What we know is that illnesses began March 1 and it is now almost May 1 – why did it take so long to figure out that 177 people with E. coli O103 were linked to ground beef? Why do we do not yet know the original source of the contamination? Why is the public not being told the location where known illnesses occurred? Finally, are more people going to get sick?
What we also do know – According to the CDC and 10 state health agencies, a total of 177 people infected with the outbreak strain of E. coli O103 have been reported from 10 states – Georgia (41), Kentucky (65), Ohio (10), Tennessee (52), Virginia (2), Indiana (1), Florida (3), Illinois (1), Mississippi (1) and Minnesota (1). The Illnesses started on dates from March 1, 2019, to April 14, 2019. Ill people range in age from less than 1 year to 84 years, with a median age of 18. Fifty-one percent are female. Twenty-one people have been hospitalized. However, fortunately, no deaths and no cases of hemolytic uremic syndrome have been reported.
Why does in take time to count the ill and come to a conclusion as to a common cause – The CDC says that illnesses that occurred after March 29, 2019, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks. The truth is that takes time for people to become ill – onset (between ingestion and illness) can be 1 to 10 days. It then takes time for tests to be run to confirm an infection and then to have the E. coli “genetically fingerprinted” using PFGE and the good people at CDC Pulsenet. Then it takes time to interview people and to ask them to recall what they consumed in the 1-10 before they became ill. And, finally it takes time to see what the growing number of ill across 10 states do and do not have in common. It simply takes time.
It is therefore possible that we are seeing the end of the outbreak. And, in looking at the “Epi Curve,” the trend line is down. Perhaps the number of ill, assuming all tainted product is eventually recalled, might crest 200. However, this sadly is still the largest E. coli outbreak linked to ground beef in decades (think 1993 Jack in the Box).
Recall too that early on that Kentucky health authorities reported that the outbreak might well be related to “fast food.” In part, that might well be because the median age of the ill is 18, and that they generally consume more “fast food” than the average consumer? Also, the younger, but not too young, age likely accounts for less severe illness, but it also may be a less virulent STEC E. coli?
So, why have we not learned the ultimate source of the E. coli O103 contamination? And, what I mean by ultimate source is where the originating contamination occurred.
According to investigators, ill people in this outbreak report eating ground beef at home and in restaurants. Ill people in this outbreak ate ground beef from many sources. Investigators continue to trace other sources for ground beef. Authorities say that at this time, no common supplier, distributor, or brand of ground beef has been identified that could account for the whole outbreak.
However, the investigators caught a scientific break of sorts. E. coli O103 was identified in samples of ground beef collected from two locations (not disclosed) where ill people reported eating – one in Kentucky and one in Tennessee. Laboratory testing identified the outbreak strain of E. coli O103 in both of the ground beef samples. Presumably, we will hear shortly that the E. coli O103 found in the samples of beef are matches to the E. coli O103 found in the 177 ill. Here is what we know about the positive tests and what we do not know about the locations.
K2D Foods, doing business as Colorado Premium Foods, in Carrollton, Georgia, recalled approximately 113,424 pounds of raw ground beef products on April 23, 2019 after an unopened, intact ground beef collected as part of the ongoing investigation from a unnamed restaurant location, where multiple case-patients reported dining, tested positive for E. coli O103. The products subject to recall bear establishment number “EST. 51308” inside the USDA mark of inspection on the boxes. These items were shipped to distributors in Port Orange, Florida and Norcross, Georgia for further distribution to restaurants.
Grant Park Packing in Franklin Park, Illinois, recalled approximately 53,200 pounds of raw ground beef products on April 24, 2019 after an unopened, intact, packages of ground beef collected as part of the ongoing investigation tested positive for E. coli O103 at an FSIS laboratory. The sample was collected at an unnamed point of service where multiple case patients ate. The products subject to recall bear establishment number “EST. 21781” inside the USDA mark of inspection. These items were shipped to Minnesota for further distribution and Kentucky for institutional use.
The first next question is where did K2D and Grant Park get the beef that went into the packages that tested positive? Were there multiple sources? Is there a common supplier?
However, even if the answer comes to the beef served at the “unnamed restaurant location” in Kentucky and the “unnamed point of service” in Tennessee, what accounts for all the other ill in Kentucky and Tennessee and the case in Georgia, Ohio, Virginia, Indiana, Florida, Illinois, Mississippi and Minnesota.
Much more work needs to be done and much more needs to be uncovered and disclosed.