As of September 19, 2018, 18 people infected with the outbreak strain of E. coli O26 were reported from 4 states – Colorado (10), Florida (15), Massachusetts (1) and Tennessee (1). Illnesses started on dates ranging from July 5, 2018 to July 25, 2018. Ill people ranged in age from one year to 75, with a median age of 16. Sixty-seven percent of ill people were male. Of 18 people with information available, 6 (33%) were hospitalized, including one person who died in Florida.

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

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Fourteen (100%) of 14 people interviewed reported eating ground beef. Ill people purchased ground beef from several different grocery stores, including Publix Super Markets, Inc.

USDA-FSIS conducted traceback investigations from stores where ill people reported buying ground beef. Initial information collected from ill people in Florida indicated that the ground beef was purchased from various Publix grocery stores. On August 30, 2018, Publix Super Markets, Inc. recalled ground chuck products sold in several Florida counties.

Further traceback investigation by USDA-FSIS identified Cargill Meat Solutions in Fort Morgan, Colorado as the source of the contaminated ground beef linked to illness, including the recalled ground beef sold at Publix stores in Florida. On September 19, 2018, Cargill Meat Solutions recalled ground beef products that were produced and packaged on June 21, 2018. Products are labeled with the establishment number “EST. 86R” inside the USDA mark of inspection. The products were shipped to retailers nationwide.

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.

Cargill Ground Beef 2018 – 17 Ill, 1 Death – E. coli O26

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 beef was the probable source of the reported illnesses. The epidemiological investigation identified 17 illnesses and one death with illness onset dates ranging from July 5 to July 25, 2018.  On August 30thPublix Super Markets Inc., a Lakeland, Fla., retail grocery store chain recalled an undetermined amount of ground beef products made from chuck that may be contaminated with Escherichia coli O26.  On September 19th, Cargill Meat Solutions, a Fort Morgan, Colorado establishment, recalled approximately 132,606 pounds of ground beef products made from the chuck portion of the carcass that may be contaminated with Escherichia coli O26,

A bit of History:

Cargill Ground Beef 2012 – 40 Ill – Salmonella

On July 22, 2012 Cargill Meat Solutions announced a recall of 29,339 pounds of fresh ground beef products due to possible contamination with Salmonella Enteritidis. Using epidemiologic and traceback data public health investigators in 8 states (MA, ME, NH, NY, RI, VA, VT, and WV) and the CDC linked 40 patients diagnosed with S. Enteritidis to consumption of Cargill ground beef sold at Hannaford grocery stores in Massachusetts, Maine, New Hampshire, New York and Vermont. Among 40 persons for whom information is available, illness onset dates ranged from June 6, 2012 to July 9, 2012. Eleven patients were hospitalized. The Vermont Department of Health isolated the outbreak strain in leftover product.

Cargill Meat Solutions Ground Turkey 2011 – 181 Ill – Salmonella

The U.S. Department of Agriculture’s Food Safety and Inspection Service(FSIS) issued a public health alert, on July 29, due to concerns about illnesses caused by Salmonella Heidelberg that associated with the use and the consumption of ground turkey. The alert was initiated after continuous medical reports, ongoing investigations and testing conducted by various departments of health across the nation determined an association between consumption of ground turkey products and illness. On August 3, Cargill Meat Solutions issued a recall of ground turkey products. The products subject to recall bear the establishment number “P-963” inside the USDA mark of inspection. On August 4, the Centers for Disease Control published their first outbreak summary. The Salmonella Heidelberg was multi-drug resistant, resistant to ampicillin, streptomycin, tetracycline, and gentamycin. The CDC began their investigation on May 23, after recognizing an “unusual clustering” of Salmonella Heidelberg cases. About the same time, routine surveillance by a federal food monitoring system found the same strain of Salmonella Heidelberg in ground turkey in stores. On July 29, the initial outbreak strain and a second, closely related, strain of Salmonella Heidelberg was isolated from a sample of leftover unlabeled frozen ground turkey from the home of an outbreak case in Ohio. Since February 27, 2011, a total of 23 ill persons were reported to Pulse Net with this second, closely related, strain. Eighty-four ill persons were infected with the initial strain. The consumer product sample originated from the Cargill Meat Solutions Corporation establishment in Springdale, Arkansas. On September 11, Cargill Meat Solutions recalled an additional, approximately 185,000 pounds, of ground turkey contaminated with an identical strain of Salmonella Heidelberg that had led to the earlier recall on August 3. As of September 27, no illnesses had been linked to the additionally recalled, ground turkey products.

Cargill Meat Solutions/BJ’s Wholesale Club Ground Beef 2010 – 3 Ill – E. coli O26

A recall of ground beef was issued on August 28 when three people developed illnesses caused by rare strain of E. coli O26 after they had eaten the product. The ground beef produced by Cargill Meat Solutions, of Pennsylvania and was distributed to BJ’s Wholesale Clubs in New York, Maine, Connecticut, Virginia, New Jersey, New Hampshire, Massachusetts, and Maryland.

Beef Packers, Inc., Cargill, Ground Beef 2009 – 2 Ill – Salmonella

In December, Beef Packers, Inc., owned by Cargill, recalled over 20,000 pounds of ground beef contaminated with a drug-resistant strain of Salmonella Newport. The company issued an earlier recall in August 2009, due to contamination of ground beef with the same strain of Salmonella Newport. This contaminated ground beef was produced in September and was distributed to Safeway grocery stores in Arizona and New Mexico. The Arizona Department of Health linked two illnesses to the ground beef.

Beef Packers, Inc., Cargill, Ground Beef 2009 – 68 Ill – Salmonella

A Beef Packers, Inc. plant in California owned by Cargill, distributed approximately 830,000 pounds of ground beef that was likely contaminated with Salmonella Newport. The beef was shipped to distribution centers in Arizona, California, Colorado, and Utah where it was repackaged into consumer-sized packages and sold under different retail brand names. The contaminated beef contained a strain of Salmonella resistant to several commonly used antibiotics (called MDR-AmpC resistance). Sixty-eight outbreak associated cases were reported by 15 states. Most of the ill in Colorado had purchased the ground beef at Safeway grocery stores.

Cargill Ground Beef Sold at Sam’s Club Stores 2007 – 46 Ill – E. coli O157:H7

A multistate outbreak of E. coli O157:H7 began in August and led to the eventual recall of 845,000 pounds of Cargill ground beef. Forty-six cases were reported by 15 states. Interviews with the case-patients found a common exposure of Cargill hamburger.

Emmpak/Cargill Ground Beef 2002 – 57 Ill – E. coli O157:H7

Wisconsin epidemiologists noted a cluster of E. coli O157:H7 cases. The health department interviewed case-patients and found a common exposure. All victims had eaten ground beef from Emmpak, a meat producer. The same strain of E.coli O157:H7 was isolated from the ground beef. The case investigation resulted in a 2.8-million-pound recall of Emmpak meat and resulted in related illnesses in at least six states. The responsible Emmpak plant was closed for inadequate sampling and testing procedures.

Cargill Deli Turkey 2000  – 29 Ill – Listeria

A case-control study implicated sliced, processed, turkey deli meat in a multistate (11 state) outbreak. A traceback investigation identified a single processing plant in Texas as the likely source of the outbreak. The company recalled 16 million pounds of processed meat. The same plant had been implicated in a Listeria contamination involving the same strain of Listeria more than a decade previously.

Today the CDC reported that it, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Enteritidis infections.

As of September 7, 2018, 14 people infected with the outbreak strain of Salmonella Enteritidis have been reported from Alabama and Tennessee.

Illnesses started on dates ranging from July 10, 2018 to August 7, 2018 Ill people range in age from 1 year to 94, with a median age of 31. Fifty percent are female. Of 9 people with information available, 2 (22%) have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicates that shell eggs from Gravel Ridge Farms in Cullman, Alabama are a likely source of the outbreak.

On September 8, 2018, Gravel Ridge Farms recalled cage-free large eggs because they might be contaminated with Salmonella Enteritidis bacteria. Recalled eggs were sold in grocery stores and to restaurants in Alabama, Georgia, and Tennessee. The FDA website has a list of the grocery stores where recalled eggs were sold. Consumers who have any Gravel Ridge Farms cage-free large eggs in their homes should not eat them. Return them to the store for a refund or throw them away. Restaurants and retailers should not serve or sell recalled Gravel Ridge Farms cage-free large eggs.

As some of the readers might know, in my spare time I am the managing partner at Marler Clark in Seattle.  Our long-time Epidemiologist, Patti Waller, has moved into semi-retirement and is running www.outbreakdatabase.com for us.  Katrina Deardorff, who has been with us for a nearly two years, has decided to take a job back in the public sector, and we wish her well.

So, I am working here on a Saturday (not that uncommon), thinking about how to replace the irreplaceable, but knowing how important this job is to the quality of work we do at Marler Clark.

Minimum requirements are a Masters in Public Health or Epidemiology and some experience in foodborne disease investigations and willingness to live in Seattle.

Please send your resume and salary requirements to me at bmarler@marlerclark.com.  Also, take a chance to see the below.  I think it helps understand the job and its importance.

SPEAKER: William Marler, Managing Partner, Marler Clark, The Food Safety Law Firm
TIME: 4:30 – 5:30 pm
LOCATION: Wynne Courtroom and atrium, Inlow Hall, 530 W. New York Street, Indianapolis, IN
CONTACT: Hall Center for Law and Health at centerlh@iupui.edu

Please join the Indiana University Robert H. McKinney School of Law Hall Center for Law and Health Grand Rounds on Thursday, September 13th at 4:30pm.

William Marler, Managing Partner, Marler Clark, The Food Safety Law Firm

This is a free event, but registration is required.

Bio:

An accomplished attorney and national expert in food safety, William (Bill) Marler has become the most prominent foodborne illness lawyer in America and a major force in food policy in the U.S. and around the world.  Marler Clark, The Food Safety Law Firm, has represented thousands of individuals in claims against food companies whose contaminated products have caused life altering injury and even death.

He began litigating foodborne illness cases in 1993, when he represented Brianne Kiner, the most seriously injured survivor of the historic Jack in the Box E. coli O157:H7 outbreak, in her landmark $15.6 million settlement with the company.  The 2011 book, Poisoned: The True Story of the Deadly E. coli Outbreak that Changed the Way Americans Eat, by best-selling author Jeff Benedict, chronicles the Jack in the Box outbreak and the rise of Bill Marler as a food safety attorney.

For the last 25 years, he has represented victims of nearly every large foodborne illness outbreak in the United States.  He has filed lawsuits against such companies as Chili’s, Chi-Chi’s, Cargill, ConAgra, Dole, Excel, Golden Corral, KFC, McDonald’s, Odwalla, Peanut Corporation of America, Sheetz, Sizzler, Supervalu, Taco Bell and Wendy’s, securing over $600,000,000 for victims of E. coli, Salmonella, and other foodborne illnesses.

Among the most notable cases he has litigated, Bill counts those of nineteen-year-old dancer Stephanie Smith, who was sickened by an E. coli-contaminated hamburger that left her brain damaged and paralyzed, and Linda Rivera, a fifty-seven-year-old mother of six from Nevada, who was hospitalized for over 2 years after she was stricken with what her doctor described as “the most severe multi-organ [bowel, kidney, brain, lung, gall bladder, and pancreas] case of E. coli mediated HUS I have seen in my extensive experience.”

New York Times reporter Michael Moss won a Pulitzer Prize for his coverage of Smith’s case, which was settled by Cargill in 2010 for an amount “to care for her throughout her life.” Linda’s story hit the front page of the Washington Post and became Senate Majority Leader Harry Reid’s touchstone for successfully moving forward the Food Safety Modernization Act in 2010.

Bill Marler’s advocacy for a safer food supply includes petitioning the United States Department of Agriculture to better regulate pathogenic E. coli, working with nonprofit food safety and foodborne illness victims’ organizations, and helping spur the passage of the 2010-2011 FDA Food Safety Modernization Act.  His work has led to invitations to address local, national, and international gatherings on food safety, including testimony before the U.S. House of Representatives Committee on Energy and Commerce.

At little or no cost to event organizers, Bill travels widely and frequently to speak to food industry groups, fair associations, and public health groups about the litigation of claims resulting from outbreaks of pathogenic bacteria and viruses and the issues surrounding it.  He gives frequent donations to industry groups for the promotion of improved food safety and has established numerous collegiate science scholarships across the nation.

He is a frequent writer on topics related to foodborne illness.  Bill’s articles include “Separating the Chaff from the Wheat: How to Determine the Strength of a Foodborne Illness Claim”, “Food Claims and Litigation”, “How to Keep Your Focus on Food Safety”, and “How to Document a Food Poisoning Case” (co-authored with David Babcock.)  He is the publisher of the online news site, Food Safety News and his award-winning blog, www.marlerblog.com is avidly read by the food safety and legal communities. He is frequent media guest on food safety issues and has been profiled in numerous publications.

In 2010 Bill was awarded the NSF Food Safety Leadership Award for Education and in 2008 earned the Outstanding Lawyer Award by the King County Bar Association.  He has also received the Public Justice Award from the Washington State Trial Lawyers Association.

Bill graduated from the Seattle University School of Law in 1987, and in 1998 was the Law School’s “Lawyer in Residence.”  In 2011 he was given Seattle University’s Professional Achievement Award.  He is a former board member of the Washington State Trial Lawyers, a member of the board of directors of Bainbridge Youth Services, former President of the Governor-appointed Board of Regents at Washington State University.

Parking:

Due to road construction on or near campus, we recommended parking at the IUPUI Sports Garage at 875 West New York Street.  Please note this is a change from previous years.

Parking is available for a nominal fee (credit/debit card) at the Sports Garage, as well as the Gateway Garage.

Special Accommodations:

Individuals with disabilities who need special assistance should call (317) 278-4789 no later than one week prior to the event. Special arrangements can be made to accommodate most needs.

Prior E. coli outbreak in 2009 and recall in 2013.

The Department of Health cautioned consumers today to be aware of the risks of drinking raw milk especially for infants and young children, older adults, pregnant women, and people with weakened immune systems.

“Raw milk doesn’t go through the pasteurization process where harmful germs and bacteria are destroyed. This puts infants, young children, the elderly, pregnant women and those with a weakened immune system at a greater risk of illness when they drink it,” said Dr. Scott Lindquist, Washington state communicable disease epidemiologist.

Lab results recently confirmed a child under 5 years old from Island County and resident in their 70s of Clallam County became ill with an E. coli infection after drinking Dungeness Valley Creamery raw milk.

E. coli infections may cause severe diarrhea, stomach cramps and bloody stool. Symptoms generally appear three to four days after exposure, but can take up to nine days to appear. In some cases, the infection causes a serious disease resulting in kidney failure.

Individuals who have any of these symptoms after consuming raw milk should consult their health care provider and notify their local health departments.

In 2009 an outbreak was linked to the consumption of raw, unpasteurized, whole milk produced by the Dungeness Valley Creamery. There were a total of three cases. There were two E. coli strains implicated. One strain was confirmed and was E. coli O121. The other strain was suspected and was E. coli O157:H7. Raw milk was legal to sell and buy in Washington, provided the dairy underwent a series of inspections and was licensed. This dairy had been licensed since 2006.

In 2013, the Washington State Department of Agriculture (WSDA) is warned consumers not to drink Dungeness Valley Creamery brand raw Jersey whole milk, raw Jersey skim milk, and raw Jersey cream because the products may be contaminated with Escherichia coli bacteria (E. coli) that can cause serious illness.

Dungeness Valley Creamery raw Jersey cream, raw Jersey whole milk and raw Jersey skim milk with any Best Buy dates of 03/02 or later may be contaminated. The firm sells its products in gallon, half gallon, quart and pint containers. Today’s health alert includes all container sizes of the unpasteurized milk products.

The health alert is being initiated after routine sampling by WSDA found toxin-producing E. coli in a sample of raw cream. Based in Sequim, the Dungeness Valley Creamery and WSDA are continuing their investigation into the source of the problem. Currently, no human illnesses have been linked with these products.

Some strains of E. coli produce a toxin called Shiga toxin that can lead to severe illness. Shiga toxin-producing E. coli infections may cause severe diarrhea, stomach cramps, and bloody stool. Symptoms generally appear three to four days after exposure, but can take as long as nine days to appear. Anyone experiencing these symptoms should contact a health care provider.

The infection sometimes causes hemolytic uremic syndrome, a serious disease in which red blood cells are destroyed and the kidneys fail. Infants, children, pregnant women, the elderly and those with compromised immune systems are especially at risk.

According to the Dungeness Valley Creamery website, the firm’s products are sold at the following retail locations:
• Bainbridge Island: Real Foods; Pan D’Amore; Walt’s Lynwood Center Market
• Bothell: Tru Health
• Bremerton: CJ’s Evergreen General Store; Fresh Local
• Federal Way: Marlene’s Market & Deli
• Issaquah: Front Street Red Apple
• Longview: Country village Nutrition Shoppe
• Olympia: Olympia Food Co-op East; Olympia Food Co-op West
• Port Angeles: Country Aire; Good To Go
• Port Townsend: Port Townsend Food Co-op
• Poulsbo: Abundantly Green
• Seattle: Madison Market; My Asia’s Essentials; Pike Place Market Creamery
• Sequim: Sequim Prairie Grange; Red Rooster Grocery; Sunny Farms Farm Store
• Tacoma: Marlene’s Market & Deli
• Vancouver: Chuck’s Produce; Neighbors Market

South Africa on Monday declared an official end to the world’s worst recorded listeria outbreak after it killed 216 people and sickened more than 1,000 since early 2017.

Health Minister Aaron Motsoaledi said no news cases had been recorded over the past three months.

Health officials announced in March that they had traced the outbreak to an Enterprise Food plant owned by Tiger Brands

At least 216 people died during the outbreak, according to the country’s National Institute for Communicable Diseases.

A total of 1,060 people contracted the disease, which is caused by bacteria from soil, water, vegetation and animal feces which can contaminate fresh food, notably meat.

The United Nations had said South Africa’s listeriosis outbreak was believed to be the largest-ever worldwide.

See press alert:

http://www.nicd.ac.za/index.php/media-statement-by-the-minister-of-health-on-the-listeriosis-outbreak/

See last outbreak update:

http://www.nicd.ac.za/wp-content/uploads/2018/07/Listeriosis-outbreak-situation-report-_26July2018_fordistribution.pdf

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.

2018 Outbreak of E. Coli O26 Linked to Homegrown Restaurants, King County, Washington

  • Organism:
  • Non-O157 STEC
  • Vehicle:
  • Chicken pesto sandwich

On May 25, 2018 Public Health Seattle King County (PHSKC) announced an outbreak of E. Coli O26 associated with Homegrown Restaurants. Four cases were reported. Three were laboratory confirmed with a genetically indistinguishable strain of E. Coli …Read More »

2017 E. coli O157:H7 and E. coli O26 outbreak among Marine recruits, California

  • Organism:
  • coli O157:H7, Non-O157 STEC
  • Vehicle:
  • beef

In October 2017 an outbreak of E. coli O157:H7 and E. coli O26 occurred among recruits at the Marine Corps Recruit Depot in San Diego and the command’s field training facilities at Edson Range, Camp Pendleton, California. Investigators identified 62 …Read More »

2017 Outbreak of E. coli O26 in Multiple Counties, Colorado

  • Organism:
  • Non-O157 STEC
  • Vehicle:
  • Unknown

Six people residing in Adams, Arapahoe, Denver and Douglas counties, Colorado were laboratory confirmed with E. coli O26 between September 1, 2017 and October 15, 2017. One person was hospitalized. No one died. Three out of 6 cases consumed raw spina…Read More »

2015 Outbreak of E. coli O26 Linked to Chipotle Mexican Grill, Washington and Oregon

  • Organism:
  • Non-O157 STEC
  • Vehicle:
  • unknown

The CDC, FDA, USDA FSIS and public health officials in several states investigated two outbreaks of E. coli O26 linked to food sold at Chipotle Mexican Grill restaurants. Public health investigators used PulseNet to identify illnesses that were part …Read More »

2013 Multi-state Outbreak of E. coli O26 Suspected to be Caused by Iceberg Lettuce

  • Organism:
  • Non-O157 STEC
  • Vehicle:
  • Iceberg lettuce

In the spring of 2013 twenty six cases of E. coli O26 were reported by 13 states: Illinois (6), Minnesota (5), Wisconsin (3), Michigan (2), California (2) and Kentucky, Missouri, Mississippi, New Jersey, new York, Ohio, Washington and West Virginia, …Read More »

2011 Outbreak of E. coli O26 at Jimmy John’s Restaurants Linked to Raw Clover Sprouts

  • Organism:
  • Non-O157 STEC
  • Vehicle:
  • Vegetables, Sprouts, Clover Sprouts

On February 15, 2012, the Centers for Disease Control first announced an ongoing investigation into illnesses linked to the consumption of raw clover sprouts consumed at Jimmy John’s Restaurants in several states. The illnesses were caused by E. co…Read More »

Cargill Meat Solutions/BJ’s Wholesale Club Ground Beef 2010

  • Organism:
  • Non-O157 STEC
  • Vehicle:
  • Beef, Ground Beef

A recall of ground beef was issued on August 28 when three people developed illnesses caused by rare strain of E. coli O26 after they had eaten the product. The ground beef produced by Cargill Meat Solutions, of Pennsylvania and was distributed to B…Read More »

Thanks for Outbreak Database Dot Com.

And, there is some history to consider:

Last year (2010), the USDA’s Food Safety and Inspection Service (FSIS) was petitioned to declare six additional disease-causing and potentially life-threatening strains of E. coli, those referred to as non-O157 Shiga-toxin producing E. coli (STECs) or more succinctly, “the big six,”  as adulterants.Specifically, those six strains include E. coli O26, O11, O103, O121, O45 and O145. Those strains of the E. coli bacteria were targeted because of their capacity to produce the same deadly Shiga toxins as E. coli O157.

Today, despite much controversy and debate and after many months of waiting, those six dangerous strains of E. coli will now be banned from the nation’s meat supply and take their place with E. coli O157 to be classified as adulterants. Accordingly, it will be illegal for meat packers to sell meat contaminated with those pathogens.

William Neuman of The New York Times explained that in his report:

Under the rule, any meat that is found to contain the Big Six E. coli, in tests by government or industry, will have to be diverted for use in cooked products. The bacteria is killed by heating the meat to 160 degrees.

Previously, in 1994, FSIS declared E. coli O157 to be an adulterant an outbreak linked to tainted hamburger patties sold at Jack in the Box restaurants sickened more than 700 people in four states and led to 171 hospitalizations and four deaths. In 2010, in support of the petition to label “the big six” as adulterants, Bill Marler wrote: “the people of this nation do not deserve another Jack in the Box-sized catastrophe as a pre-requisite for currently needed agency action.”

According to a news story by MSNBC health reporter JoNel Aleccia:

The move was hailed as a long-sought victory by food safety advocates, who said they wondered why it took so long to require testing for bacteria that last year collectively caused more infections in the U.S. than E. coli 0157.

“I think what consumers can expect is less contaminated product making it into commerce,” said Nancy Donley, president of the agency STOP Foodborne Illness. “It’s fantastic news.”

Bill Marler, seasoned attorney and food safety advocate, also applauded the move by FSIS as a step in the right direction. In an interview with Aleccia, Marler said, “I am more than pleased. It’s a big recognition that there are other pathogens out there that cause human disease.”

As Aleccia noted in her report:

In 2010, for the first time, those rarer strains of E. coli were responsible for more infections in the U.S. than E. coli O157, according to a June study released by the Centers for Disease Control and Prevention. The non-STECs caused 451 confirmed infections last year, including 69 people who were hospitalized and one death. E. coli O157 caused 442 infections, 184 hospitalizations and two deaths.

However, CDC officials say many infections are never detected. The agency estimates that overall, as many as 265,000 STEC infections occur each year in the United States, with the non-0157 strains causing up to 113,000 illnesses and 300 hospitalizations annually.

Today’s decision will hopefully serve to better protect the public from foodborne illness. As Elisabeth Hagen, the head of food safety for the Department of Agriculture, told William Neuman, “This is one of the biggest steps forward in the protection of the beef supply in some time.” She added, “We’re doing this to prevent illness and to save lives.”

I have been thinking today about what growers in Yuma are going to do next season?  With the FDA and CDC fingering the water from an irrigation canal that flowed by a feedlot with some 100,000 cows, you have to wonder what is going to happen next season if nothing changes?  What are grocery stores and restaurants going to do?  What will consumers demand?

This Years Outbreak

In April 2018 local, state and federal public health and agriculture agencies announced an outbreak of E. coli O157:H7 linked to romaine lettuce from the Yuma, Arizona growing area. On June 28, 2018 the Centers for Disease Control and Prevention (CDC) declared the outbreak over.

The outbreak strain was identified as PulseNet strain EXHX01.0047/EXHA26.0626. A total of 210 people in the United States infected with the outbreak strain of E. coli O157:H7 were reported from 36 states.

States reporting outbreak associated case patients

Illnesses started on dates ranging from March 13, 2018 to June 6, 2018. Ill people ranged in age from 1 to 88 years, with a median age of 28 years. Sixty-seven percent of ill people were female. Of 201 people with information available, 96 (48%) were hospitalized, including 27 people who developed hemolytic uremic syndrome (HUS), a type of kidney failure. Five deaths were reported from Arkansas, California, Minnesota (2), and New York.

WGS analysis of isolates from 184 ill people identified antibiotic resistance to chloramphenicol, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Standard antibiotic resistance testing of eight clinical isolates by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these findings. Isolates from four of those ill people also contained genes for resistance to ampicillin and ceftriaxone.

In Canada there were eight illnesses of E. coli O157:H7 with a similar genetic fingerprint to illnesses reported in the U.S. investigation. The eight Canadian illnesses were reported in five provinces:  British Columbia (1), Alberta (1), Saskatchewan (2), Ontario (3), and Quebec (1). Individuals in Canada became sick between March and April 2018. One patient was hospitalized and no one died. Based on the evidence from the U.S. outbreak investigation and information provided by individuals who became sick, Canadian investigators concluded that the likely source of illness in Canada was contaminated romaine lettuce. All of the individuals reported having eaten romaine lettuce at home or in prepared salads purchased at grocery stores, restaurants and fast food chains before their illnesses occurred. Two Canadians did report traveling to the U.S. before getting sick and eating romaine lettuce while they were there.[1]

The FDA and state and local regulatory officials traced the romaine lettuce to many farms in the Yuma growing region. The FDA, along with CDC and state partners, started an environmental assessment in the Yuma growing region and collected samples of water, soil, and manure. CDC laboratory testing identified the outbreak strain of E. coli O157:H7 in water samples taken from a canal in the Yuma growing region. WGS showed that the E. coli O157:H7 found in the canal water was closely related genetically to the E. coli O157:H7 isolated in ill people. Investigators believe this finding suggests that contaminated water coming into contact with produce, either through direct irrigation or other means, is a viable explanation for transmission of the bacteria to romaine lettuce. The FDA also notes that the canal is close to a Concentrated Animal Feeding Operation (CAFO), a facility that can hold in excess of 100,000 head of cattle at any one time. FDA traceback information showed a clustering of romaine lettuce farms nearby. The Environmental Assessment report will be made publicly when complete.[2]  

And a Bit(e) of Lettuce History

Date Vehicle Etiology Confirmed
Cases		 States/Provinces
July 1995 Leafy Greens E. coli O157:H7 74 1:MT
Sept. 1995 Romaine E. coli O157:H7 20 1:ID
Sept. 1995 Iceberg E. coli O157:H7 30 1:ME
Oct. 1995 Iceberg E. coli O157:H7 11 1:OH
May-June 1996 Mesclun Mix E. coli O157:H7 61 3:CT, IL, NY
May 1998 Salad Mix E. coli O157:H7 2 1:CA
Feb.-Mar. 1999 Iceberg E. coli O157:H7 72 1:NE
Oct. 1999 Salad E. coli O157:H7 92 3:OR, PA, OH
Oct. 2000 Lettuce E. coli O157:H7 6 1:IN
Nov. 2001 Lettuce E. coli O157:H7 20 1:TX
July-Aug. 2002 Romaine E. coli O157:H7 29 2:WA, ID
Nov. 2002 Lettuce E. coli O157:H7 13 1:Il
Dec. 2002 Lettuce E. coli O157:H7 3 1:MN
Oct. 2003-May 2004 Salad Mix E. coli O157:H7 57 1:CA
Apr. 2004 Spinach E. coli O157:H7 16 1:CA
Nov. 2004 Lettuce E. coli O157:H7 6 1:NJ
Sept. 2005 Romaine E. coli O157:H7 32 3:MN, WI, OR
Sept. 2006 Spinach E. coli O157:H7 and other serotypes 205 Multistate and Canada
Nov./Dec. 2006 Lettuce E. coli O157:H7 71 4:NY, NJ, PA, DE
Nov./Dec. 2006 Lettuce E. coli O157:H7 81 3:IA, MN, WI
July 2007 Lettuce E. coli O157:H7 26 1:AL
May 2008 Romaine E. coli O157:H7 9 1:WA
Oct. 2008 Lettuce E. coli O157:H7 59 Multistate and Canada
Nov. 2008 Lettuce E. coli O157:H7 130 Canada
Sept. 2009 Lettuce: Romaine or Iceberg E. coli O157:H7 29 Multistate
Sept. 2009 Lettuce E. coli O157:H7 10 Multistate
April 2010 Romaine E. coli O145 33 5:MI, NY, OH, PA, TN
Oct. 2011 Romaine E. coli O157:H7 58 Multistate
April 2012 Romaine E. coli O157:H7 28

1:CA

Canada
June 2012 Romaine E. coli O157:H7 52 Multistate
Sept. 2012 Romaine E. coli O157:H7 9 1:PA
Oct. 2012 Spinach and Spring Mix Blend E. coli O157:H7 33 Multistate
Apr. 2013 Leafy Greens E. coli O157:H7 14 Multistate
Aug. 2013 Leafy Greens E. coli O157:H7 15 1:PA
Oct. 2013 Ready-To-Eat Salads E. coli O157:H7 33 Multistate
Apr. 2014 Romaine E. coli O126 4 1:MN
Apr. 2015 Leafy Greens E. coli O145 7 3:MD, SC, VA
June 2016 Mesclun Mix E. coli O157:H7 11 3:IL, MI, WI
Nov. 2017 Leafy Greens E. coli O157:H7 67 Multistate and Canada
Mar. 2018 Romaine E. coli O157:H7 219 Multistate and Canada

 

[1] https://www.canada.ca/en/public-health/services/public-health-notices/2018/public-health-notice-outbreak-e-coli-infections-linked-romaine-lettuce.html

[2] https://www.cdc.gov/ecoli/2018/o157h7-04-18/0; and https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm604254.htm