Tag Archives: O26

E. coli O26 and (O121) loves flour

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I wrote this in May, and it’s still relevant:

I used to be a lick-the-batter-off-the-spoon kind of guy. I stopped doing that a few years ago. I don’t eat raw cookie dough, or let my kids eat it. I’m probably not the most fun dad, but outbreaks recalls like what is going on right now is why.

General Mills announced today a voluntary national recall of five-pound bags of its Gold Medal Unbleached All Purpose Flour with a better if used by date of September 6, 2020. The recall is being issued for the potential presence of E. coli O26 which was discovered during sampling of the five-pound bag product. This recall is being issued out of an abundance of care as General Mills has not received any direct consumer reports of confirmed illnesses related to this product.

This recall only affects this one date code of Gold Medal Unbleached All Purpose Flour five-pound bags. All other types of Gold Medal Flour are not affected by this recall.

Guidance from the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) continues to warn that consumers should refrain from consuming any raw products made with flour. E. coli O26 is killed by heat through baking, frying, sautéing or boiling products made with flour. All surfaces, hands and utensils should be properly cleaned after contact with flour or dough.

I think they mean cleaned and sanitized.

There’s something about O26 and O121 and flour that we’re all gonna have to figure out.

Here’s the outbreak from May 2019. Here’s a Canadian outbreak from 2017. Oh, here’s another outbreak from 2016.

Raw is risky: 19 children develop HUS in France from E. coli O26 linked to raw milk cheese

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Gabrielle Jones, Sophie Lefevre, et al report in Eurosurveillance that from 25 March to 27 April 2019, 19 suspected Shiga toxin-producing Escherichia coli (STEC) associated paediatric haemolytic uraemic syndrome (HUS) cases were notified by French hospital paediatric departments to Santé publique France, compared with 5–10 cases during the same period in previous years [1].

Thirteen cases were confirmed as serogroup O26, with whole genome sequencing (WGS) underway for strain comparison. Initial epidemiological investigations using a trawling questionnaire identified the consumption of raw cow’s milk soft cheeses (Saint-Félicien and Saint-Marcellin) as the common link for eight of these 13 cases. Trace-back investigations using supermarket loyalty cards identified a common producer (producer A) of these cheeses for three cases and on the basis of this information a recall was initiated by French health authorities on 27 April 2019 [2]. As at 27 May 2019, investigations identified 16 outbreak cases including 14 paediatric HUS cases and two cases with uncomplicated diarrhoea (one child and one adult). Investigations are ongoing for one suspected case. The 16 outbreak cases reside in six administrative regions in France. All paediatric cases are under 5 years of age; the median age is 22 months (overall age range: 6 months–63 years). Eight cases are female. Date of symptom onset was between 31 March (week 13) and 29 April (week 18). All HUS cases were hospitalised. Thirteen cases received blood and/or platelet transfusion and seven underwent haemodialysis. Six cases had neurological complications, all of them received transfusions and three also had haemodialysis.

The families of all 16 outbreak cases and the suspected case were interviewed about their at-risk exposures during the 10 days before symptom onset. Families of 16 cases (15 outbreak cases and one suspected case) reported the consumption of Saint-Félicien or Saint-Marcellin raw cow’s milk cheeses by either the case (n = 12) or household members (n = 4). One outbreak case did not report consumption of these cheeses. For the 16 cases with reported consumption of these cheeses, trace-back investigations using loyalty cards and supply data from the different shops where the caretakers reported purchasing the cheeses identified a link with producer A for 13 (all outbreak cases).

Producer A manufactured only Saint-Félicien and Saint-Marcellin cheeses. To date, no positive STEC O26 cheese or milk samples have been identified. Investigations, including sampling of the cheeses and trace-back of the milk supply chains, are ongoing.

Four outbreak cases had not consumed the cheeses themselves but a household member had. This suggests the affected child may have been infected via cross contamination (knives, cutting board, hands, etc.). None of the household members reported symptoms of illness, indicating that the cases were unlikely to have been infected by person-to-person transmission. Investigations are ongoing in an attempt to further document the exposures of these cases (consumption of cheeses or other food items cut by the knives or on the same cutting board as the suspected cheeses). Only one in 16 outbreak cases reported a family member with self-limiting diarrhoea (no stool analysis).

Note: If that many people developed HUS, hundreds could have potentially been sickened.

Trade live cattle, introduce next E. coli O26 sequence type

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Shiga toxin–producing Escherichia coli serogroup O26 is an important public health pathogen. Phylogenetic bacterial lineages in a country can be associated with the level and timing of international imports of live cattle, the main reservoir.

We sequenced the genomes of 152 E. coliO26 isolates from New Zealand and compared them with 252 E. coli O26 genomes from 14 other countries. Gene variation among isolates from humans, animals, and food was strongly associated with country of origin and stx toxin profile but not isolation source. Time of origin estimates indicate serogroup O26 sequence type 21 was introduced at least 3 times into New Zealand from the 1920s to the 1980s, whereas nonvirulent O26 sequence type 29 strains were introduced during the early 2000s.

New Zealand’s remarkably fewer introductions of Shiga toxin producing Escherichia coli O26 compared with other countries (such as Japan) might be related to patterns of trade in live cattle.

Use of genomics to investigate historical importation of shiga toxin-producing Escherichia coli serogroup O26 and nontoxigenic variants into New Zealand

March 2019

Emerging Infectious Diseases vol. 25 no. 3

Springer Browne1, Patrick J. Biggs, David A. Wilkinson, Adrian L. Cookson, Anne C. Midwinter, Samuel J. Bloomfield, C. Reed Hranac, Lynn E. Rogers, Jonathan C. Marshall, Jackie Benschop, Helen Withers, Steve Hathaway, Tessy George, Patricia Jaros, Hamid Irshad, Yang Fong, Muriel Dufour, Naveena Karki, Taylor Winkleman, and Nigel P. French

https://wwwnc.cdc.gov/eid/article/25/3/18-0899_article

1 dead, 17 sick from E. coli O26 in Cargill ground beef

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The U.S. Centers for Disease Control (CDC), public health and regulatory officials in several states, and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) investigated a multistate outbreak of Shiga toxin-producing Escherichia coli O26 (E. coli O26) infections linked to ground beef from Cargill Meat Solutions. This outbreak appears to be over.

On September 19, 2018, Cargill Meat Solutions in Fort Morgan, Colorado recalled ground beef products.

Recalled ground beef products were produced and packaged on June 21, 2018 and were shipped to retailers nationwide.

Products are labeled with the establishment number “EST. 86R” inside the USDA mark of inspection.

Restaurants and retailers should not serve or sell recalled ground beef and should check freezers and storage for recalled products.

If possible, retailers who received recalled ground beef should contact their customers to alert them of the recall.

When available, the retail distribution list will be posted on the USDA-FSIS website.

Consumers with questions regarding the recall can call 1-844-419-1574. Consumers with ground beef in their freezers can contact the store where it was purchased to determine if it is recalled ground beef.

Final Outbreak Information

At A Glance

Reported Cases: 18

States: 4

Hospitalizations: 6

Deaths: 1

Illnesses started on dates ranging from July 5, 2018 to July 25, 2018.

Six people were hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. One person in Florida died.

Epidemiologic, laboratory, and traceback evidence indicates that ground beef from Cargill Meat Solutions is a likely source of the outbreak.

On September 19, 2018, Cargill Meat Solutions recalled ground beef products that were produced and packaged on June 21, 2018 and shipped to retailers nationwide. Visit the USDA-FSIS website for a full list of recalled products[PDF – 40.2 KB].

Laboratory testing identified the outbreak strain of E. coli O26 in leftover ground beef collected from the home of one ill person in Florida. WGS analysis showed that the E. coli O26 strain identified in the leftover ground beef was highly related genetically to the E. coli O26 strain isolated from ill people.

18 sick: E. coli O26 linked to Publix ground chuck products

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Publix Super Markets Inc., a Lakeland, Fla., retail grocery store chain is voluntarily recalling an undetermined amount of ground beef products made from chuck that may be contaminated with Escherichia coli O26, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The ground chuck items were purchased by consumers from June 25, 2018, through July 31, 2018. The following products are subject to recall: https://www.fsis.usda.gov/wps/wcm/connect/330436d0-f5bb-4ee3-a3eb-cca6459bf014/072-2018-List-Products.pdf?MOD=AJPERES&useDefaultText=0&useDefaultDesc=0   

These items were shipped to Publix Super Market retail locations in the following Florida counties: https://www.fsis.usda.gov/wps/wcm/connect/68f37b9e-2b95-45c9-8ba7-36500f13a6ac/072-2018-Affected-Counties-Florida.pdf?MOD=AJPERES&useDefaultText=0&useDefaultDesc=0

On Aug. 16, 2018, FSIS was notified of an investigation of E. coli O26 illnesses. FSIS, the Centers for Disease Control and Prevention, and state public health and agriculture partners determined that raw ground chuck was the probable source of the reported illnesses. The epidemiological investigation identified 18 case-patients, predominantly from Florida, with illness onset dates ranging from July 5 to July 25, 2018. Traceback information indicated that case-patients consumed ground chuck products purchased at various Publix Super Markets that was supplied by a yet-to-be determined source. As this investigation further develops, FSIS will continue to work with the supermarket, suppliers and public health partners, and will provide updated information should it become available.

  1. coli O26, like the more common E. coli O157:H7, is a serovar of Shiga toxin-producing E. coli (STEC). People can become ill from STECs 2–8 days (average of 3–4 days) after exposure to the organism.

Most people infected with STEC O26 develop diarrhea (often bloody) and vomiting. Some illnesses last longer and can be more severe. Infection is usually diagnosed by testing of a stool sample. Vigorous rehydration and other supportive care is the usual treatment; antibiotic treatment is generally not recommended. Most people recover within a week, but rarely, some develop a more severe infection. Hemolytic uremic syndrome (HUS), a type of kidney failure, is uncommon with STEC O26 infection. HUS can occur in people of any age but is most common in children under 5 years old, older adults and persons with weakened immune systems. It is marked by easy bruising, pallor and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately

FSIS is concerned that some product may be frozen and in consumers’ freezers. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase.

FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers. When available, the retail distribution list(s) will be posted on the FSIS website at www.fsis.usda.gov/recalls.

1 child dead, 14 sick from E. coli O26 in French ‘Our regions have talent’ raw milk cheese

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Outbreak News Today reports on a statement from the French about the Escherichia coli ( E. coli ) O26 outbreak linked to the consumption of raw milk reblochons produced at the Cruseilles (Haute-Savoie) site of Chabert. French health officials are now reporting 14 children aged one to five years included in the investigation.

As of May 31, 6 children with HUS were infected with the same strain of E. coli O26, for which the consumption or reblochon incriminated is documented. These six children are domiciled in several regions of metropolitan France (Center-Val de Loire, PACA, Ile-de-France, Auverhne-Rhone-Aples, Pays-de-la-Loire); and for 8 other children, investigations are in progress. Of these, two had signs of gastroenteritis and six had HUS. One of the children with HUS died; the investigation around this case is in progress. To date, it cannot be dismissed or affirmed that these cases of HUS are linked to the consumption of reblochon: non-isolated and characterized strain, or consumption of reblochon incriminated not yet documented.

7 children sick with E. coli O26: France’s Leclerc recalls ‘Our regions have talent’ cheese

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French food retailer Leclerc has issued a recall of a brand of cheese made with raw milk that has been linked by the authorities to cases of E.coli O26 among young children.s

Leclerc, France’s biggest supermarket chain by market share, said on its website that it was withdrawing Reblochon cheese supplied by cheesemaker Chabert in the Savoy region and sold under the “Nos regions ont du talent” (“Our regions have talent”) brand.

The move came after the French health authorities linked seven cases of E. coli O26 bacteria among children between one-and-a-half and three years to the cheese, which is a creamy speciality of the French Alps.

“The investigations conducted by the health authorities have confirmed an epidemiological link between these cases and the consumption of whole Reblochon cheese made with raw milk under the brand and sold by the Leclerc chain in several regions,” France’s health and agriculture ministries said in a joint statement.

The ministries said that six of the seven cases of infection involved hemolytic-uremic syndrome, a potentially serious condition that can cause kidney failure among young children.

Six children were taken to hospital and one is yet to return home, the health ministry added in an emailed response.

If six of the seven cases have HUS, there are dozens more that are sick.

Costco recalls cut broccoli because of E. coli O26

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Non O157 STECs aren’t new but it’s still kinda notable when they pop up in recalls. The more folks look, whether buyers or suppliers are testing for them, the more folks find.

In 2015 E. coli O26 caused 60 illnesses (including 22 hospitalizations) associated with Chipotle. No source was identified, but the pathogen has been seen in both meats and produce. Today’s winner is cut broccoli.

According to a CFIA post, Costco is recalling Gold Coast brand broccoli florettes after someone found the pathogen. Or as CFIA so helpfully says, ‘This recall was triggered by the company.’

Gold Coast has a food safety page on their website. They say stuff like, ‘Microbiological Testing Program – Our new, fully equipped, in-house Microbiological Laboratory performs raw product, in process, finished product, and environmental testing.’

and

‘All raw and finished products are “lot coded” and can be traced back to specific suppliers, growers, ranches, fields, and plots.’

I look forward to hearing more.

E. coli O26, HUS and dairy

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In their recent article in Eurosurveillance, Germinario et al. describe a community-wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26:H11 infections associated with haemolytic uraemic syndrome (HUS) and involving 20 children between 11 and 78 months of age in southern Italy during the summer 2013 [1]. The investigation identified an association between STEC infection and consumption of dairy products from two local milk-processing establishments. We underline striking similarities to a recent multi-country STEC O26 outbreak in Romania and Italy and discuss the challenges that STEC infections and their surveillance pose at the European level.

e-coli-colbertIn March 2016, Peron et al. published, also in Eurosurveillance, early findings of the investigation of a community-wide STEC infection outbreak in southern Romania [2]. As at 29 February 2016, 15 HUS cases with onset of symptoms after 24 January 2016, all but one in children less than two years of age, had been identified, three of whom had died. Aetiological confirmation was retrospectively performed through serological diagnosis and six cases were confirmed with STEC O26 infection. Shortly after this publication, and following the identification of the first epidemiologically-linked case in central Italy, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) published a joint Rapid Outbreak Assessment [3]. The Italian and Romanian epidemiological, microbiological and environmental investigations implicated products from a milk-processing establishment in southern Romania as a possible source of infection. The dairy plant exported milk products to at least four European Union (EU) countries. The plant was closed in March 2016 and the implicated food products recalled or withdrawn from the retail market.

Pulsed Field Gel Electrophoresis (PFGE) and whole genome sequencing (WGS) analyses did not establish a microbiological link between the Italian (2013) and the Romanian/Italian (2016) outbreaks (personal communication, Stefano Morabito, October 2016). However, the epidemiological similarities between the two community-wide outbreaks associated with HUS and STEC O26 infections, mostly affecting young children and implicating dairy products, are notable. While raw milk and unpasteurised dairy products are well known potential sources of STEC infection, milk products, as highlighted by Germinaro et al. [1], have been rarely implicated in community-wide STEC outbreaks in the past, emphasising an emerging risk of STEC O26 infection associated with milk products.

Reporting of STEC O26 infections has been steadily increasing in the EU since 2007, partly due to improved diagnostics of non-O157 sero-pathotypes [4]. The attention to non-O157 STEC sero-pathotypes rose considerably after the severe STEC O104 outbreak that took place in Germany and France in 2011 during which almost 4,000 cases and more than 50 deaths were reported [5]. In light of the recently published outbreaks related to dairy products and the simultaneous increased reporting of isolations of STEC O26 from milk and milk products in the EU/European Economic Area (EEA) [6], strengthening STEC surveillance in humans and food and enhancing HUS surveillance in children less than five years of age is warranted. Paediatric nephrologists should be sensitised to this effect

Community-wide outbreaks of haemolytic uraemic syndrome associated with Shiga-toxin producing Escherichia coli O26 in Italy and Romania: A new challenge for the European Union

Eurosurveillance, Volume 21, Issue 49, 08 December 2016, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.49.30420

E Severi, F Vial, E Peron, O Mardh, T Niskanen, J Takkinen

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22664

National Meat and Provisions recalls beef and veal products due to possible E. coli O26 contamination

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National Meat and Provisions, a Reserve, La. establishment, is recalling approximately 2,349 pounds of beef and veal products that may be contaminated with E. coli O26, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

ground-beef-recallThe raw non-intact beef and veal items were produced and packaged on Sept. 14-15, 2016. The following products are subject to recall: [View Labels (PDF Only)]

51.40-lb. of VACUUM-PACKED “BEEF GROUND COMPANY BURGER BLEND,” packed on 9/14/2016 with a lot number of “00028584” and case codes of 53085/CB136 in the upper left-hand corner of the label

50.00-lb. of VACUUM-PACKED “BEEF GROUND COURSE STEAK TRIM,” packed on 9/14/2016 with a lot number of “00028582” and case codes of 53080/02300H in the upper left-hand corner of the label

10.00-lb. of VACUUM-PACKED “BEEF GROUND FRESH,” packed on 9/14/2016 with a lot number of “00028583” and case codes of 53110/02300P in the upper left-hand corner of the label

50.00-lb. VACUUM-PACKED “BEEF GROUND CHIMES FINE,” packed on 9/14/2016 with a lot number of “00028581” and case codes of 56660/02300C in the upper left-hand corner of the label

51.46-lb. VACUUM-PACKED “BEEF GROUND COMPANY BURGER BLEND,” packed on 9/15/2016 with a lot number of “00028597” and case codes of 53085/CB136 in the upper left-hand corner of the label

10.00-lb. VACUUM-PACKED “BEEF FAT OF RIB CAP,” packed on 9/15/2016, with a lot number of “00028595,” and case codes of 50010/1138 in the upper left-hand corner of the label

10.83-lb. VACUUM-PACKED “BEEF GROUND CHUCK DAT DOG,” packed on 9/15/2016, with a lot number of “00028593,” and case codes of 56135/02150 in the upper left-hand corner of the label

10.23-lb. VACUUM-PACKED “BEEF GROUND CHUCK BRISKET BURGER,” packed on 9/15/2016 with a lot number of “00028596,” and case codes of 53060/208116120 in the upper left-hand corner of the label

5.00-lb. VACUUM-PACKED “BEEF STEAK CUBED 5#,” packed on 9/15/2016, with a lot number of “00028594,” and case codes of 50565/04902 in the upper left-hand corner of the label

10.00-lb. VACUUM-PACKED “BEEF GROUND CHUCK 10#,” packed on 9/15/2016, with a lot number of “00028592,” and case codes of 53015/02100 in the upper left-hand corner of the label

10.11-lb. VACUUM-PACKED “BEEF STEAK CUBED,” packed on 9/15/2016, with a lot number of “00028591,” and case codes of 50555/1100GJ in the upper left-hand corner of the label

10.32-lb. VACUUM-PACKED “BEEF GROUND CHUCK BRISKET 8 oz.,” packed on 9/15/2016, with a lot number of “00028585,” and case codes of 53050/05M8 in the upper left-hand corner of the label

9.98-lb. VACUUM-PACKED “VEAL SIRLOIN CUBED POLY BAGED,” packed on 9/15/2016, with a lot number of “00028590,” and case codes of 56070/0776 in the upper left-hand corner of the label

The products subject to recall bear establishment number “EST. M-22022” inside the USDA mark of inspection. These items were shipped to a distributor, as well as hotels, restaurants and institutions in Louisiana.

The problem was discovered when the establishment received a positive STEC sample during their quarterly E. coli testing program on Sept. 29, 2016. There have been no confirmed reports of adverse reactions due to consumption of these products.

Many clinical laboratories do not test for non-O157 Shiga toxin-producing E. coli (STEC), such as STEC O26 because it is harder to identify than STEC O157. People can become ill from STECs 2–8 days (average of 3–4 days) after consuming the organism. Most people infected with STEC O26 develop diarrhea (often bloody), and vomiting. Some illnesses last longer and can be more severe. Infection is usually diagnosed by testing of a stool sample. Vigorous rehydration and other supportive care is the usual treatment; antibiotic treatment is generally not recommended.