Oregon family to sue hospital for missing E. coli O157 that killed girl, 4

The devastated family of a 4-year-old Oregon girl who died Monday after contracting E. coli plans to sue a hospital the family says failed to properly diagnose the illness.

serena1Serena Profitt was taken off life support Monday evening after falling sick just a week prior, despite several attempts to get her medical help as her condition grew increasingly worse, her family said.

“We don’t want money, we want them to be accountable … to say this will not happen again to another child,” the girl’s aunt, Aleasha Hargitt, told KATU-TV.

Her family took the blond child to the Samaritan North Lincoln Hospital in Lincoln City, Ore., Sept. 3 and sent her home

“(Serena’s mom) asked (the hospital) to run the tests, so they dismissed her from the hospital at Lincoln City on Wednesday with the rotavirus, they said go home, check in with their pediatrician on Thursday, which was recommended by the hospital,” Hargitt told the TV station.

The next day, the family returned to the same hospital with the girl, who’d had a fever, abdominal pain and bloody diarrhea. A different doctor saw the sick girl, but again sent the family home, this time with a misdiagnosis, Hargitt says.

“He specifically said E. coli was negative,” Hargitt told KATU.

The family again returned home, but Serena showed no improvement. Distressed and concerned, they drove about 50 miles Saturday to a hospital in McMinnville, Ore., where doctors realized her condition was grave.

“Everybody was very surprised. I know the McMinnville doctor was maddened, like, he was upset,” Hargitt told the station. “If (North Lincoln Hospital) ordered (the test), why didn’t (they) run it? Why did you cancel it? Is it too expensive? Is it too time consuming? Is it too much out of you day. I don’t know. It’s a question they don’t want to answer right now.”

USDA strengthens procedures for detecting and removing unsafe ground beef

The U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service (FSIS) announced new procedures that will allow the agency to trace contaminated ground beef back to its source more quickly, remove it from commerce, and find the root cause of the incident to prevent it from recurring. The changes being announced today build on other initiatives the agency has instituted this summer to improve the safety of ground beef, including a proposed requirement that retailers keep records of their ground beef source suppliers and new laboratory methods the agency is using to test these products for multiple pathogens at one time. 

hamburger.grind“A critical component of preventing foodborne illness is quickly identifying sources of contamination and removing unsafe products from store shelves,” said Brian Ronholm, Deputy Under Secretary for Food Safety.  “The expedited traceback procedures being announced today will allow FSIS to take action more quickly, which will make a significant difference in food safety investigations and in preventing foodborne illnesses.”

Under the new traceback procedures, FSIS will conduct immediate investigations at businesses whose ground beef tests positive for E. coli O157:H7 during initial testing and at suppliers that provided source materials. These traceback investigations will begin as soon as FSIS receives a presumptive positive result and the grinding facility can provide supplier information. Previously, FSIS began investigations at the grinding facility only after a presumptive positive test result was confirmed, which can take two days. A similar investigation of the grinding facility’s suppliers would have taken place 30 days later, and more intensive investigations of suppliers will now also begin immediately. Beginning investigations at the point of a presumptive positive test result can save FSIS valuable time.  

As part of the traceback investigation, FSIS will review establishment records to determine whether the grinding or supplying establishment’s food safety system experienced a breakdown. The agency will also determine whether the supplying establishment shipped product that may be contaminated to other grinding facilities or further processors. If so, FSIS will take steps to have that product removed from commerce.

FSIS estimates that dozens more recalls may occur once these new protections are in place. By expediting investigations and more quickly removing unsafe product from commerce, FSIS is taking another step to strengthen public health protections and prevent foodborne illnesses.

The improved traceback procedures will be fully implemented 60 days after publication in the Federal Register on October 14, 2014. The Federal Register Notice is available at http://www.fsis.usda.gov/wps/wcm/connect/a054fc30-2af6-4ea5-a9e9-468c2df788e8/2011-0009.pdf?MOD=AJPERES.  

Manage problems before, not after alienating customers; what the NHL should learn from business

Some genius at CNN decided the National Hockey League, which resumes play in a few days after a protracted strike, could learn from the 1996 E. coli outbreak in unpasteurized juices produced by Odwalla that killed one and sickened at least 65.

While Odwalla did some creative risk communication, they, like the NHL, utterly failed at risk management by letting the crisis happen.

I’m gong back to Australia to play hockey, not talk about it.

Sometime in late September 1996, 16-month-old Anna Gimmestad of Denver has a glass of Smoothie juice manufactured by  Odwalla Inc. After her parents noticed bloody diarrhea, Anna was admitted to sorenne.hockey.jan.13Children’s Hospital on Oct. 16.  On 8 November 1996 she died after going into cardiac and respiratory arrest.  Anna had severe kidney problems, related to hemolytic uremic syndrome and her heart had stopped several times in previous days.

The juice Anna — and 65 others who got sick — drank was contaminated with E. coli O157:H7, linked to fresh, unpasteurized apple cider used as a base in the juices manufactured by Odwalla.  Because they were unpasteurized, Odwalla’s drinks were shipped in cold storage and had only a two-week shelf life.  Odwalla was founded 16 years ago on the premise that fresh, natural fruit juices nourish the spirit.  And the bank balance: in fiscal 1996, Odwalla sales jumped 65 per cent to $60 million (U.S.).  Company chairman Greg Steltenpohl told reporters that the company did not routinely test for E. coli because it was advised by industry experts that the acid level in the apple juice was sufficient to kill the bug.

Who these industry experts are remains a mystery.  Odwalla insists the experts were the U.S. Food and Drug Administration.  The FDA isn’t sure who was warned and when.   In addition to all the academic research and media coverage concerning verotoxigenic E. coli cited above, Odwalla claimed ignorance.

In terms of crisis management — and outbreaks of foodborne illness are increasingly contributing to the case study literature on crisis management — Odwalla responded appropriately.  Company officials responded in a timely and compassionate fashion, initiating a complete recall and co-operating with authorities after a link was first made on Oct. 30 between their juice and illness.  They issued timely and comprehensive press statements, and even opened a web site containing background information on both the company and E. coli O157:H7.  Upon learning of Anna’s death, Steltenpohl issued a statement which said, “On behalf of myself and the people at Odwalla, I want to say how deeply saddened and sorry we are to learn of the loss of this child.  Our hearts go out to the family and our primary concern at this moment is to see that we are doing everything we can to help them.”

For Odwalla, or any food firm to say it had no knowledge that E. coli O157 could survive in an acid environment is unacceptable.  When one of us called this $60-million-a-year-company with the great public relations, to ask why they didn’t know that E. coli O157 was a risk in cider, it took over a day to return the call.   That’s a long time in crisis-management time.  More galling was that the company spokeswoman said she had received my message, but that her phone mysteriously couldn’t call Canada that day.

Great public relations; lousy management.  What this outbreak, along with cyclospora in fresh fruit in the spring of 1996 and dozens of others, demonstrates is that, vigilance, from farm to fork, is a mandatory requirement in a global food system.  Risk assessment, management and communication must be interlinked to accommodate new scientific and public information.  And that includes those funky and natural fruit juices.

60 sick with E. coli O157 in 10 states: it was Romaine lettuce (grown in California?) served at Schnucks salad bars by Mr. Green

A day after Missouri health types announced the source of the Schnucks-salad-bar-related E. coli O157 outbreak may never be found, the feds announced they found a source.

The U.S. Centers for Disease Control (CDC) reported today that as of Dec. 4, 2011, 60 persons infected with the outbreak strain of E. coli serotype O157:H7 had been reported from 10 states.

Collaborative investigative efforts of state, local, and federal public health and regulatory agencies indicate that romaine lettuce is the likely source of illnesses in this outbreak, and contamination likely occurred before the product reached retail stores.

CDC called Schnucks Chain A, and the farm the lettuce was traced to Farm A, without saying in what state the lettuce originated. But one of the Missouri health types did, saying a grower in California was suspected of being connected but records were “insufficient to complete the picture.”

The public reporting of this outbreak reeks of the Leafy Greens Cone of Silence – that the most noticeable achievement since the California Leafy Greens Marketing Agreement was created in the wake of the 2006 E. coli O157-in-spinach mess is the containment cone of silence that has descended upon outbreaks involving leafy greens.

Things didn’t sound quite right back on Oct. 28, 2011, when St. Louis County health officials first publicly confirmed that the source of the E. coli O157 strain that had sickened 23 people was foodborne, but that the investigation was ongoing. Though retailers have not been asked to pull any food, Schnucks voluntarily replaced or removed some produce in salad bars and shelves, beginning Oct. 26, 2011.

"Once we heard that the health department had declared an outbreak, we took some proactive steps with our food safety team to switch products out that recent history told us could be potential sources," said Schnucks spokeswoman Lori Willis.

A Schnucks store, Culinaria in downtown St. Louis, put a sign up on empty shelves that read in part, "Due to a voluntary recall on pre-packed lettuce, we will not be able to produce these pre-made salads. Be assured quality is our main concern. All of the lettuce on the salad bar is fresh and not involved with the recall."

As a retailer, Schnucks drew my attention earlier this year when it announced it was expanding its so-called Peace of Mind initiative from pricing to quality assurance with a new website, www.peaceofmindquality.com, that emphasizes the chain’s dedication to quality and food safety. Unfortunately, quality and safety are seemingly used interchangeably on the website when they are actually two different concepts.

A table of leafy green related outbreaks is available at http://bites.ksu.edu/leafy-greens-related-outbreaks.

I’m not feeling peace of mind.

More from the CDC report:

As of December 4, 2011, 60 persons infected with the outbreak strain of E. coli O157:H7 have been reported from10 states. The number of ill persons identified in each state is as follows: Arizona (1), Arkansas (2), Georgia (1), Illinois (9), Indiana (2), Kansas (3), Kentucky (1), Minnesota (3), Missouri (37), and Nebraska (1).

Among persons for whom information is available, illnesses began from October 10, 2011 to November 4, 2011. Ill persons ranged in age from 1 to 94 years, with a median age of 29 years old. Sixty-three percent were female. Among the 45 ill persons with available information, 30 (67%) were hospitalized, and 2 developed hemolytic uremic syndrome (HUS). No deaths have been reported.

Collaborative investigative efforts of state, local, and federal public health agencies indicate that romaine lettuce sold primarily at several locations of a single grocery store chain (Chain A) was the likely source of illnesses in this outbreak. Contamination likely occurred before the product reached grocery store Chain A locations.

Ill persons reported purchasing salads from salad bars at grocery store Chain A between October 5 and October 24, 2011. A total of 9 locations of grocery store Chain A were identified where more than one ill person reported purchasing a salad from the salad bar in the week before becoming ill. This included 2 separate locations where 4 ill persons reported purchasing a salad at each location. For locations where more than one ill person reported purchasing a salad from the salad bar and the date of purchase was known, dates of purchase were all within 4 days of other ill persons purchasing a salad at that same location. Chain A fully cooperated with the investigation and voluntarily removed suspected food items from the salad bar on October 26, 2011, out of an abundance of caution. Romaine lettuce served on salad bars at all locations of grocery store Chain A had come from a single lettuce processing facility via a single distributor. This indicates that contamination of romaine lettuce likely occurred before the product reached grocery store Chain A locations.

The FDA and several state agencies conducted traceback investigations for romaine lettuce to try to identify the source of contamination. Traceback investigations focused on ill persons who had eaten at salad bars at several locations of grocery store Chain A and ill persons at university campuses in Minnesota (1 ill person) and Missouri (2 ill persons). Traceback analysis determined that a single common lot of romaine lettuce harvested from Farm A was used to supply the grocery store Chain A locations as well as the university campus in Minnesota during the time of the illnesses. This lot was also provided to a distributor that supplied lettuce to the university campus in Missouri, but records were not sufficient to determine if this lot was sent to this university campus. Preliminary findings of investigation at Farm A did not identify the source of the contamination. Farm A was no longer in production during the time of the investigation.

E. coli O157 toll up to 11 at Pennsylvania park lake

There are now 11 confirmed and two probable E. coli infections linked to the outbreak at Cowans Gap State Park, and most of the afflicted were in the lake on the same weekend.

Pennsylvania Department of Health spokesperson Christine Cronkright released the updated numbers Thursday. Nine of the confirmed E. coli O157:H7 cases involved people from Pennsylvania, and two are from Maryland. All but one of the sick people are children.

In the weeks since her son contracted E. coli O157, Melanie Royer has been a mother on a mission to encourage illness reporting and the closure of the lake at Cowans Gap State Park.

Royer is thankful the lake was closed as a precaution because she watched the bacteria ravage her 12-year-old son’s body.

"This whole thing is so scary because you’re helpless as a parent," she said.

She encourages people with suspected E. coli cases to not only seek medical attention, but also ensure their cases are being reported to the state health department.

Royer criticized the delay between when children were being diagnosed and when the lake closed.

Best in show: dog show leads to E. coli outbreak in Sweden

Around 50 dog owners and several dogs are believed to have been infected with enterohaemorrhagic E. coli (EHEC) following a dog show in eastern Sweden.

"We’re right in the middle of investigating where the bacteria came from," Britt Åkerlind of the infectious disease unit of Östergötland County told The Local.

So far, two Swedes have been confirmed as infected by EHEC, one from Skåne in the south, and another from Gothenburg in the west.

"But we’re expecting more confirmed cases to come in," said Åkerlind.

Those infected with the bacteria all attended a dog show near Norrköping in eastern Sweden held the first weekend in June.

Of the roughly 120 participants, who traveled from all over Sweden as well as from Denmark, Norway, and Finland, about half have come down with symptoms stemming from EHEC infection.

"We’ve also received reports that some of the dogs have had upset stomachs," said Åkerlind, who labeled the outbreak as "quite large."