Tag Archives: e. coli O157

FDA speaks: E. coli O157 in leafy greens

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Between August and December 2020, the U.S. Food and Drug Administration (FDA) and multiple state and federal partners were involved in an outbreak investigation related to E. coli O157:H7 illnesses and the consumption of leafy greens. The outbreak, which caused 40 reported domestic illnesses, was linked via whole genome sequencing (WGS) and geography to outbreaks traced back to the California growing region associated with the consumption of leafy greens in 2019 and 2018. FDA, alongside state and federal partners, investigated the outbreak to identify potential contributing factors that may have led to leafy green contamination with E. coli O157:H7. The E. coli O157:H7 outbreak strain was identified in a cattle feces composite sample taken alongside a road approximately 1.3 miles upslope from a produce farm with multiple fields tied to the outbreaks by the traceback investigations. In addition, several potential contributing factors to the 2020 leafy greens outbreak were identified.

Isolates within this cluster of illnesses are part of a reoccurring strain of concern and are associated with outbreaks that have occurred in leafy greens each fall since 2017. The two most recent outbreaks associated with this strain were an outbreak in 2018 (linked to romaine lettuce from the Santa Maria growing region of California) and an outbreak in 2019 (linked to romaine lettuce from the Salinas growing region of California). Clinical isolates from cases in this 2020 outbreak appear more closely related to those from the 2019 outbreak than the 2018 outbreak. In addition, several specific food and environmental isolates that appear to be highly related to this 2020 outbreak include a fecal-soil composite sample collected by FDA in February 2020 from the Salinas growing region and two leafy green samples collected in 2019 by state partners as a part of the 2019 investigation that traced back to the Salinas growing region.

As part of this investigation, tracebacks of leafy greens consumed by ten ill individuals from eleven points of service were conducted. Although that traceback investigation was based on a relatively small number of the total cases, it was based on those cases which presented the strongest evidence via purchase card information, invoices, bills of lading, and electronic data. The traceback investigation identified the Salinas growing region of California as a geographical region of interest.

In light of this most recent finding, combined with previous outbreak investigation findings in the region, FDA has identified key trends regarding the issues of a reoccurring strain, a reoccurring region, and reoccurring issues around adjacent and nearby land use of primary importance in understanding the contamination of leafy greens by E. coli O157:H7 that occurred in 2020 and previous years.

FDA also recognizes the interconnection between people, animals, plants, and their shared environment when it comes to public health outcomes. As such, we strongly encourage collaboration among various groups in the broader agricultural community (i.e. livestock owners; leafy greens growers, state and federal government agencies, and academia) to address this issue. With this collaboration, the agricultural community, alongside academic and government partners, can work to identify and implement measures to prevent contamination of leafy greens. FDA recommends that these parties participate in efforts to understand and address the challenge of successful coexistence of various types of agricultural industries to ensure food safety and protect consumers against foodborne illnesses.

Frank Yiannas, Deputy Commissioner for Food Policy and Response – Food and Drug Administration said in a release that as part of our ongoing efforts to combat foodborne illness, today the U.S. Food and Drug Administration published a report on the investigation into the Fall 2020 outbreak of Shiga Toxin-Producing E. coli (STEC) O157:H7 illnesses linked to the consumption of leafy greens grown in the California Central Coast. The report describes findings from the investigation, as well as trends that are key to understanding leafy green outbreaks that are linked to the California Central Coast growing region, specifically encompassing the Salinas Valley and Santa Maria growing areas every fall since 2017.

We released our preliminary findings earlier this year that noted this investigation found the outbreak strain in a sample of cattle feces collected on a roadside about a mile upslope from a produce farm. This finding drew our attention once again to the role that cattle grazing on agricultural lands near leafy greens fields could have on increasing the risk of produce contamination, where contamination could be spread by water, wind or other means. In fact, the findings of foodborne illness outbreak investigations since 2013 suggest that a likely contributing factor for contamination of leafy greens has been the proximity of cattle. Cattle have been repeatedly demonstrated to be a persistent source of pathogenic E. coli, including E. coli O157:H7.

Considering this, we recommend that all growers be aware of and consider adjacent land use practices, especially as it relates to the presence of livestock, and the interface between farmland, rangeland and other agricultural areas, and conduct appropriate risk assessments and implement risk mitigation strategies, where appropriate. Increasing awareness around adjacent land use is one of the specific goals of the Leafy Greens Action Plan we released last March, which we’re also announcing is being updated today to include new activities for 2021.

During our analysis of outbreaks that have occurred each fall since 2017, we have determined there are three key trends in the contamination of leafy greens by E. coli O157:H7 in recent years: a reoccurring strain, reoccurring region and reoccurring issues with activities on adjacent land. The 2020 E. coli O157:H7 outbreak associated with leafy greens represents the latest in a repeated series of outbreaks associated with leafy greens that originated in the Central Coast of California (encompassing Salinas Valley and Santa Maria) growing region (that’s me and Frank and the woman who wants to divorce me in our Kansas kitchen, 10 years ago)

In the investigation, the FDA recommends that growers of leafy greens in the California Central Coast Growing Region consider this reoccurring E. coli strain a reasonably foreseeable hazard, and specifically of concern in the South Monterey County area of the Salinas Valley. It is important to note that farms covered by the Food Safety Modernization Act (FSMA) Produce Safety Rule are required to implement science and risk-based preventive measures in the rule, which includes practices that prevent the introduction of known or reasonably foreseeable hazards into or onto produce.

The FDA also recommends that the agricultural community in the California Central Coast growing region work to identify where this reoccurring strain of pathogenic E. coli is persisting and the likely routes of leafy green contamination with STEC. Specifically, we have outlined specific recommendations in our investigation report for growers in the California Central Coast leafy greens region. Those recommendations include participation in the California Longitudinal Study and the California Agricultural Neighbors workgroup. When pathogens are identified through microbiological surveys, pre-harvest or post-harvest testing, we recommend growers implement industry-led root cause analyses to determine how the contamination likely occurred and then implement appropriate prevention and verification measures.

In response, Tim York wrote in The Packer that on April 16 the California LGMA Board took decisive action to endorse pre-harvest testing guidance. The guidance recommends pre-harvest testing specifically when leafy greens are being farmed in proximity to animal operations. 

It’s the intention of the board to include pre-harvest testing as part of the LGMA audit checklist so the government can verify that all LGMA members are in compliance. 

This is the first time an entire commodity group will be required to conduct pre-harvest testing.

This is a big deal, but a necessary response to the recent U.S. Food and Drug Administration report on outbreaks associated with lettuce in 2020.  The findings and regulatory language used by FDA in this report were nothing short of a warning shot that calls on our industry to do more to stop outbreaks. 

And so, we must do more.

Updating LGMA’s required food safety practices is an involved process that seeks input from scientists, food safety experts and the public. No other entity is capable of making such widespread change as quickly as we can.<

Some weeks ago, in the first piece I wrote for The Packer as CEO of the California LGMA, I stressed the need for collaboration with the retail and foodservice buying community, noting that we must lean on each other to make needed improvements together. And now, I am asking for your help.

Updating LGMA’s required food safety practices is an involved process that seeks input from scientists, food safety experts and the public. No other entity is capable of making such widespread change as quickly as we can.

Best communication practices in communicating a drinking water-related public health emergency

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I guess someone published this again, since the Walkerton outbreak of E. coli O157 which killed seven and sickened over 2,000 k in a town of 5,000 happened in May 2000.

I know it’s not the best writing, but I tried, and it was 20 years ago. I severed on an expert (I hate that word) committee and we wrote our report.

We live near the publicaly funded Princess Alexandria hospital in Brisbane.

A helicopter flies over our house a couple of times a day bringing some victim from the outback or the coast.

The state of Queensland is really, really big.

It reminds me of my Walkerton-resident friend and what he went through in the aftermath of the E. coli O157 outbreak in drinking water.dying being flown to the medical center in London, Ontario (that’s in Canada, like Walkerton).

I think of Jim and the victims every time a chopper goes past.

The E. coli O157:H7 waterborne outbreak in Walkerton, Ont., Canada, in May 2000, presented a clear and present danger of risk to citizens who consumed that water — at least in retrospect. More challenging though, is to know when a risk is severe enough to warrant extraordinary communications and how best to compel citizens to comply with health advisories.

Risk theory, involving assessment, management and communication, is important to underpin discussions of how regulators, industry and citizensincorporate and act on information about risks — such as the hazards posed by E. coli O157:H7 in drinking water. Today it is well accepted that the three components of risk analysis cannot be separated and are, in fact, integrated, and that communication involves the multi-directional flow of information.

Evidence from recent water-borne disease outbreaks illustrates the importance of timeliness in health related warnings.

Timeliness of message delivery is dependent on how quickly a problem is identified, and how the message is delivered. The public can passively receive information on health related risks  from the media or the utility, or actively seek out information from information sources such as the Internet, telephone hotlines or library services (Casman et al., 2000).

In determining when to go public with health advisories, health authoritiesreport that every outbreak of food- or water-borne illness must be examine dusing factors such as severity, potential impact and incubation time of the suspect pathogen. The health risk outcome of microbiological hazards to the public should be assessed, discussed and quantified among workers from diverse disciplines, including health officials, veterinarians, food processing experts, microbiologists, medical doctors, risk analysis experts, and consumer behavior experts.

Once sufficient evidence exists to issue a public health advisory, risk messages must be designed that accurately describe the risk to individuals and provide concrete steps that individuals can take to reduce the chances of risk exposure.

Further, the number of suspected or confirmed illnesses related to the particular outbreak should be included as a matter of course in any public communications. And once health advisories have been created, a variety ofmessage delivery techniques need to be employed, again depending on the severity of the hazard, the size of the impacted population and local circumstances.

For a severe and immediate hazard such as E. coli O157:H7 in drinking water, a mixture of low-to-high technology message delivery mechanisms should be employed, including door-to-door, the buddy system, the use of existing community networks such as Neighbourhood Watch, emergency hubsite information centers and even mobile megaphones, complimented by more broader mechanisms such as local media, posting information on a website, automated telephone messages, broadcast faxes, and electronic mail distribution.

However, the key to using any of these technologies effectively is to plan ahead and be prepared.  Effective planning will establish which techniques are best for the size of the community and the existing infrastucture.  No one technology can reach all members of the target audience, therefore combining delivery methods is essential.

The current state of risk management and communication research suggests that those responsible with food and water safety risk management must be actively seen to be reducing, mitigating or minimizing a particular risk. The components for managing the stigma associated with any food safety issue seem to involve all of the following factors:

  • effective and rapid surveillance systems;
  • effective communication about the nature of risk;
  • a credible, open and responsive regulatory system;
  • demonstrable efforts to reduce levels of uncertainty and risk; and,
  • evidence that actions match words.

This report has been concerned with the second point, the ability to effectively communicate about the nature of risk. E. coli O157:H7 is not regular E. coli. It is a highly virulent and dangerous pathogen that sickens tens of thousands annually in North America and kills hundreds. Each year since the 1993 Jack-in-the-Box outbreak has brought a high profile and deadly outbreak of E. coli O157:H7 from some corner of the developed world; outbreaks that receive significant media coverage and provide new insights; Australia in 1994 (involving the related E. coli O111); Scotland and Japan in 1996; a waterpark in Atlanta, Ga in 1998. While many Canadians may be unfamiliar with such outbreaks — media coverage in Canada is superficial at best, frequently focused on the hypothetical risks posed by various food-related technologies while ignoring the carnage associated with food and water-borne pathogens

Any local efforts must be supported by a national culture of awarenessregarding a risk such as E. coli O157:H7, which has been known to cause outbreaks and severe illness, and sometimes death, for almost 20 years. When compared to outbreaks and response in the U.S., it is observed that outbreaks, particularly of E. coli O157:H7 bring a sustained policy response from the highest levels of government, including the Office of the President. While there have been many private-sector initiatives in Canada to enhance the safety of the food supply, these efforts are rarely communicated or discussed by government, short of admonitions to “cook hamburger thoroughly.

If I dance, it’s poorly, but I loved it.

Canadian boy permanently brain damaged after eating lettuce contaminated with E. coli

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Tyana Grundig, Greg Sadler and Asha Tomlinson report for CBC’s Marketplace (see below) that the last decade has seen recall after recall of tainted romaine lettuce coming into Canada from the United States. At least seven people have died, and hundreds have been sickened or hospitalized in both countries.

Toddler Lucas Parker was one of them.

In the fall of 2018, his parents, Nathan Parker and Karla Terry of Richmond, B.C., took Lucas and his siblings to Disneyland, their first trip outside Canada. But what they couldn’t know at the time was that a few bites of romaine salad Lucas ate one night at a small California roadside restaurant would change their lives forever. 

Soon after that dinner, an outbreak of E. coli O157: H7 contamination spread across both Canada and the United States — eventually leaving 35 people hospitalized.

Like most people who get sick from this strain of E. coli, Lucas, then two years old, didn’t show symptoms right away. When he started feeling unwell, the family headed out for the long drive home. By the time he was in a Canadian hospital, the E. coli had shut down one of his kidneys and led to two brain injuries. There are no current treatments for E. coli that can help alleviate infections or prevent complications. 

Lucas can no longer walk, talk or see. 

“Lucas was just a beaming ray of light … he was a caring person … a cheeky boy, a loving brother,” said his father, Nathan Parker. “I remember him in the hospital waking up out of a coma and looking around, just lost, not talking, not walking, not moving much. Such a brain injury that his brain was so swollen that there was no comfort, there was nothing. It was just hell.”

Bill Marler, an American lawyer and food-safety advocate who has been fighting for food safety for almost 30 years, represents Lucas and his parents. Marler has filed suit on behalf of the family against the restaurant where they ate, as well as the farm and suppliers of the lettuce; the case is currently in the discovery phase in a court system slowed down because of the COVID-19 pandemic. 

Lucas, “is the most devastatingly injured human who has survived a food-borne illness outbreak — ever,” said Marler. “The fact that he survived at all and his parents care for him as gently and as caringly as they do is a testament to them.”

Young children and older adults are most at risk of developing serious complications from E. coli O157: H7 contamination. While most people simply experience an upset stomach, some develop life-threatening symptoms, including stroke, kidney failure and seizures — and some die. 

Between 2009 and 2018, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) say they identified 40 food-borne outbreaks of infections from this strain of E. coli in the U.S. with a confirmed or suspected link to leafy greens.

Marler says he believes cows — and a society that values convenient, bagged lettuce — are to blame.

Romaine recalls: Why our salads can make us sick

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CBC’s Marketplace (that’s a TV show in Canada) notes that Canada has been hit by a number of romaine lettuce recalls. We set out to the U.S., where the majority of our leafy greens come from, to dig up why E. coli outbreaks continue to plague our food supply. We meet one B.C. family whose lives have been forever changed by a contaminated salad (thanks to Bill Marler for posting on this).

Foodborne fungus impairs intestinal wound healing in Crohn’s disease

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Researchers at Washington University School of Medicine in St. Louis and the Cleveland Clinic have discovered that a fungus found in foods such as cheese and processed meats can infect sites of intestinal damage in mice and people with Crohn’s and prevent healing. Moreover, writes Tamara Bhandari of News Room treating infected mice with antifungal medication eliminates the fungus and allows the wounds to heal.

The findings, published March 12 in the journal Science, suggest that antifungal drugs and dietary changes are potential new approaches to improving intestinal wound healing and reducing symptoms of Crohn’s disease.

“We’re not suggesting that people stop eating cheese and processed meat; that would be going far beyond what we know right now,” said first author Umang Jain, PhD, an instructor in pathology & immunology at the School of Medicine. “What we know is that this foodborne fungus gets into inflamed, injured tissue and causes harm. We’re planning to perform a larger study in people to figure out if there’s a correlation between diet and the abundance of this fungus in the intestine. If so, it is possible dietary modulation could lower levels of the fungus and thereby reduce symptoms of Crohn’s disease.”

Crohn’s is a subtype of inflammatory bowel disease. As the name suggests, it is driven by chronic inflammation in the digestive tract and primarily treated with immunosuppressive medications. Crohn’s patients endure repeated cycles of gastrointestinal symptom flare-up and remission. During a flare, their digestive tracts are dotted with inflamed, open sores that can persist for weeks or even months.

To understand why intestinal ulcers take so long to heal in some people, Jain and senior author Thaddeus Stappenbeck, MD, PhD, formerly at Washington University and now at the Cleveland Clinic, studied mice whose intestines had been injured. By sequencing microbial DNA at the site of injury, they discovered that the fungus Debaryomyces hansenii was abundant in wounds but not in uninjured parts of the intestine.

People acquire the fungus through their food and drink, Jain said. D. hansenii is commonly found in all kinds of cheeses, as well as sausage, beer, wine and other fermented foods.

FDA, California agricultural stakeholders launch multi-year study to enhance food safety

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This is a few months old, but if Frank’s in it, I’ll run it, late but not never.

The following quote is attributed to Frank Yiannas, FDA Deputy Commissioner for Food Policy and Response:

“The FDA is committed to providing innovative food safety approaches that build on past learnings and leverage the use of new information and data. Today we’re announcing a partnership with the California Department of Food and Agriculture (CDFA), the University of California, Davis, Western Center for Food Safety (WCFS), and agricultural stakeholders in the Central Coast of California to launch a multi-year longitudinal study to improve food safety through enhanced understanding of the ecology of human pathogens in the environment that may cause foodborne illness outbreaks.”

“The launch of this longitudinal study follows a series of E. coli O157:H7 outbreaks in recent years linked to California’s leafy greens production regions, particularly three outbreaks that occurred in Fall 2019. Due to the recurring nature of outbreaks associated with leafy greens, the FDA developed a commodity-specific action plan to advance work in three areas: prevention, response, and addressing knowledge gaps. We’ve already made great strides executing our 2020 Leafy Greens Shiga toxin-producing E. coli (STEC) Action Plan by engaging with state partners to implement new strategies for preventing outbreaks before they occur, collaborating with industry partners to assess and augment response efforts when an outbreak occurs, and analyzing past leafy greens outbreaks to identify areas of improvement important to enhance leafy greens safety.”

“In alignment with the FDA’s New Era of Smarter Food Safety initiative, the findings from this longitudinal study will contribute new knowledge on how various environmental factors may influence bacterial persistence and distribution in the region, and how those factors may impact the contamination of leafy greens.”

The California longitudinal multi-year study will examine how pathogens survive, move through the environment and possibly contaminate produce, through work with water quality, food safety, and agricultural experts from CDFA, the WCFS, representatives from various agriculture industries, and members of the leafy greens industry.

Foodborne illness source attribution estimates for 2018 for Salmonella, Escherichia coli O157, Listeria monocytogenes, and Campylobacter using multi-year outbreak surveillance data, United States, December 2020

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The U.S. Centers for Disease Control and Prevention reported in Dec.2020 that each year in the U.S.an estimated 9 million people get sick, 56,000 are hospitalized, and 1,300 die of foodborne disease caused by known pathogens. These estimates help us understand the scope of this public health problem. However, to develop effective prevention measures, we need to understand the types of foods contributing to the problem.

The Interagency Food Safety Analytics Collaboration (IFSAC) is a tri-agency group created by the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS). IFSAC developed a method to estimate the percentages of foodborne illness attributed to certain sources using outbreak data from 1998 through the most recent year for four priority pathogens: Salmonella, Escherichia coli O157, Listeria monocytogenes, and Campylobacter. IFSAC described this method and the estimates for 2012 in a report, peer-reviewed journal article, and at a public meeting. IFSAC derived the estimates for 2018 using the same method used for the 2012 estimates, with some modifications. The data came from 1,459 foodborne disease outbreaks that occurred from 1998 through 2018 and for which each confirmed or suspected implicated food was assigned to a single food category. The method relies most heavily on the most recent five years of outbreak data (2014 – 2018). Foods are categorized using a scheme IFSAC created that classifies foods into 17 categories that closely align with the U.S. food regulatory agencies’ classification needs. Salmonella illnesses came from a wide variety of foods.

More than 75% of Salmonella illnesses were attributed to seven food categories: Chicken, Seeded Vegetables (such as tomatoes), Pork, Fruits, Other Produce (such as nuts), Eggs and Turkey. E. coli O157 illnesses were most often linked to Vegetable Row Crops (such as leafy greens) and Beef. Over 75% of illnesses were linked to these two categories. Listeria monocytogenes illnesses were most often linked to Dairy products and Fruits. More than 75% of illnesses were attributed to these two categories, but the rarity of Listeria monocytogenes outbreaks makes these estimates less reliable than those for other pathogens. Non-Dairy Campylobacter illnesses were most often linked to Chicken. Over 75% of non-Dairy foodborne illnesses were attributed to Chicken, Other Seafood (such as shellfish), and Turkey, with Campylobacter illnesses most often linked to Chicken. An attribution percentage for Dairy is not included because, among other reasons, most foodborne Campylobacter outbreaks were associated with unpasteurized milk, which is not widely consumed, and we think these over-represent Dairy as a source of illness caused by Campylobacter. Removing Dairy illnesses from the calculations highlights important sources of illness from widely consumed foods, such as Chicken.

This collaborative effort to provide annual attribution estimates continues IFSAC’s work to improve foodborne illness source attribution, which can help inform efforts to prioritize food safety initiatives, interventions, and policies for reducing foodborne illnesses. These consensus estimates allow all three agencies to take a consistent approach to identifying food safety priorities to protect public health. For more information on IFSAC projects visit https://www.cdc.gov/foodsafety/ifsac/projects/index.html.

Raw is risky: Beware fresh produce and E. coli

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Technology Networks reports that E. coli food poisoning is one of the worst food poisonings, causing bloody diarrhea and kidney damage. But all the carnage might be just an unintended side effect, researchers from UConn Health report in the 27 November issue of Science Immunology. Their findings might lead to more effective treatments for this potentially deadly disease.

Escherichia coli are a diverse group of bacteria that often live in animal guts. Many types of E. coli never make us sick; other varieties can cause traveler’s diarrhea. But swallowing even a few cells of the type of E. coli that makes Shiga toxin can make us very, very ill. Shiga toxin damages blood vessels in the intestines, causing bloody diarrhea. If Shiga toxin gets into the bloodstream it can cause kidney failure.

“This is especially common in children; about 15% of kids with Shiga toxin-producing E. coli infections get kidney disease, and some can suffer long term kidney damage,” says UConn Health immunologist Sivapriya Vanaja.

A group of Shiga toxin-producing E. coli called enterohemorrhagic E. coli, or EHEC, are especially common in the United States. When you hear that a batch of romaine lettuce is being recalled because of a dangerous outbreak of food poisoning, it’s almost certainly due to EHEC.

EHEC normally live in cattle without making them sick. It used to be relatively common to have EHEC outbreaks coming from unhygienically prepared ground meat, but stringent regulations on slaughterhouses have made this less common. Now it’s more likely for EHEC to appear on vegetables grown in fields adjacent to cattle or manure runoff.

But no matter where it comes from, once EHEC bacteria get inside a human, the infection is hard to treat. Antibiotics tend to make it worse—when the bacteria feel themselves dying, they make more Shiga toxin. And EHEC are very good at inhibiting the part of the immune system that normally responds early to this kind of infection, allowing them to grow unchecked in the human gut.

In a study led by Morena Havira, a postdoctoral fellow in Vanaja’s lab, the team wanted to know how EHEC suppresses the immune system. The body normally responds to early stages of E. coli infections by activating an enzyme that kicks off an alarm inside cells. The cell bursts open to release a cloud of warning molecules that call other parts of the immune system to come and fight the bacteria.

But EHEC squashes that early response. To figure out how it does that, Vanaja and her colleagues decided to see which individual gene in EHEC was responsible. They took many different varieties of EHEC from a bacterial mutant library, and infected immune cells with them.

The team found that cells infected with EHEC that was missing the gene for Shiga toxin mustered a higher immune response compared to normal EHEC.

It was surprising. Shiga toxin is very well-studied for its toxic activity; it wasn’t known that it had another function,” Dr. Vanaja says. So Shiga toxin’s stealthy suppression of the immune system may have a link to all the bloody drama that ensues. Spurred on by this exciting observation, they conducted a series of detailed molecular studies, which revealed that Shiga toxin blocks a protein from bursting open the infected cell and alerting the body of infection.

Now that Vanaja and her colleagues know the specific molecular step Shiga toxin interferes with inside the immune cells, they are trying to figure out how, exactly, it blocks it. Once they know that, they may be able to find medicines that prevent toxin from interfering with immune responses.
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No hair, sharper blog, more love: US E. coli investigation details

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Yeah, I fell again a couple of weeks ago, lost a lot of blood, so the doc wanted to have a look at the two contusions.

She started shaving the back of my head, the long hair that gives me strength, and eventually my friend and I told the doc, “Let’s try something different and take it all off.”

There are those who call me Uncle Fester.

The U.S. Centers for Disease Control, public health and regulatory officials in several states, the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are collecting different types of data to identify the food source of a multistate outbreak of E. coli O157:H7 infections.

As of February 1, 2021, a total of 16 people infected with the outbreak strain have been reported from 5 states.

Illnesses started on dates ranging from December 23, 2020, to January 7, 2021.

Sick people range in age from 10 to 95 years, with a median age of 31, and 88% are female. Of 12 people with information available, 9 have been hospitalized. Of 11 people with information, 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS). One death has been reported from Washington.

State and local public health officials are interviewing people to find out what foods they ate in the week before they got sick.

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

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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.