Toddler contracts serious E. coli infection on NZ family farm

Eight months on from a rescue helicopter dash to Starship children’s hospital, two-year-old Grace Dheda is enjoying being back on her family’s farm – even though it nearly killed her.

grace-dhedaIn March, Grace and her family were savouring rural life in Wellsford.

Mum Megan and Dad Kirin were planning their up-coming wedding. 

That all came to a sudden halt when their daughter began to show signs of illness.

After two days of vomiting and diarrhea, a doctor diagnosed a tummy bug.

Grace was sent home and prescribed plenty of fluids, Megan says.

At home Grace played on the deck like her normal self, but collapsed at bedtime.

Grace was rushed back to the doctors.

“They put her on oxygen straight away. She’d been unconscious for about 45 minutes and they were starting to worry about potential brain damage.”

Given the severity of the situation and the closest ambulance an hour away, the Auckland Westpac Rescue Helicopter was called.

Grace and Megan were ferried to a helipad and arrived to see the chopper landing.

“It was such a relief to see the helicopter,” Megan says.

Megan recalls, “At first nobody knew what was wrong with her and why she was having these seizures. It wasn’t until a few days before we left the hospital that we found out she had contracted E. coli and HUS (Hemolytic Uremic Syndrome).”

HUS is a severe complication of the E. coli infection that can lead to kidney failure.

At first it was thought that Grace had contracted the bacterial infection through the water supply, however this was later tested and found to be normal.

It is now believed that she contracted it via the farm animals.

Megan says, “We’ve got cows here on the farm and I don’t like Grace going anywhere near them. The doctor told me I have ‘parental anxiety.’ ‘I love the farm life, but I’m a bit paranoid now and have about 20 bottles of sanitiser around the place.”

The Helicopter Trust is actively fundraising at present in order to purchase three new ventilators for use on their helicopters and in their Rapid Response Vehicle.

Food safety begins on the farm; Campylobacter reduction in UK

Zoe Kay of Farmers Weekly writes that reducing human infection from campylobacter is the Food Standard Agency’s highest priority – and that means farmers through to supermarkets must play their part.

The reason, according to Javier Dominiguez Orive, deputy veterinary director at the FSA, is simple: Each year in the UK there are 460,000 cases of campylobacter food poisoning, 22,000 hospitalisations and 110 deaths, costing the NHS an estimated £540m.

30913_1The bacteria is endemic in the environment, he adds, and can be caught from pets. But chicken is responsible for 60-80% of all human cases.

“Birds from houses that are thinned are eight times more likely to be colonised at the end of the cycle,” Mary Howell, a senior scientific officer at the FSA told the conference. She pointed to the significant biosecurity risk that thinning presents, as well as the movement of modular crates. While these crates are routinely cleaned, this may not be done at a high enough temperature to kill the campy bug.

In addition to not thinning, Ms Howell also recommended sending evenly sized birds for slaughter by employing sexing and an effective culling-out policy as a way of potentially reducing campylobacter.

Veterinary consultant Jane Downes led a UK-wide on-farm project with the aim of demonstrating that biosecurity can work in controlling campylobacter.

Freshly-slaughtered-pluck-007“It is important for farmers to focus on producing safe food and not just see their chickens as animals.”

While much of the problem of Campylobacter can be traced back to farms, slaughterhouse practices also play a major part.

Cross contamination by carcass washing is one issue and trial work using barbecue dust has investigated the effectiveness of different nozzle types and settings. A web-based tool has since been developed, allowing processors to learn which measures work for them and compare their performance with others.

Eight-year-old UK girl’s health ordeal after E. coli infection

Eight-year-old Daisy Blakemore-Creedon, of St James’ Avenue, New England, underwent surgery and needed blood transfusion and dialysis after contracting E. coli O157, according to the Peterborough Telegraph.

She was rushed to Peterborough City Hospital after being violently sick and suffering with bloody diarrhea and fever.

Mum Hannah and dad Craig say their daughter spent four days in hospital and had seemed to get better.

She was released but no sooner had she left hospital when the sickness and stomach pains returned.

“We were also told that she might need a kidney transplant in the future, that she will have to see a doctor each month and there is a real risk of kidney failure in later life.’’

Mrs Blakemore added, “The experience has left her very distressed.”

Daisy’s ordeal began shortly after she returned from a visit to Sacrewell Country Farm at Thornhaugh, on March 16.

A spokeswoman for Peterborough City Hospital said, “We can confirm that there have been four cases of this particular strain that the hospital has diagnosed.”

Environmental sources of E. coli are not always what they seem

Up to 24 per cent of E. coli in soil sediment is from urban, not farm runoff, in areas of California.

U.S. Department of Agriculture (USDA) scientists have identified sources of E. coli bacteria that could help restore the reputation of local livestock. Studies by Agricultural Research Service (ARS) scientist Mark Ibekwe suggest that in some parts of California, pathogens in local waterways are more often carried there via runoff from urban areas, not from animal production facilities.

Even though most strains of E. coli are non-pathogenic, the bacterium is monitored by public health officials as an indicator of water quality. Cows are often seen as the culprits when E. coli is found in local lakes, rivers and other bodies of water.

Ibekwe, who works at the ARS U.S. Salinity Laboratory in Riverside, Calif., and his colleagues collected 450 water and sediment samples from 20 sites throughout California’s middle Santa Ana River Watershed. The collection sites included urban areas, livestock feeding areas, parks, National Forest lands, and three wastewater treatment plants.

Then the scientists extracted E. coli bacteria from each sample and identified 600 different isolates of E. coli in their samples, many of which could be placed into six clonal populations. They found the greatest variety of different types of E. coli in runoff discharged from areas dominated by urban development or human activities.

Ibekwe also tested all the E. coli isolates for resistance to various antibiotics. He found that from 88 to 95 percent of the isolates were resistant to rifampicin, and that around 75 percent were resistant to tetracycline. Tetracycline resistance was by far the most common type of resistance observed in E. coli isolates collected near wastewater treatment plants.

The scientists also found that 24 percent of E. coli collected in sediment samples associated with urban runoff—a total of 144 isolates—showed resistance to as many as seven antibiotics. Results from this work were published in PLOS ONE.

Two outbreaks of diarrhea in nurseries in Norway after farm visits, April to May 2009

As the parents of two young children file a lawsuit against the Cleveland County Fair, part of the 106 sickened and one death from E. coli O157, Eurosurveillance reports on two separate outbreaks of shiga-toxin producing E. coli in two nurseries where the children had recently visited farms  in Norway in 2009. The nursery outbreaks probably wouldn’t have been noticed except for the increased awareness in Norway at the time due to an on-going outbreak of E coli O157 that sickened 13 children and led to one death.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

Abstract below.

During a 2009 nationwide outbreak of sorbitol-fermenting Escherichia coli O157 in Norway, the Norwegian Institute of Public Health was notified of diarrhea outbreaks in two nurseries. A link to the nationwide outbreak was suspected and investigated, including retrospective cohort studies. Both nurseries had recently visited farms.

Fecal specimens were obtained from symptomatic children as well as from the farm animals and tested for Campylobacter, Salmonella, Yersinia, Shigella and pathogenic E. coli, and isolates were further characterized.  Nursery A had 12 symptomatic children, and we found the same strain of C. jejuni in feces from children and lambs. Nursery B had nine symptomatic children, including one child with bloody diarrhoea carrying enterohaemorrhagic E. coli (EHEC) O26. EHEC O26 with a similar multiple-locus variable number tandem repeat analysis (MLVA)-profile was found in sheep.  Five children had enteropathogenic E. coli (EPEC) O76. 

Animals were not tested for EPEC O76. We found no significant association between illness and risk factors for either nursery. The isolated pathogens differed from the one involved in the nationwide outbreak. In each nursery outbreak, the pathogens isolated from children matched those found in farm animals, implicating animal feces as the source. Hygiene messages are important to prevent similar outbreaks.

UK school boycotted in E. coli scare

The. U.K. is sorta ground zero for E. coli O157 outbreaks in schools and little kids.

So it’s understandable that a primary school has been boycotted by terrified parents amid fears of E. coli contamination.

The playground of Lawfield Primary School in Midlothian was flooded with contaminated water from a neighbouring farm field.

The local council admitted “a wide range of bacteria” was present and warned parents of a potential risk by text message.

They also cordoned off the affected area and are insisting all pupils wash their hands with antibacterial gel.

Despite the measures, it is understood that as many as 30 children have been taken out of the school.

Parents say they will not return to the school, which has 230 pupils, until the presence of potentially deadly E-coli bacteria is ruled out.

Mark Wilkinson, 38, who has two sons at the Edinburgh school, was especially concerned as his wife contracted the bacteria while being treated for kidney stones at a city hospital.

The dad-of-three said: “They’re not going back until I know for a fact there’s no E-coli.

“My wife nearly died of E-coli a couple of years ago so I know how easy it is to catch it – it’s a silent killer.

“There is water running into the playground off a farmer’s field which the school believes may be contaminated with E-coli.

“If the council is testing the water why is the school still open?”

Another father, who wished to remain anonymous, said he received a text from the school around 8.30am advising children to bring a second set of footwear, but by that time it was too late.

He said: “I took the girls to school and a nursery teacher said there had been an outbreak of E-coli in the playground – I was shocked.

“When I went to pick my daughter up from nursery at 11.45am about 30 parents were there taking their kids out of school.

“I decided to take my oldest daughter out of school too – I won’t send them back until the council gives the all-clear.”

10 sickened; crypto outbreak at UK farm ‘over’

The British media has a microbiology problem. Anything that causes illness is routinely labeled a virus or superbug. It happens daily.

Today’s winner is South Wales Argus, which called cryptosporidium a virus, while reporting that an outbreak linked to a Welsh farm that sickened 10 people appears to be over.

Tests showed those who were ill had the same strain of the parasite, cryptosporidium, as lambs and kid goats at Greenmeadow community farm, Cwmbran.

Dr. Lika Nehaul, consultant in communicable disease control, said Public Health Wales is confident the removal of the affected animals has removed the source, and the outbreak can be declared over.

"Nine of those who were unwell were staff or volunteers who had fed the animals by hand," he said.

"Only one case was in a visitor. In the time between the kid goats and lambs arriving at the farm and the last case being confirmed, there had been almost 7,000 visitors, which will reassure the public that the risk was extremely small.”

Scottish council cancels cattle show because E. coli fears not taken seriously

This is proactively awesome.

After decades of farm-show-petting-zoo-fair related outbreaks, particularly of E. coli O157, and after four people were sickened last year, this weekend’s Drymen Show has been cancelled because organizers did not take appropriate steps to reduce risk of E. coli infection.

The Scottish Farmer, my favorite bathtime reading, reports the Drymen Show has been cancelled – and Stirling Council officials have laid the blame at the show organizers’ door, saying that they failed to follow steps to reduce the risk to visitors from E.coli O157 in animal dung.

Further, Stirling Council made it clear that the show’s organizers had been given several reminders about the bio-security rules, as concerns had been raised last year, when four people with links to Drymen Show were diagnosed with E. coli O157.

A spokesperson for the Council said the "Scottish Government provide guidance on the recreational use of animal pasture to reduce the risk of E.coli O157, stating that farm animals should be kept off fields for three weeks prior to use with removal of any visible animal droppings. Contact with farm animal feces on farm pasture presents a risk to the public, especially young children, from the spread of E. coli O157.

"Despite having received assurances that the animals had been removed, this was found not to be the case and animals remained on the show ground area as of May 18 – only 8 days before the date of the Show.

"It is particularly disappointing that the Drymen Show’s organizers did not act upon the proper advice given by Council officers. The same advice and licence conditions are adhered to by other agricultural shows in the Stirling area."

UK issues handwashing reminder ahead of petting farm season

Sorenne’s school is doing the hatching-chicks-thing in anticipation of Easter (which is a surprisingly big deal in Australia) and I’ve been doing my best Dougie-Downer about handwashing, Salmonella, pestilence and death.

In the northern Hemisphere, this is apparently the start of the petting farm season (didn’t have that one penciled in), so the UK Health Protection Agency is reminding people, especially those with responsibility for young children, to enjoy their farm visits safely by ensuring good hand hygiene after touching farm animals or their surroundings.

Outbreaks of gastrointestinal illness associated with contact with farm animals peak in the spring and summer as this coincides with schools holidays when visits to petting farms tend to be more popular, although outbreaks can occur at other times.

The route of transmission in these illnesses, which include the infections E. coli O157 and Cryptosporidium, is direct contact with animals in petting and feeding areas as well as contact with the droppings of animals on contaminated surfaces around farms.

Dr Bob Adak, head of the gastrointestinal diseases department at the HPA, said, “… hand gels or wipes have their uses in areas that are generally clean, such as offices or hospitals, but they are not effective in completely removing from soiled hands bugs such as E. coli or Cryptosporidium that are commonly found in animal droppings and on contaminated surfaces around farms. This is why washing the hands thoroughly with soap and water is so important – it is the only way to effectively remove the bacteria and reduce the risk of becoming unwell.”

Figures from the HPA’s national surveillance system show that there were 61 outbreaks of gastrointestinal illness associated with farms visits between 1992 and 2011. Twenty two of these outbreaks (36 per cent) occurred in the last three years (2009-11).

Around half were caused by E. coli O157 and around half were caused by Cryptosporidium. A handful were caused by Salmonella. Overall 1,238 people were affected in these outbreaks – 1,003 people with Cryptosporidium and 235 with E. coli O157.

A table of petting farm-related outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

We’ll have more to say about this once our research paper, led by Gonzalo, completes the peer review process and gets published.

Salmonella stays with chickens, from birth to kitchen

 News21 is part of a national Knight-Carnegie university reporting project that worked on a bunch of food safety stories over the summer. I spent a lot of time on the phone with these students, as did many others. One of the results was published in the Washington Post over the weekend; excerpts below.

On a late June morning, thousands of newborn chicks in a West Virginia chicken house huddled together for warmth, forming a fuzzy, moving yellow carpet.

Over the next two months, these chicks pecked at the dirt, nibbled on pellets, grew up. They were packed into crates, trucked to a slaughterhouse, cut into parts and sent to a distribution center for shipment to supermarkets and restaurants.

At every step along the way, some of those chickens were infected with salmonella, a pathogen that lives in the intestinal tracts of birds and other animals and can easily spread. Invisible, tasteless and odorless, it doesn’t make the chickens sick. But transferred to humans, it can lead to salmonellosis — an infection that causes diarrhea, fever and stomach cramps, and, in severe cases, can spread from the intestines to the bloodstream.

A look at how the nation’s food safety system operates in the case of salmonella-infected poultry shows how a combination of industry practices and gaps in government oversight results in a fractured effort that leaves the ultimate responsibility for safe food with the consumer.

Food safety experts and poultry scientists say that salmonella control must start on the farm, but federal food safety inspectors never set foot there. The Agriculture Department’s Food Safety and Inspection Service lacks the legal authority to test for salmonella on farms or to require farmers to have a food safety plan.
As a result, attempts to prevent salmonella are done voluntarily by farmers or because poultry processing companies ask them to — leading to a patchwork of efforts, some of which work better than others.

Stan Bailey, a retired USDA microbiologist, said that during his career, he noticed that some companies worked harder than others on food safety. “I think different people have different attitudes on how much they’re willing to spend,” he said.

And no matter how much salmonella USDA finds in raw meat, it cannot be kept off the market.