20 years on, Scotland E. coli tragedy saw heart ripped from town

In November 1996, over 400 fell ill and 21 were killed in Scotland by E. coli O157:H7 found in deli meats produced by family butchers John Barr & Son. The Butcher of Scotland, who had been in business for 28 years and was previously awarded the title of Scottish Butcher of the Year, was using the same knives to handle raw and cooked meat.

e-coli-scotland-1996-1A memo at the time, unearthed by The Herald shows what many suspected: that the interests of the food and agriculture industries were given higher priority than public health.

Then Scottish Office health minister, James Douglas-Hamilton, wrote on Dec. 5, 1996 to Sir Russell Hillhouse, the under-secretary of state at the Scottish Office that, “The key issue to be addressed is that when there is an outbreak of infectious disease whether the public health interest should over-ride the food industry and agricultural interests. I believe the public health interest should be paramount, but it was not seen to do so in this case.”

The aptly named agriculture minister, Douglas Hogg, argued E. coli was a “Scottish issue” and that licensing should only be in Scotland.

A memo to Secretary of State for Scotland Michael Forsyth, on March 19, 1997, noted: “The Cabinet Office and No 10 were not impressed by Mr Hogg’s idea.”

Ross Thompson of the Daily Record reports that 20 years later, a Wishaw Old Parish Church member believes the heart was ripped from the congregation in the wake of the crippling E. coli tragedy.

Wishaw Old Parish Church session clerk Tom Donaldson was served the same meal as 10 others who lost their lives from the killer bug when infected meat, from John Barr’s Butchers, was served at an annual church lunch.

This week marks 20 years since the outbreak claimed its first victim, 80-year-old Harry Shaw.

Over the next few weeks, 20 others died and hundreds more were infected in what is still the world’s worst E. coli outbreak.

This week, Tom reflected on the horrific events two decades on.

He said: “Many of our members and office-bearers still carry the sad memories of that time.

e-coli-scotland-barr“The heart was torn from the church by the loss of so many members.

“We lost eight members, including three valued elders.

“We held the same meal for over 10 years. For a lot of the people going, it was a chance to get out of the house and see people they hadn’t seen for a while.

“I had the same meal as everyone else but, thankfully, I didn’t have any symptoms. When we heard that people were unwell and then that people had died we couldn’t believe it.

“It was really heart-breaking.”

Over the next few weeks, the world’s media converged on Wishaw to cover the ongoing tragedy.

One man who carried the burden more than most was church minister Rev James Davidson.

Indeed, after burying three of his congregation, Rev Davidson admitted it had been the worst week of his life.

Tom added: “The minister carried the heavy burden as pastor; not only by conducting so many funerals in such a short period but also having to continue to minister to the congregation Sunday by Sunday.

“In one week he had to carry out three funerals. He was heart-broken.

“He really needed more help than he got because not only was he doing those funerals but he was also going to the hospital to visit the sick as well.

“The local media, like the Wishaw Press, and the guys who worked for the Scottish television channels were very respectful. But there was the other side where others would confront the minister and other office- bearers, at their homes and at the church for a comment.

“For quite a few years we had to deal with being ‘that E. coli church’ and people still remember that.”


HUS from Shiga-toxin E. coli sucks, in kids and old people and anyone

Hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli O157:H7 has been widely known as a common cause of acute renal failure in children.

john.barrThere are only a few reports of sporadic Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome in adults in the USA.

Analyses from the 2011 outbreak of hemolytic uremic syndrome associated with Escherichia coli O104:H4 reported that mortality rates are highest in those patients with age >60-years old. Therefore, recognizing Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome in older people can help early introduction of the appropriate therapy.

We describe an 86-year-old Caucasian woman, initially treated as suspected thrombotic thrombocytopenic purpura, with worsening neurological and renal functions despite plasmapheresis (plasma exchange). A subsequent normal ADAMTS13 activity level and positive stool sample for Escherichia coli O157:H7 confirmed the diagnosis of Shiga toxin-associated hemolytic uremic syndrome. We shifted our management towards aggressive supportive care. Despite conventional treatment, hemolytic uremic syndrome unfortunately led to her death.

Our case demonstrates the importance of recognizing Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome as an etiology of microangiopathic hemolytic anemia in older people. According to the current literature, supportive care is the best approach for Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome. Therapies such as plasma exchange and eculizumab (a complement inhibitor) are not shown to be effective in Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome.

There is a dire need to continue research to find better treatment options in this disease entity with a high mortality, particularly in older people.

Hemolytic uremic syndrome associated with Escherichia coli O157:H7 infection in older adults: a case report and review of the literature

Journal of Medical Case Reports, Volume 10, Issue 175, June 2, 2016, DOI: 10.1186/s13256-016-0970-z

Heidi Ko, Hossein Maymani, and Cristhiam Rojas-Hernandez