Lombard Illinois Subway Shigella Illnesses on Rise

According to local press reports, the DuPage County Health Department is staffing its call center throughout the weekend to keep tabs on the rising number of gastrointestinal illnesses being reported from a Subway restaurant in Lombard.

Four more cases of shigellosis were confirmed Friday, bringing the total number of confirmed cases caused by the outbreak at the restaurant to 12, health department spokesman Dave Hass said. Of those 12 cases, seven have required hospitalization. Six of those who were hospitalized have been released, Hass said.

The restaurant at 1009 E. Roosevelt Road in Lombard remains closed as investigators try to determine the cause of the outbreak. Hass said the restaurant would open sometime next week at the earliest. Anyone who ate at the restaurant between Feb. 24 and March 1 and became ill within 12 hours to four days afterward is asked to report the incident to the health department by calling (630) 682-7400.

Shigella is a family of bacteria that can cause sudden and severe diarrhea (gastroenteritis) in humans. Shigellosis – the illness caused by the ingestion of Shigella bacteria – is also known as bacillary dysentery. It can occur after ingestion of fewer than 100 bacteria (American Public Health Association [APHA], 2000), making Shigella one of the most communicable and severe forms of the bacterial-induced diarrheas (Gomez et al., 2002). Shigella thrives in the human intestine and is commonly spread both through food and by person-to-person contact. It is named after Kiyoshi Shiga, a Japanese scientist who discovered Shigella dysenteriae type 1 in 1896 during a large epidemic of dysentery in Japan (Keusch & Acheson, 1996).

The number of shigellosis cases reported annually to the Centers for Disease Control and Prevention (CDC) has varied over the past several years, from more than 17,000 during 1978–2003, to an all-time low of 14,000 in 2004, to almost 20,000 in 2007 (CDC, 2009b). Many cases go undiagnosed and/or unreported, however. The CDC estimates that 450,000 total cases of shigellosis occur in the U.S. every year (Baer et al., 1999; CDC, 2009a). Shigellosis is also characterized by seasonality, with the largest percentage of reported isolates occurring between July and October and the smallest proportion occurring in January, February, and March (Gupta et al., 2004).

Posted on March 6, 2010 by Shigella Lawyer
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Poultry Workers and Pig Farmers May Spread Bacteria Too

Well, the stocking are hung and the presents are all wrapped, and I am surfing the net to see what there is to blog about (my version of the “Night Before Christmas”) when I found this quote:

“Nine billion food animals are produced and slaughtered in the United States annually, and all of those animals are defecating and shedding bacteria, including drug-resistant bacteria…. We are running out of antibiotics to treat human infections.” Lance Price

Antibiotic-resistant bugs have been in the news recently. Some, like Salmonella Newport, have caused illness in consumers of Safeway ground beef.  Newsday recently reported - "Poultry Workers may spread E. coli" – No, not E. coli O157:H7, but gentamicin-resistant E. coli.

Public health investigators at Johns Hopkins University estimate that workers in poultry factories in the United States are 32 times more likely to be colonized with E. coli that repels the antibiotic gentamicin than other people. The drug is used to treat both poultry and humans.

Recently, in a new study, “MRSA prevalent in Canadian pig farms and pig farmers,” published in Veterinary Microbiology found methicillin-resistant Staphylococcus aureus (MRSA) prevalent in Canadian pig farms and pig farmers, pointing to animal agriculture as a source of the deadly bacteria.

The US Government seems concerned enough to at least study the problem of antibiotic resistant bugs in our food supply.  It created the National Antimicrobial Resistance Monitoring System (NARMS) in 1996 as a collaborative effort between the United States Department of Agriculture,  Food and Drug Administration's Center for Veterinary Medicine and the Centers for Disease Control and Prevention.

The NARMS program monitors changes in antimicrobial drug susceptibilities of selected enteric bacterial organisms in humans, animals, and retail meats to a panel of antimicrobial drugs important in human and animal medicine.  Animal and human isolates currently monitored in NARMS include Salmonella, Campylobacter, E. coli, Listeria and Shigella.  Some selected articles on antibiotic resistance:

Antibiotic Resistance in Listeria, Antibiotic Resistance in Shigella, Antibiotic Resistance in Escherichia coli, Antibiotic Resistance in Campylobacter, Antibiotic resistance in Salmonella

Well, looks like it will be a far too busy and profitable New Year.

Posted on December 25, 2007 by Food Poisoning Attorney
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TOXIC TACOS: A microbial combination plate

When Taco Bell offered free tacos for every American during baseball’s World Series last month, all I could do was hold my head and mutter something like: "Hasta luego, Amigos!"

The very idea of doling out fast-food tacos to millions of baseball fans should ring like a casino jackpot jingle in the corridors of a personal injury law firm like mine - or all the "wannabees" that are beginning to light up the Internet with "google ads" and plagiarized blogs.  Recently tacos seem have a food-poisoning track record right up there with Chinese-manufactured pet food.  In the past few years alone, we’ve seen outbreaks of deadly E. coli O157:H7, Salmonella, Hepatitis A, Listeria, Shigella and Norovirus in at least 13 states, from Washington and California to New York and Texas – all traced to restaurant tacos.

Just this year there have been taco-related outbreaks in Alabama, Illinois and Oregon.  And those are just the outbreaks scientifically traced by public health officials.  We’ll never know how many more people have been sickened without identifying a source.  Tracing the source of disease outbreaks isn’t easy.  Health officials need to detect an outbreak early, thoroughly interview sick people and find the common denominator before memories fade and evidence disappears.

And even when tacos are suspect, the specific source of the poison varies from one outbreak to the next.  In the Alabama outbreak last summer, the culprit may have been lettuce laced with E. coli.  In Illinois, it was Salmonella in the cheese.  An outbreak at Taco Bell last year in East Coast states was blamed on tainted lettuce, or as my post below says - maybe not.  Others have been tracked back to green onions, cilantro or undercooked meat.  It seems that when restaurants layer tortillas, meat, cheese, tomatoes, onions, avocado and lettuce, there are multiple opportunities to contaminate, cross-contaminate and make people sick.

Take, for example, a major outbreak of Hepatitis A in Florida in December, 2000.  Officials at the Lake County Health Department learned that seven people were sick, and five were hospitalized with Hepatitis A, all in a two-week span.  State and local officials identified the toxin and questioned each of the patients, including family members and friends who were not so sick.  Eventually, officials identified 78 people sickened in five eastern states. In the Florida case, most of the sick people had eaten at a Taco Bell restaurant in Fruitland Park.  Further inquiry narrowed the possibilities down to six menu items and eight ingredients, and only two of those items had been eaten by a majority of the sick people. Eventually, they zeroed in on the green onions as the most likely cause.  But, given the fact that nearly every menu item in a Taco Bell has nearly the same ingredients, how do you really know what ingredient was contaminated?

My point: Tacos can be dangerous.  The ingredients – meat and lettuce and green onions – come from an array of sources, are handled by so many people and are all tossed into the same products, creating a very muddy trail of evidence.  A list of outbreaks below:

Date Location Vendor Microorganism Food type
Oct 98 WA Finley School E. coli O157:H7 Taco Meal
Aug 00 TN San Antonio Salmonella Unknown
Oct 00 CA Viva Mexico Shigella Salsa
Feb 02 IL Laredo Salmonella Employee
Aug 03 TX Cheese LIsteria Cheese
Aug 03 MO Habaneros E. coli O157:H7 Salsa
Nov 03 PA Chi-Chi's Hepatitis A Onions
Sep 05 CA La Golondrina Hepatitis A Lettuce?
Jun 06 OH La Fiesta Norovirus Employee
Nov 06 Several Taco Bell E. coli O157:H7 Lettuce?
Nov 06 Several Taco Johns E. coli O157:H7 Lettuce
Jan 07 AU Mex Express Botulism Cheese
Jan 07 OR Sergio's Dos Norovirus Unknown
Mar 07 IL El Paso Salmonella Cheese
Jul 07 AL Little Rosie's E. coli O157:H7 Lettuce


And there have been more - In October 2007, Tortilla Flat was the scene of a Norovirus outbreak and just a few days ago, Carniceria Y Taqueria served Salmonella-Tainted Tacos in North Carolina.  Buenos Noches.  Thanks to my friends at K-State (who bring you BARFBLOG) for providing a "bite" of the history of the "terrible tacos."

Posted on November 19, 2007 by Food Poisoning Attorney
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Foodborne Illness

The Centers for Disease Control and Prevention (CDC) estimates that each year 76 million - or one out of every four - Americans are sickened as a result of consuming contaminated foods or beverages. Some become seriously ill; 325,000 require hospitalization and 5,000 die. Older adults, young children, and those who have weakened immune systems are particularly vulnerable.

More than 250 different foodborne diseases have been identified. Most of these diseases are infections caused by a variety of bacteria, viruses, and parasites.

Foods that are contaminated with poisonous chemicals or harmful substances can also cause illness. Symptoms of foodborne illness vary by disease but the most common are nausea, vomiting, abdominal cramps, and diarrhea.

I have some of the symptoms described. Do I have a foodborne illness?

Possibly. For example, scientists estimate that 35% of diarrheal illness is caused by a foodborne pathogen. Diarrhea that is caused by food poisoning usually lasts one week or less. Symptoms that appear suddenly are a sign of foodborne illness, although the last food consumed is not necessarily the cause of illness. Different microbes have different incubation periods. The incubation period refers to the time between ingestion and onset of symptoms.

Incubation Periods of Common Foodborne Pathogens

PATHOGEN INCUBATION PERIOD
Staphylococcus aureus1 to 8 hours, typically 2 to 4 hours.
Campylobacter 2 to 7 days, typically 3 to 5 days.
E. coli O157:H7 1 to 10 days, typically 2 to 5 days.
Salmonella 6 to 72 hours, typically 18-36 hours.
Shigella 12 hours to 7 days, typically 1-3 days.
Hepatitis A 15 to 50 days, typically 25-30 days.
Listeria 3 to 20 days, typically 14 days
Norovirus 24 to 72 hours, typically 36 hours.

How can I find out if I am sick because of something I ate or drank?

Foodborne infections are usually diagnosed by laboratory tests that identify the organism. Bacteria such as E. coli O157:H7, Salmonella, Shigella, and Campylobacter are found by microbiologic testing of the ill person's stool. Parasites can be identified by examining stool specimens under the microscope. Laboratory testing to detect viruses requires stool specimens or serum derived from blood samples. Many foodborne infections are not detected through routine laboratory procedures and health care providers must order appropriate testing before the cause can be identified.

Should I see a doctor if I think I have a foodborne illness?

A person with symptoms of a foodborne illness should seek prompt medical attention if there is blood in the stools, if they are experiencing prolonged vomiting or show signs of dehydration, if diarrhea last 3 days or more or if diarrhea lasts more than 3 days. Anyone at risk for serious consequences - the very young, the very old, or those with immune impairment - should consult a health care provider if symptoms do not improve after 24 hours.

What else should I do?

If you think you have a foodborne illness contact your local health department. They will ask you questions about your symptoms, when they started, and what you have eaten for several days prior to symptom onset. Because some of the organisms that cause illness can be spread by ways other than food, they will ask you about other potential sources such as contact with others with similar symptoms or exposure to animals. This distinction is important so that public health authorities can if necessary, take steps to stop others from becoming ill.

If you know others who have similar symptoms, urge them to contact the health department. Oftentimes, information compiled from a group of individuals provides clues to the source of illness that can be missed when only one person reports to the health department.

If you suspect that your illness is food related, keep any left over food for possible testing. If laboratory tests show the food was contaminated, you will have powerful evidence that the food is the likely cause of your illness. The health department will advise you about any laboratory tests that should be conducted and how long food should be kept. Similarly, keep retail or restaurant receipts showing that you purchased the suspected food. Receipts often contain valuable pieces of information about a food product that the consumer does not know or cannot recall.

Common myths of foodborne illness

As you attempt to determine if you have a foodborne illness and what the potential source could be, avoid these common misconceptions.

The last thing I ate is what made me sick.

Not necessarily. Refer to the table that shows how long it takes for certain microbes to grow inside your body and cause illness. Write down what you ate, where you ate, and when you ate in as much detail as possible. Health department investigators will ask you for this information and accurate recall is critical.

If other people ate what I ate and did not become ill, that particular meal could not be the source of my illness.

Not necessarily. It is well documented that microbes that cause foodborne illness are not always uniformly distributed in a food item. Also, people have different immune systems. One person may consume hamburger prepared from a package of ground beef and become seriously ill with E. coli O157:H7 or Salmonella while his dining companion consumes ground beef from the same package and remains healthy.
Posted on July 6, 2005 by Marler Lawyer
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Camping? Dining out? Don't let tainted food spoil the trip

Kathleen Doheny of Healthy Traveler did an article today on our client Ernie Lyon of Florida who was sickened with Shigella from an airplane meal (a chicken potpie, a roll and a salad topped with cucumbers and carrots).

From the article:

Lyon, his wife, Debbie, and eight other travelers are suing Gate Gourmet, which prepared the food and services many other major airlines, says Drew Falkenstein, a Marler Clark attorney working on the case. "We have filed a lawsuit against Gate Gourmet for negligence, strict liability and breach of warranty," Falkenstein says. They are asking for unspecified compensatory and punitive damages.
Gate Gourmet serves 195 million meals a year, says John Bronson, a company spokesman. "We take our commitment to food safety very seriously," says Bronson, who declined to comment on the litigation.

Although a food safety expert says tainted food on airlines is not common, the Northwest incident is a reminder that food-borne illness is common, and about 76 million people in the U.S. are sickened by tainted food and drink each year, according to the federal Centers for Disease Control and Prevention.

Summer is peak season for food-borne illness, says Christine Bruhn, director of the Center for Consumer Research at UC Davis and a food safety expert. Travelers are especially vulnerable, as campers become outdoor cooks and others seek out unfamiliar restaurants.

Travelers who are cooking outdoors or scouting out new restaurants can take some simple measures to reduce the odds of illness. Most important for outdoor cooks, says Bruhn, is washing hands thoroughly before handling food and avoiding cross-contamination.

That means not serving the meat you barbecued on the same plate that you used to hold the raw meat without washing it and not using the utensils you used to handle the raw meat for cooked meats.

And the no-mayo rule at picnics? "Commercially prepared mayonnaise is usually safe," says Mike Doyle, a microbiologist at the University of Georgia, Griffin, and a spokesman for the Institute of Food Technologists. "It has sufficient acid - vinegar - to prevent harmful bacteria from growing."

Temperature control is crucial. "Keep hot things hot, cold things cold," Bruhn says. And eat food within two hours of preparation.

If you are dining out in a restaurant, how do you find out if it makes the grade? "Most states do have some sort of grading system," says Donna Garren, of the National Restaurant Assn., a Washington, D.C.-based trade group. Some use letters, others numbers, she says. To check a restaurant's score, see http://www.allfoodbusiness.com/health_inspections.php , a site hosted by restaurant owners.

If nothing is displayed in a restaurant, Garren suggests asking the manager for a recent inspection record. They should be able to provide one, she says.

If there's no grading system or inspection record, look around the dining area, Garren suggests, to get a sense of cleanliness. Bruhn advises visiting the bathroom before ordering food. "When I go to a restaurant, I always go to the restroom first," she says, "to see how the restaurant handles sanitation. Are there soap and towels?" If the restroom is in good shape, that's a good sign the rest of the place is, Bruhn says.

Posted on July 1, 2005 by Marler Lawyer
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More plaintiffs seek punitive damages in lawsuit against airline caterer

Marler Clark has filed a second lawsuit against Gate Gourmet, the airline caterer responsible for an August, 2004 Shigella outbreak among passengers on outbound flights departing from Honolulu Airport. The complaint, which was filed Wednesday in United States District Court for the District of Hawaii (Case number CV05-00401 ACK LEK), was filed on behalf of seven more victims of the outbreak.

According to the Hawaii Department of Health, travelers aboard flights departing Honolulu for destinations in Japan, Australia, American Samoa, and twenty-two U.S. states became ill with a genetically indistinguishable strain of Shigella. The first complaint filed by Marler Clark was on behalf of a Florida resident, while the amended complaint includes plaintiffs from Michigan, Maryland, California, South Dakota, and Washington State. All plaintiffs were aboard one of three flights that departed Honolulu for the US mainland on August 22 or 23, 2004.

"I must commend the health department for their efforts in this investigation. Given the widespread nature of this outbreak, they did a tremendous job of identifying the outbreak in the first place, then tracing it back to a source," said William Marler, managing partner of Marler Clark, the Seattle law firm nationally recognized for the successful representation of victims of foodborne illness.

Attorneys ask the Court to award plaintiffs punitive damages to "deter [Gate Gourmet] from similar conduct in the future." An April, 2004 inspection by the Food and Drug Administration (FDA) found numerous health code violations at the Gate Gourmet Honolulu facility that serviced airlines at Honolulu Airport. See http://www.fda.gov/foi/warning_letters/g5318d.htm.

"The FDA noted a host of problems at Gate Gourmet when investigators inspected the Honolulu facility in April. It's only right that the company is punished for continuing to operate with a conscious disregard for the health of consumers," Marler added. "Punitive damages would be the civil justice system's way of punishing Gate Gourmet for not acting to meet health codes and for having knowledge that its products could lead to illness."
Documents Marler Clark obtained from the Minnesota Department of Health indicate that genetically indistinguishable Shigella infections were found in residents of California, Connecticut, Iowa, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, Ohio, Oklahoma, Rhode Island, Tennessee, Texas, Utah, and Washington State.
Posted on June 24, 2005 by Marler Lawyer
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Florida man seeks damages against isle airline caterer

Our client Ernie Lyon is the focus of an article in today's Star Bulletin after we filed a lawsuit yesterday against Honolulu airline caterer Gate Gourmet yesterday:

Ernie Lyon accused the company of serving food contaminated with the Shigella bacteria, causing him to develop a 104-degree fever and accrue $3,000 in medical bills. The suit seeks unspecified damages.

The U.S. Food and Drug Administration warned Gate Gourmet in an April letter of unsanitary conditions at its Honolulu kitchen, including employees preparing meals in bug-infested areas.

"We're talking about investigators finding vermin, food stored at temperatures over 50 degrees higher than what is considered safe, and a 'pink, slimy substance' in the washing machine," Marler said.

The state Health Department also linked an outbreak of food poisoning to carrots served by Gate Gourmet on flights out of Honolulu April 22-24, 2004. But the investigation could not determine whether the carrots were contaminated by the caterer or elsewhere.

Posted on May 20, 2005 by Marler Lawyer
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Marler Clark Files Class Action Shigella Lawsuit

Marler Clark filed a class action lawsuit today in King County Superior Court against Senor Felix Gourmet Mexican Foods, a California Corporation implicated in the recent Shigella outbreak. The named plaintiffs are Larissa Spafford, Robert B. Spafford, and their two-year-old son, Jasper, of Port Townsend, Washington. Ms. Spafford purchased the dip at a Port Townsend QFC. Both she and her son became ill.

Ms. Spafford's and her son's symptoms were relatively mild, although they included diarrhea, fever, and stomach cramps. They were very fortunate not to have suffered more severe injury.

The Washington State Department of Health has confirmed that at least 30 people in Washington have shown symptoms of shigellosis. Dozens more were sickened in Oregon and California. This number is expected to rise over the next few weeks. Marcia Goldloft, Medical Epidemiologist with the Washington State Department of Health, said, "Shigellosis can be very serious and is highly contagious. People who think they might have been infected should pay close attention to hygiene. Carefully washing your hands could prevent getting a family member sick."

This dip was sold under several names, including the above, Trader Joe's 5 Layer Fiesta Dip, and Delicioso 5 Layer Fiesta Dip. It was sold in jars and on seven-inch trays, with a distinctly layered appearance. The list of retailers that carried this product includes the following: Costco, Trader Joe's, Puget Consumers Co-op (PCC), and SAM'S Club. It was also distributed to QFC, Thriftway, Red Apple Markets, Zupan's, and Homegrocer.com, as well as other individual retailers.

Posted on January 7, 2005 by Marler Lawyer
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First lawsuit filed after fatal bacteria outbreak at restaurant

As the Associated Press reported today, Marler Clark has filed a lawsuit on behalf of Suzie and and Hector Lapuyade of Redwood City against the owners of Viva Mexico, a local restaurant shut down after the area's worst food poisoning outbreak in years.

The enchilada meal the Lapuyade family ate Oct. 21 led to days of excruciating abdominal cramps, severe diarrhea, fever and vomiting for Suzie and her young son. Lab tests confirmed that Suzie Lapuyade, 40, and her 9-year-old son Maurice contracted shigellosis, a gastrointestinal disease that spread through bacteria-tainted food.

From the article:

"They are certainly entitled to a decision about what the value of what they went through for a week is worth," attorney Marler said. Marler's firm has represented 1,500 food poisoning victims in the past seven years, including those affected by the 1998 E. coli contamination of Odwalla juice. "Twelve jurors in San Mateo County will help us all make a decision."
Posted on January 7, 2005 by Marler Lawyer
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