According to Kim Archer of the Tulsa World, Oklahoma state health officials have determined that a relatively rare and virulent form of E. coli infected dozens of patrons of Country Cottage, killing one and sickening more than 73 people. More than 50 of those who fell ill were hospitalized. Five children remain in the pediatric intensive care unit at Children’s Hospital at St. Francis. Four are on dialysis. Two other children were sent to OU Children’s Hospital. Ms. Archer quoted State epidemiologist Dr. Kristy Bradley as saying the E. coli strain is not the commonly known E. coli O157:H7. Non-O157 strains are more common in South America and parts of Europe, according to the Pediatric Infectious Disease Journal.
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I could not agree more. Shiga toxin is one of the most potent toxins known to man, so much so that the Centers for Disease Control and Prevention (CDC) lists it as a potential bioterrorist agent (CDC, n.d.). It seems likely that DNA from Shiga toxin-producing Shigella bacteria was transferred by a bacteriophage (a virus that infects bacteria) to otherwise harmless E. coli bacteria, thereby providing them with the genetic material to produce Shiga toxin.
Although E. coli O157:H7 is responsible for the majority of human illnesses attributed to E. coli, there are additional Stx-producing E. coli (e.g., E. coli O121:H19) that can also cause hemorrhagic colitis and post-diarrheal hemolytic uremic syndrome (D+HUS). HUS is a syndrome that is defined by the trilogy of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney failure.
Stx-producing E. coli organisms have several characteristics that make them so dangerous. They are hardy organisms that can survive several weeks on surfaces such as counter tops, and up to a year in some materials like compost. They have a very low infectious dose meaning that only a relatively small number of bacteria (< 50) are needed “to set-up housekeeping” in a victim’s intestinal tract and cause infection.
I represented three Hemolytic Uremic Syndrome victims in an outbreak of E. coli O21:H19 linked to a Utah Wendys in 2006. Non-O157:H7 was also likely responsible for some of the illnesses in the Dole Spinach outbreak of 2006.
I also recently gave a speech in front of the USDA/FSIS on making all Shiga-toxin producing E. coli’s adulterants under the US Meat Inspection Act. Here is that text:
Another issue facing, not only the meat industry, but all of us, is the extent to which non-O157 E. coli may be present in food products – FSIS regulated or not. It is clear that Non-O157 Shiga toxin producing E. coli have emerged as a public health issue. Some non-O157 possess the same range of virulence factors as E. coli O157:H7 and are capable of causing serious illnesses, or death. Numerous serotypes, including O26, O103, O111 and O145 have been identified as agents of food borne disease.
I have seen their nasty work in the Dole spinach outbreak and an outbreak in Utah involving Wendy’s. Since 1990, 13 outbreaks of non-O157 E. coli have been reported in the US. While E. coli O157 is the principal strain isolated from implicated food and clinical isolates in the US, non-O157 predominate in other countries, including several of our beef trading partners like Australia, Brazil and Canada.
I will leave this to scientists and public health officials to sort all out. However, perhaps one needs to look no further than the FEDERAL MEAT INSPECTION Act and look at the term ”adulterated" for and answer. A product is adulterated: (1) if it bears or contains any poisonous or deleterious substance which may render it injurious to health." If non-O157 E. coli fits the bill, then to me that answers the question. However, what do we then do about salmonella, listeria, campylobacter, and shigella – especially those with particular virulence or antibiotic resistance?
One thing to remember, whether a product is considered to be an adulterant under the FMI or not, if a food product contains a bacteria or virus that sickens or kills, civil liability can, and often will attach. My vote is to simply get pathogens out of your product.