighteen (56%) of 32 people interviewed reported eating sprouts. This percentage is significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy people in which 8% reported eating sprouts in the week before they were interviewed.

Seventeen (63%) of 27 people interviewed reported eating sprouts at a Jimmy John’s restaurant. Jimmy John’s LLC reported that all of their restaurants stopped serving clover sprouts on February 24, 2020. Clover sprouts are no longer available at Jimmy John’s restaurants.

Additionally, FDA identified the outbreak strain of E. coli O103 in samples of Chicago Indoor Garden products that contain sprouts. On March 16, 2020, Chicago Indoor Garden recalledexternal icon all products containing red clover sprouts.

FDA’s traceback investigationexternal icon showed that a common seed lot was used to grow both the sprouts recalled by Chicago Indoor Garden and sprouts that were served at some Jimmy John’s locations. The same seed lot was also used to grow sprouts linked to an outbreakexternal icon of the same strain of E. coli O103 infections in 2019.

As of April 22, 2020, this outbreak appears to be over.

PCR in Sweden

Enteroinvasive Escherichia coli (EIEC) and Shigella spp. are both Gram-negative bacteria causing diarrheal disease worldwide [1,2]. The clinical presentations of these two pathogens are very similar [3,4] and commonly manifested through diarrhoea, abdominal cramps, nausea and fever both in children and adults [5,6]. In addition to a similar clinical picture, EIEC and Shigella share laboratory features that can make it difficult to distinguish between them in routine clinical laboratory practice. Both pathogens are transmitted via the faecal-oral route and infections are frequently associated with consumption of contaminated food and water [710]. While Shigella is associated with large-scale food-borne outbreaks [11,12], outbreaks caused by EIEC are rarely recorded.

High prevalence of EIEC infections have been documented in rural areas and settings with poor sanitation in high-risk countries [5,13] while EIEC infections in Europe are typically sporadic and travel related [14]. Nevertheless, a few EIEC outbreaks have been reported in Europe, with the most recent ones having occurred in Italy in 2012 [15] and in the United Kingdom (UK) in 2014 [16]. These outbreaks affected 109 cases and 157 probable cases, respectively, highlighting the fact that EIEC, like Shigella, has the capacity to cause large gastrointestinal disease outbreaks. The outbreak strain identified in these recent European outbreaks, EIEC O96:H19, is an emergent type of EIEC that has phenotypic characteristics more resembling those of non-invasive Escherichia coli (E. coli) than those described for Shigella [17]. These characteristics are suggested to contribute to improved survival abilities as well as the ability to better adapt to different ecological niches [17].

Traditionally, culturing of faecal specimens has been the mainstay of laboratory diagnostics for enteric bacteria, and EIEC has been differentiated from Shigella by assessing a combination of several phenotypic characteristics, including biochemical, motility and serological traits [18,19]. This is now changing as PCR-based methods are becoming routine in many diagnostic laboratories [20]. In contrast to non-invasive E. coli, EIEC and Shigella can invade and multiply in intestinal epithelial cells [21], a process that is partially mediated by the products of the invasion plasmid antigen (ipa) genes [22]. For this reason, PCR targeting the ipaH gene can separate EIEC from other non-invasive E. coli, but cannot differentiate between EIEC and Shigella [23]. The lacY gene has been proposed as an additional molecular marker for which most E. coli are positive and Shigella is negative [24]. Its use as a PCR target in separating Shigella and EIEC is restricted to bacterial isolates since many faecal samples are lacY positive because of the presence of E. coli in the normal flora.

In Sweden, several clinical laboratories have shifted towards the use of direct PCR testing on faecal specimens as the primary diagnostic tool. However, most of these laboratories culture PCR-positive samples, so called PCR-guided culturing. Although culturing of PCR-positive faecal specimens is routinely performed, it can be difficult to obtain EIEC isolates since the morphology of EIEC strains on commonly used substrates can mimic the morphology of the enteric background flora, yellow colonies on xylose lysine deoxycholate (XLD) agar, rather than the morphology of Shigella, red colonies on XLD agar. Hence, separating EIEC from other bacteria in the normal flora usually whhttps://www.technologynetworks.com/applied-sciences/news/sticker-could-improve-safety-of-our-cold-chain-food-333138?utm_campaign=NEWSLETTER_TN_Food%20%26%20Beverage%20Analysis&utm_source=hs_email&utm_medium=email&utm_content=86254121&_hsenc=p2ANqtz–MMoS1KFFGpgRZ_seNnO0bmNz_SMVvraj4jqMu9SDGvKY_0jhrfEnmyzyUGUG4KMiZPINfu3qM8tMQOAJhBtcRodwdNw&_hsmi=86254121

Which is considered too time consuming for most clinical laboratories. For this reason, it is likely that a patient with specimens that are ipaH PCR-positive but culture negative would not be notified as a case if the diagnostic algorithm at the laboratory requires a detected Shigella isolate. In addition, PCR is a more sensitive method than culturing [25] and Shigella is known for its limited survival ability in faecal samples [26], which also may lead to samples being ipaH PCR-positive but culture negative.

Shigellosis is notifiable by law in Sweden as in the majority of countries in Europe [27]. In 2017, the incidence was 2.1 per 100,000 inhabitants in Sweden, and the majority of cases had been infected abroad [28]. The mandatory reporting of diseases allows the implementation of a series of public health actions, including public health management and surveillance activities, and helps define risk exposures. In contrast to shigellosis, reporting is not mandatory for EIEC and the occurrence of this pathogen in Sweden is currently unknown.It requires additional laboratory procedures such as screening large numbers of colonies,

Outbreak of gastroenteritis highlighting the diagnostic and epidemiological challenges of enteroinvasive Escherichia coli, county of Halland, Sweden, November 2017, 12 December 2019

Eurosurveillance

Nina Lagerqvist1,2Emma Löf1,3Theresa Enkirch1,2Peter Nilsson4Adam Roth1Cecilia Jernberg1

https://doi.org/10.2807/1560-7917.ES.2020.25.9.1900466

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.9.1900466

Whittaker: Market food safety

Ashley Nickle of The Packer wrote in Oct. 2019 (did I mention the bit about catch up, 8 broken ribs and a broken collarbone) PMA chief science and technology officer Bob Whitaker gave an impassioned presentation at Fresh Summit on the improvements that need to be made in food safety across the industry. Ten years after the formation of the Center for Produce Safety, companies can’t assert anymore that there isn’t relevant research to inform practices, Whitaker said.

Whitaker gave specific examples of potentially risky practices that are common. He mentioned setting harvest containers on the ground before they’re filled, and spoke about relying on the presence of generic E. coli in agricultural water to indicate pathogenic E. coli, along with several other examples.

Whitaker encourages companies to get competitive on food safety if that will get them to push past the status quo. He urged industry members to consider the costs when outbreaks happen, and he mentioned the death of a toddler during the 2006 outbreak linked to spinach.

“If we look at the recent issues we’ve had, we had an issue that involved water,” Whitaker said. “People said, ‘Well, we measured the water, we looked at generic E. coli.’ Well yeah, but the research has told us for years that generic E. coli does not represent the presence of pathogenic E. coli or salmonella. And In fact, at the volumes we do, we’re not going to find it.

“We also know that in every water system we’ve looked at around the U.S., I don’t care what crop, it has nothing to do with crop, every place the researchers have looked at and we’ve had a concentrated effort, we found contamination in open water sources — back east, out west, up north, doesn’t make a difference,” Whitaker said. “That’s where it is.”

Growing near concentrated animal feeding operations is another practice that the research indicates carries some risk.

“We know that dust will make the stuff travel,” Whitaker said. “Now we don’t know how far, but we know the one experiment that was done went out to 600 and it was there, so maybe it went farther …”

He also noted several practices in the field that he described as problematic yet commonplace.

“If I had a nickel for every picture I get every summer of people showing me Port-A-Johns being serviced in the field next to a harvest crop, I could have retired a couple years ago,” said Whitaker, who plans to retire from PMA in January.

“Don’t tell me it doesn’t drip, and then we wonder how we get some of these things like parasites in our fields,” Whitaker said.

He mentioned harvest sleds being left in the field overnight with the day’s debris still on them as another potential problem.

 “I’m seeing companies now breaking away from what everybody else is doing and say, ‘You know what, this is what we’re going to do,’” Whitaker said. “And we’ve always abhorred that idea. We’ve always said that food safety is something we share with each other, we don’t compete on it.

“To hell with that,” Whitaker said. “One thing this industry knows how to do is compete … You’ve always been marketing it anyway — you know you have. I see the stories. I see myself show up in people’s marketing things to their customers. I know that they’re marketing that.

“So do it,” Whitaker said. “If that’s what it’s going to take to get better, to create competition to get better, then do it. Because that’s what we need to do. We need the impetus to do it.”