Tag Archives: Stec

29 sick: An outbreak of Shiga toxin-producing Escherichia coli O121 infections associated with flour- Canada, 2016-2017

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On December 29, 2016, PulseNet Canada identified a cluster of six Escherichia coli non-O157 isolates with a matching pulsed-field gel electrophoresis (PFGE) pattern combination that was new to the PulseNet Canada database. The patients resided in three geographically distinct provinces. In January 2017, the Public Health Agency of Canada (PHAC) initiated an investigation with local, provincial, and federal partners to investigate the source of the outbreak.

A case was defined as isolation of E. coli non-O157 with the outbreak PFGE pattern or closely related by whole genome sequencing (WGS) in a Canadian resident or visitor with onset of symptoms of gastroenteritis on or after November 1, 2016. Patients’ illness onset dates ranged from November 2016 to April 2017 (Figure). As of May 23, 2017, a total of 29 cases were identified in six provinces (Alberta, British Columbia, Newfoundland and Labrador, Ontario, Quebec, and Saskatchewan). One additional case was identified in a U.S. resident who traveled to Canada during the exposure period. Patients’ ages ranged from 2–79 years (median = 23.5 years) and 50% were female. Eight patients were hospitalized, and one developed hemolytic uremic syndrome. Clinical isolates were typed as E. coli O121:H19 (one case was typed as E. coli O121:H undetermined) with Shiga toxin 2–producing genes by in silico toxin testing and had closely related PFGE patterns and WGS.

Initial investigation into the source of the outbreak did not identify any clear hypotheses; common exposures were ground beef, sausage style deli-meats, pizza, and pork, but the data did not converge on any specific products. Patients were reinterviewed by PHAC using an open-ended approach. Knowledge of a recent E. coli O121 flour-associated outbreak prompted interviewers to ask about baking and exposure to raw flour or dough (1). Patients were also asked if any food items of interest, including flour, were available for testing.

In March 2017, E. coli O121 with the outbreak PFGE pattern was isolated from an open flour sample from a patient’s home and a closed sample collected at a retail store, both of the same brand and production date. The clinical and flour isolates grouped together, with only 0–6 whole genome multilocus sequence typing allele differences. As a result of these findings, a product recall was issued. Based on possible connections to the recalled lot of flour, market sampling of flour within certain periods was initiated. The investigation led to additional recalls of flour and many secondary products (2).

As of May 23, 2017, 22 patients had been asked about flour exposure in the 7 days before illness onset; 16 (73%) reported that the implicated brand of flour was used or probably used in the home during the exposure period. Comparison data on the expected proportion with exposure to this brand of flour were not available. Eleven of these sixteen patients reported they ate or probably ate raw dough during their exposure period.

This is the first national outbreak of non-O157 Shiga toxin–producing E. coli infections identified in Canada and the first Canadian outbreak linked to flour. An open-ended interview approach and flour sampling were used to implicate flour as the source. Because of the recent emergence of E. coli outbreaks linked to flour, public health professionals should consider flour as a possible source in E. coli outbreaks and communicate the risk associated with exposure to flour, raw batter, and dough in public health messaging.

Use a fucking thermometer: Ireland says eating undercooked burgers ‘like driving without a seatbelt’

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Diners who enjoy a juicy burger have been warned that eating them pink in the middle is “like driving without wearing a seatbelt”.

Fiachradh McDermott of The Irish Times reports that safefood began its new campaign, “Burger Fever”, on Thursday to inform people that eating undercooked burgers could lead to serious or sometimes life-threatening food poisoning.

What she didn’t report is that color is a terrible indicator of safety, and that needle-or-blade-tenderized steaks carry the same risk as mince, so this science-based agency is publishing fairy tales.

But I’ll let the bureaucrats speak for themselves and you judge.

The body advised people to always ask for burgers to be well-cooked in restaurants.

In an online survey conducted by safefood, 96 per cent of people considered themselves well-informed about food safety. However, 51 per cent admitted to eating undercooked burgers.

Two thirds of respondents said they would reconsider their choice if they knew there was a possibility of food poisoning.

Undercooked burgers carry the risk of E. coli, which can have long-term effects. The biggest worry is a type called VTEC, which causes severe diarrhoea.

Dr Linda Gordon, chief specialist in food science at safefood, said it can result in “frequent serious complications.” VTEC can affect the blood and kidneys, and is most serious in older people and children under five. However, it only takes as little as ten E. coli cells to make a person sick, she said.

Dr Gordon said the campaign is intended as a preventative measure, but “emphasising the difference between a burger and a steak” is an important aspect.

According to Dr Gary Kearney, director of food science at safefood, “Mince used in hamburgers is a higher risk as the food poisoning bacteria that live on the surface of the beef (steak) is then mixed through the middle of the burger when the beef is minced – so in effect, the outside is now on the inside.”

Dr Martin Cormican, Professor of Bacteriology at National University of Ireland, Galway (NUIG), emphasised the possibility and danger of contracting VTEC from undercooked meat.

“Eating burgers that are pink in the middle is a bit like driving without a seatbelt; you might get away with it for years but if something goes wrong and you are harmed, will you still think it was worth it?”

No mention of thermometer, cooking temps and hold times, just plain pandering.

Use a fucking thermometer and stick it in.

Assessment of risk communication about undercooked hamburgers by restaurant servers

E. Thomas, E,M,, Binder, A., McLaughlin, A., Jaykus, L., Hanson, D, Powell, D.A., Chapman, B. 2016.

Journal of Food Protection Vol. 79, No. 12, pp. 2113-2118

http://www.jfoodprotection.org/doi/abs/10.4315/0362-028X.JFP-16-065?code=fopr-site

According to the U.S. Food and Drug Administration 2013 Model Food Code, it is the duty of a food establishment to disclose and remind consumers of risk when ordering undercooked food such as ground beef.

The purpose of this study was to explore actual risk communication activities of food establishment servers. Secret shoppers visited restaurants (n=265) in seven geographic locations across the U.S., ordered medium rare burgers, and collected and coded risk information from chain and independent restaurant menus and from server responses.

The majority of servers reported an unreliable method of doneness (77%) or other incorrect information (66%) related to burger doneness and safety. These results indicate major gaps in server knowledge and risk communication, and the current risk communication language in the Model Food Code does not sufficiently fill these gaps. Furthermore, should servers even be acting as risk communicators? There are numerous challenges associated with this practice including high turnover rates, limited education, and the high stress environment based on pleasing a customer. If it is determined that servers should be risk communicators, food establishment staff should be adequately equipped with consumer advisory messages that are accurate, audience-appropriate, and delivered in a professional manner so as to help their customers make more informed food safety decisions.

Tough mudders and cyclists, beware the agri-land: Outbreaks amongst participants in Norway, Scotland

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NRK reports that some 50 of 300 participants became sick with Campylobacter in a cycling event in Norway.

Competitors at the start of the 2015 Tough Mudder Scotland at Drumlanrig Castle, Dumfries and Galloway

Earlier, several people were stricken by E. coli O157 in a tough mudder event which was held at Drumlanrig Castle in Scotland on June 17 and 18.

These outbreaks follow previous, numerous outbreaks involved with playing in mud.

In Norway, the reason why the cyclists have become so bad is because animal wreckage resolved after a heavy rainfall and remained in the road. This has again sprung up on the cyclists.

“Especially if the stool is fresh and there are large amounts of water, it can sprinkle on drinking bottles and hands so you get it when you drink,” said Tor Halvor Bjørnstad-Tuveng, to NRK (something may be lost in translation).

“We have been in dialogue with the management of the race, and we have some concrete measures that we will look at. We have been very unlucky with the rides of the year, but we must definitely look at what we can do to prevent it happening again, “says Bjørnstad-Tuveng.

Per Stubban was one of those who had to go to the hospital for intravenous nutrition.

“Now I’m on my way, but there have been some tough days. Next time I will not use a handheld drink bottle, but a drinking bag, and if there is as much rain as it was now, I would probably be skeptical to start, “he said.

Participants in an endurance event at a Scottish castle have been warned to look out for symptoms of E. coli O157 after it was identified among those who took part.

NHS Dumfries and Galloway said “a small number of cases” of the bacteria have been found in those involved in the Tough Mudder event at Drumlanrig Castle last month.

It has advised anyone associated with the event who experiences symptoms to seek medical advice.

A spokesman for the health board said: “NHS Dumfries and Galloway can confirm that we are aware of a small number of cases of E.coli O157 across Scotland that appear to be associated with participation in the Tough Mudder event which was held at Drumlanrig Castle on June 17 and 18.

“Any activity undertaken on agricultural land inevitably involves a small risk of gastrointestinal infection.”

A spokesman for the event said: “The safety of Tough Mudder participants, spectators, volunteers and staff is our number one priority.

Uh-huh.

E. coli O157 is always tragic, but probably not because of the last thing you ate

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McDonald’s is a big, semi-popular fast-food chain in the way Semi-Tough (the movie) depicted American professional football as big and semi-popular.

When Shiga-toxin producing E.coli were discovered in 1977 (named verotoxigenic E. coli) and then the first outbreaks were linked to human illness in 1982 at McDonald’s in White City, Ore., and Traverse City, Mich., McDonald’s completely revamped its beef sourcing and cooking procedures.

Over the past three decades, I’ve heard everyone blame McDonald’s for everything, especially on food safety, and especially what used to be known as hamburger disease.

South Korean lawyers are apparently catching up to where North Americans were 25 years ago, but perpetuate semi-stereotypes.

According to The Korea Herald, a mother on Wednesday filed a complaint against McDonalds Korea, claiming her daughter was diagnosed with the “hamburger disease” after eating a burger with an undercooked patty in one of its outlets.

“The 4-year-old victim had no health problems, but caught hemolytic uremic syndrome after eating a McDonald’s hamburger,” lawyer Hwang Da-yeon said at a press conference held in front of the Seoul District Prosecutors Office, before submitting the complaint. 

HUS is serious shit.

McDonald’s has known about it for a long time.

The complaint claims McDonald’s violated local food safety rules by serving contaminated meat that was not fully cooked.

The plaintiff also made a tearful plea, asking state prosecutors to investigate and hold McDonald’s Korea responsible for her daughter, who has suffered irreversible damage to her kidneys and must undergo eight to 10 hours of peritoneal dialysis on a daily basis.

According to the mother, the child ate a hamburger at a McDonald’s outlet in Gyeonggi Province in September and fell ill about three hours afterwards.

HUS is always tragic, and I wouldn’t wish it on anyone.

She was brought to an intensive care unit three days later, where she was diagnosed with HUS, a food-borne disease that can cause acute kidney failure. The child was discharged from the hospital two months later, but had lost 90 percent of her kidney function.

The McDonald’s outlet denied any link between its product and the child’s illness, saying the meat is machined-cooked, eliminating human error.

I’m not sure who’s right, but Shiga-toxin producing E. coli – the kind that lead to HUS – take 2-4 days to develop – not 3 hours.

As Kate Murphy of The New York Times explained last week, when you’re fine one minute and barfing the next – what the U.S. Centers for Disease Control and Prevention calls an acute gastrointestinal event — happens to all of us at least once a year. The bouts, while extremely unpleasant, usually don’t occasion a trip to the doctor or require any medication.

But such events tend to make us spin our gears trying to pinpoint what made us so miserably sick. While it’s hard to know for sure, there are clues that might help you determine the source and reduce your risk in the future.

“People tend to blame the last thing they ate, but it’s probably the thing before the last thing they ate,” said Dr. Deborah Fisher, a gastroenterologist and associate professor at Duke University School of Medicine.

It takes the stomach around four to six hours to empty a full meal, and then the small intestine takes about six to eight hours to squeeze out all the nutrients and empty into the colon. The remains linger there for another one to three days, fermenting and being formed into what ultimately is flushed down the toilet. So-called bowel transit time varies significantly from person to person, but gastroenterologists said you can easily find out what’s normal for you by eating corn and watching for when the indigestible kernels appear in your stool.

Gross, perhaps, but with that baseline, the next time you get sick, you’ll be better able to estimate when you might have eaten the offending meal. For example, if you throw up something and don’t have diarrhea or roiling further down, it could be that what made you ill was something you ate within the last four to six hours. If you wake up in the middle of the night with cramps and diarrhea, it’s more likely something you consumed a good 18 to 48 hours earlier, depending on the results of your corn test.

We stopped at a McDonald’s on the way home from the Glass Mountains yesterday. Quality was semi-OK, but safety was there.

(No McDonald’s money was involved in this blog post; there was no money at all; I just like to write).

Always tragic regardless of religion: 2 children dead 4 others sick in E. coli outbreak linked to largely Mormon town in Utah

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Two children died from E. coli in southern Utah in recent weeks, the Southwest Utah Public Health Department confirmed Monday, as reported by KSL.

Four other incidents of E. coli have also been reported in the area of the border towns of Hildale and Colorado City, Arizona, said Southwest Utah Public Health Department spokesman David Heaton.

The incidents are limited to that area, he said.

The cause for the outbreak is still being investigated, but health officials believe it can likely be traced to contamination from food or animals. Heaton says investigators don’t think the town’s water supply is the cause.

Before Monday, Heaton had refused to confirm the deaths. He declined Monday to release the names, ages or genders of the two children who died. He said the four non-fatal cases are a combination of children and adults but said he didn’t have the exact breakdown. Some of them are still being treated, though none of their conditions were released.

Multiple people who identified themselves as relatives of 6-year-old Gabriella Addison Fullerton indicated on Facebook that she was one of the victims who died. On a GoFundMe webpage* published Friday seeking donations for funeral costs, loved ones called Gabrielle “our little angel” who “has passed on to a better place.”

“Her family is completely devastated at losing such a precious and loving child. She was taken at the tender age of 6. … Hold your babies close every chance you get,” the page states.

Both Hildale and Colorado City are well-known for being largely polygamous communities, with many residents being members of the Fundamentalist Church of Latter-Day Saints.

Poison customers, it’s good for business: Burger row hits the grills in New Zealand; try a thermometer

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New Zealand’s oldest licensed premises has pulled a burger that’s been the cornerstone of its menu – blaming it on bureaucratic red tape gone mad.

Dan Fraser, executive chef at the Duke of Marlborough restaurant in the Bay of Islands, was left stewing after a visit from a Ministry of Primary Industries inspector on Thursday. 

Nicole Lawton of The Sunday Star Times reports new food preparation guidelines from MPI state minced meat and liver needs to be cooked at high temperatures for a longer amount of time than previously, to avoid contamination. 

Fraser said the new rules were a raw deal and will now prevent him serving his signature burger The Governor’s Burger which is pink and juicy in the middle. 

The Governor’s Burger features bacon, cheese, pickle, tomato, chipotle mayonnaise and a medium rare beef mince patty.

“It’s a really good burger, we really pride ourselves in presenting it to our customers,” Fraser said.

“Basically, the ministry is telling us how our customers need to eat their food.”

MPI food and beverage manager Sally Johnston, said the new rules didn’t entirely ban medium-rare meat – but chefs would have to change how they cooked it.

“If they do want to serve a medium-rare burger, it is possible, it just might take a little more forethought and planning,” Johnston said.

“It is possible to cook a medium-rare burger safely, it just means that they need to think about the processes that they are using to do that. It might not be necessarily possible to do that on a BBQ or grill.”

She suggest sous vide methods of cooking instead – what people used to call boil-in-the-bag.

“Who the f*** wants a sous vide burger?”, Fraser said.

The new rules state meat should have an internal minimum temperature of 65°C for 15 minutes while cooked, 70°C for three minutes, or 75°C for 30 seconds.

But Fraser said those were rules drawn up by a bureaucrat and not a chef. They meant a beef mince patty would always be “rubbery and devoid of flavour”.

Johnston insists the new rules are necessary. “People have died from under cooked burgers, there is a genuine food safety risk here, we’re not doing this to take the fun out of food. Bugs that have caused people to die (such as E. coli) are frequently found in New Zealand meat.”

The new MPI guidelines detail how restaurants and food businesses should prepare, store and serve their food, and supplement the 2014 Food Act. 

Top chef Ray McVinnie told Stuff NZ that serving a medium-rare burger is “dangerous and dumb” and that any chef who complains about such regulations does not understand basic food safety.

Yesterday, the Ministry for Primary Industries decided they will be talking to chefs about ways they can serve medium rare burgers and still keep food safe for consumers.

“We’re happy to work with chefs wanting to develop a custom Food Control Plan that covers their specific menu items. It might need different methods of sourcing, storing, and handling meat to make sure consumers are still protected.”

The move by MPI to regulate chefs’ kitchens brought howls of outrage and ridicule from those interviewed by the NZ Herald.

Labour’s Damien O’Connor said it was “ridiculous overkill”.

“We’ve got strict controls on how you kill and process meat. To then look at the cooking of it is nanny-state gone mad.

Northland MP Winston Peters, who has eaten at the Duke of Marlborough often over the years, said “paternalistic bureaucrats” were killing New Zealand businesses.

Sick customers ruin biz.

I look forward to the microbiologically-based arguments the talking heads will bring to the public discussion.

Assessment of risk communication about undercooked hamburgers by restaurant servers

Ellen M. Thomas, RTI International; Andrew Binder, Anne McLaughlin, Lee-Ann Jaykus, Dana Hanson, and Benjamin Chapman, North Carolina State University; and Doug Powell, powellfoodsafety.com

Journal of Food Protection

DOI: 10.4315/0362-028X.JFP-16-065

According to the U.S. Food and Drug Administration 2013 Model Food Code, it is the duty of a food establishment to disclose and remind consumers of risk when ordering undercooked food such as ground beef. The purpose of this study was to explore actual risk communication activities of food establishment servers. Secret shoppers visited restaurants (n=265) in seven geographic locations across the U.S., ordered medium rare burgers, and collected and coded risk information from chain and independent restaurant menus and from server responses. The majority of servers reported an unreliable method of doneness (77%) or other incorrect information (66%) related to burger doneness and safety. These results indicate major gaps in server knowledge and risk communication, and the current risk communication language in the Model Food Code does not sufficiently fill these gaps. Furthermore, should servers even be acting as risk communicators? There are numerous challenges associated with this practice including high turnover rates, limited education, and the high stress environment based on pleasing a customer. If it is determined that servers should be risk communicators, food establishment staff should be adequately equipped with consumer advisory messages that are accurate, audience-appropriate, and delivered in a professional manner so as to help their customers make more informed food safety decisions.

Food safety is not simple

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Winnipeg, Manitoba, Canada correspondent, Rob Mancini, writes:

I’ve been told many times from various sources that Mancini’s always a cheerful guy, you can’t upset him… this is only because I find happiness with my family. I have an amazing wife and 2 incredible kids (6 years old and 19 months), all healthy.  What more can I ask for: nothing.

But when I read stories of kids dying from hemolytic uremic syndrome due to an E. coli infection, in particular when it could have been prevented, I get mad.

“We can’t hold him. We can’t love on him. All we can do is just stand at the bedside,” Lindsey Montgomery, Huston’s mom, told WFAA.

Heartbreaking.

Fox News reports A 2-year-old boy is on life support after contracting an E. coli infection from an unknown source while on vacation in Oklahoma with his family. Landon Huston, of Ennis, Texas, was experiencing stomach virus-like symptoms when a fecal sample tested positive for E. coli, WFAA reported.

Huston was taken to Children’s Medical Center Dallas where doctors discovered the infection had progressed to Hemolytic Uremic Syndrome (HUS), an abnormal destruction of red blood cells that leads to kidney failure, WFAA reported.

Huston underwent the first of two surgeries on June 14 and has had a blood transfusion. He was placed on life support after doctors discovered fluid in his lungs, a post on the family’s GoFundMe page said.

The Texas Department of Health Services is investigating any potential source of the bacteria. E. coli can be found in the environment, foods, and intestines of people and animals, according to the Centers for Disease Control and Prevention (CDC).

“Most parents like us had no idea, you know, the dangers of something like this,” Montgomery told WFAA. “And it’s everywhere. E. coli is something that’s everywhere.”

While most strains of the bacteria are harmless, others can cause diarrhea, urinary tract infections, respiratory illness and pneumonia. About 5-10 percent of patients who contract E. coli will develop (HUS), which could present as decreased frequency of urination, feeling tired and losing color in cheeks and inside the lower eyelids. Patients can recover in a few weeks but others may suffer permanent damage or die.

“I have faith he’s going to come out on top,” John Huston, the toddler’s dad, told WFAA.

I’ve taught many food safety courses and have lectured on the importance of food safety to many. I’ve used different techniques in teaching, heavily based on behavioral science amongst other antics, to stress the importance of certain food safety principles. Even did a TV show on the subject.  All of this doesn’t matter if your inherent belief system is contrary to the information provided.  Need to be compelling and understand how human behavior operates. At times I wish I know more psychology but it’s never too late.

Food safety is not simple, it is hard and anyone who says otherwise is clueless.

I always try to share personal stories and current relevant food safety stories in an attempt to connect with my audience or readers and gauge their interest. Doug taught me this and it works.

 

31 sickened by E. coli O55 in Dorset: 3 years later, health-types’ report remains a secret

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In Dec. 2014, an outbreak of E. coli O55 was identified in Dorset, U.K. with at least 31 sickened. Public Health England (PHE) and local environmental health officials investigated and found nothing, other than cats were also being affected.

Tara Russell of Bournemouth Echo reports again this week that a review into the outbreak in Dorset was carried out, health chiefs have insisted – but the report is not available to the public.

Public Health England (PHE) says the public can only request to see the report detailing exactly what happened when 31 people contracted the O55 strain between July 2014 and November 2015 through a Freedom of Information request.

Families including some whose children have been left with lifelong health complications say they did not know the review existed and have branded it ‘disappointing and disgusting’ they have been kept in the dark.

The Daily Echo has lodged an official FOI request on behalf of the affected families and will receive a response in July.

Nurse Jessica Archer, who today suffers crippling head pains, fatigue and depression while her nephew Isaac Mortlock (right) endures severe seizures, must be peg fed every night and will need a kidney transplant as a result of the outbreak, said: “Without the Daily Echo we wouldn’t even know this report even existed and we are very interested to see it and we have the right to know. The families affected have so many unanswered questions and have to live with the effects of this outbreak forever but yet again we feel Public Health England are trying to sweep it under the carpet and hope that it will just go away.

“It is disappointing and disgusting this report has not already been made public let alone having to wait and wait still. We feel there have been a series of failures and this is the latest.”

The news comes after Jessica last month called for PHE to be held to account telling how her and her five-year-old nephew’s Isaac Mortlock’s lives have changed irreversibly, and accused the organisation of ‘a cover up.’

In response, PHE told the Daily Echo it carries out ‘routine outbreak reviews once investigations have ended’, adding it is ‘a learning organisation and reflects on outbreaks to identify lessons learnt and to continually improve our response.’

However at the time, the organisation refused to tell the Daily Echo exactly which lessons were learned.

It was only following a further request from this newspaper, PHE said a report was compiled however it has not been available to the public.

A spokesman said: “This report was not intended for external publication – it’s not standard procedure to publish outbreak reports externally due to patient confidentiality – however if interested parties would like to request a copy they can do this via our Freedom of Information portal.”

That’s bullshit.

Outbreak investigations are routinely published while ensuring patient confidentiality.

Families say it is the latest in a string of ‘failures’ by Public Health England.

A spokesman from PHE added: “As with all outbreaks, PHE Health Protection Team ensured throughout their investigation that those affected were kept informed of any information that was uncovered at that time.”

That’s also bullshit.

And why UK health types feature prominently in our paper on when to go public for the benefit of public health.

Three years seems a bit long.

Going public: Early disclosure of food risks for the benefit of public health

Mar.17

NEHA, Volume 79.7, Pages 8-14

Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell

http://www.neha.org/node/58904

Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public.

Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions.

Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.

Handwashing is never enough: Texas family says sons infected with E. coli at petting zoo

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An Azle family wants to warn others after both their young boys were hospitalized with E. coli earlier this year.

“It’s awful. You can’t do anything but just sit there and watch your child hurt,” Emily Miller told WFAA.

Miller’s sons Brayden, 7, and Dylan, 5, were both diagnosed with an E. coli infection, and Dylan’s case impacted his kidneys. Miller said he required dialysis, and he was hospitalized for 27 days, including several nights in the ICU.

“It’s such a crazy thought that this could happen,” Miller said.

She was surprised by the intensity of the illness, but also by where her boys may have come into contact with E. coli. She said doctors believe they were likely contaminated while the family was visiting a petting zoo.

“I wasn’t aware that you could get it from animals and livestock,” Miller said.

She took the boys to the petting zoo back in January, and four days later her oldest was in the hospital.

Both brothers are now doing well, though Dylan is still on blood pressure medicine due to the illness, Miller said.

The Centers for Disease Control says petting zoos do pose risks, as livestock can carry E. coli bacteria. The CDC’s advice is to wash hands with soap and water immediately after being near animals, whether you touch them or not.

The CDC also says that soap and water is more effective than instant hand sanitizers, and if sanitizers are the only option, go ahead and use them but follow up with soap and water as soon as possible.

A table of petting zoo outbreaks is available at https://barfblog.com/wp-content/uploads/2014/04/Petting-Zoo-Outbreaks-Table-4-8-14.xlsx.

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Abstract below:

Observation of public health risk behaviors, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Best practices for planning events encouraging human-animal interactions

Zoonoses and Public Health 62:90-99, 2015

G. Erdozain , K. KuKanich , B. Chapman  and D. Powell

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. It is estimated that 14% of all disease in the US caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

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2-year-old on life support in Texas after contracting E. coli

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An Ennis family says the CDC is investigating after their 2-year-old was exposed to a dangerous strain of E.coli.

Landon Huston is now on life support at Children’s Medical Center Dallas.

“He’s usually up, rambunctious, running around,” said his mother, Lindsey Montgomery. “I’m ready for my little boy to be back.”

The family took a trip to Oklahoma two weeks ago, cooling down in a hotel pool and at a natural spring.

“I’d never heard of people swimming and get E. oli,” said his father, John Huston.

Unfortunately, many, many people have been identified as getting sick with Shiga-toxin producing E. coli from swimming, water parks, or water supplies.

“Three, four days later, Landon’s got fever, diarrhea, really sick,” said Montgomery.

But by the time a test confirmed E.coli, his kidneys were shutting down. Montgomery said the CDC interviewed her trying to determine the source of the infection.

“They asked me where he had been, what food he had ate, any restaurants,” she said.

Dr. Jeffrey Kahn, Children’s Health Chief of Pediatric Infections Diseases, said it’s normal for a case like this to trigger a public health investigation.

“That suggests that there’s some contamination somewhere. It’s usually water or food and typically that means it’s not just one individual who’s been exposed,” he said.