E. coli outbreak at Durham, NC nursing home

Raleigh ABC 11 reports the possibility of a pathogenic E. coli outbreak at the  Emerald Pond retirement home in Durham, NC. It’s early on, when information sometimes get’s messed up, but the report says:

A spokesperson from the Durham County Health Department told Eyewitness News the department learned of at least four patients and staff members at Emerald Pond who have the bacterial illness.
Some strands (sic) of the bacteria can cause diarrhea, while others cause urinary tract infections, respiratory illness, pneumonia and other illnesses.
The initial report of E. coli cases was made over the weekend, but the Health Department is just beginning its investigation.
Emerald Pond has closed its dining room as a precaution.
The retirement home said it’s cleaning the facility and "precautions are in place."

If the outbreak does happen to be pathogenic E. coli it could get messy for elderly individuals, and is often misdiagnosed.  In a 2006 article published in the Journal of the American Geriatrics Society, Reiss and colleagues write:

A growing pool of epidemiological surveys reveals that geriatric populations are at risk of severe manifestations of EHEC O157:H7 infections. A 5-year review of cases in Alberta, Canada, and in Scotland found that morbidity rates, defined as need for hospitalization, in those aged 60 and older were similar to or worse than those in young children. Of 703 patients requiring inpatient medical treatment in Alberta, Canada, during the study period, rates of hospitalization in persons aged 60 and older were nearly twice as high (68.9% of reported cases) as those of children younger than age 5.

Given the absence of fever, and often only the complaint of ‘‘bleeding per rectum,’’ it is not surprising that cases will be initially misdiagnosed as hemorrhoids, diverticulosis, or another source of painless lower gastrointestinal bleeding.

A review of nursing home outbreaks and epidemiological data indicate that nursing home patients are indeed at high risk for EHEC O157:H7 infection and related complications, although common perception may still place EHEC and associated HUS/TTP in the category of a pediatric infectious disease.

The mention of infected staff member(s) puts an interesting twist on things — raising the possibility that an infected food handler is involved.

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About Ben Chapman

Dr. Ben Chapman is a professor and food safety extension specialist at North Carolina State University. As a teenager, a Saturday afternoon viewing of the classic cable movie, Outbreak, sparked his interest in pathogens and public health. With the goal of less foodborne illness, his group designs, implements, and evaluates food safety strategies, messages, and media from farm-to-fork. Through reality-based research, Chapman investigates behaviors and creates interventions aimed at amateur and professional food handlers, managers, and organizational decision-makers; the gate keepers of safe food. Ben co-hosts a biweekly podcast called Food Safety Talk and tries to further engage folks online through Instagram, Twitter, Facebook, YouTube and, maybe not surprisingly, Pinterest. Follow on Twitter @benjaminchapman.