CDC, public health and regulatory officials in multiple states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Cyclospora cayetanensis infections.

As of September 11, 2018, CDC was notified of 511 laboratory-confirmed cases of Cyclospora infections in people from 15 states and New York City who reported consuming a variety of salads from McDonald’s restaurants in the Midwest.

Twenty-four (24) people were hospitalized. No deaths were reported.

Epidemiologic and traceback evidence indicated that salads purchased from McDonald’s restaurants were one likely source of this outbreak.

On July 13, 2018, McDonald’s voluntarily stopped selling salads at over 3,000 locations in 14 states. The company has since reportedExternal that it has replaced the supplier of salad mix in those states.

On July 26, 2018, the FDA completed final analysis of an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. The analysis confirmed the presence of Cyclospora in that sample.

What is cyclospora? Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of illness caused by cyclospora infection (that is, cyclosporiasis) were first discovered in 1977. An increase in the number of cases being reported began in the mid-1980s, in part due to the availability of better diagnostic techniques. Over 15,000 cases are estimated to occur in the United States each year. The first recorded cyclospora outbreak in North America occurred in 1990 and was linked to contaminated water. Since then, several cyclosporiasis outbreaks have been reported in the U.S. and Canada, many associated with eating fresh fruits or vegetables. In some developing countries, cyclosporiasis is common among the population and travelers to those areas have become infected as well.

Where does cyclospora come from? Cyclospora is spread when people ingest water or food contaminated with infected stool. For example, exposure to contaminated water among farm workers may have been the original source of the parasite in raspberry-associated outbreaks in North America. Cyclospora needs time (one to several weeks) after being passed in a bowel movement to become infectious. Therefore, it is unlikely that cyclospora is passed directly from one person to another. It is not known whether or not animals can be infected and pass infection to people.

What are the typical symptoms of Cyclospora infection? Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with cyclospora do not have any symptoms. Symptoms generally appear about a week after infection. If not treated, the illness may last from a few days up to six weeks. Symptoms may also recur one or more times. In addition, people who have previously been infected with cyclospora can become infected again.

What are the serious and long-term risks of cyclospora infection? Cyclospora has been associated with a variety of chronic complications such as Guillain-Barre syndrome, reactive arthritis or Reiter’s syndrome, biliary disease, and acalculous cholecystitis. Since cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in individuals who are not treated or not treated promptly. Extraintestinal infection also appears to occur more commonly in individuals with a compromised immune system.

How is cyclospora infection detected? Your health care provider may ask you to submit stool specimen for analysis. Because testing for cyclospora infection can be difficult, you may be asked to submit several stool specimens over several days. Identification of this parasite in stool requires special laboratory tests that are not routinely done. Therefore, your health care provider should specifically request testing for cyclospora if it is suspected. Your health care provider might have your stool checked for other organisms that can cause similar symptoms.

How is cyclospora infection treated? The recommended treatment for infection with cyclospora is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should rest and drink plenty of fluids. No alternative drugs have been identified yet for people with cyclospora infection who are unable to take sulfa drugs. Some experimental studies, however, have suggested that ciprofloxacin or nitazoxanide may be effective, although to a lesser degree than trimethoprim-sulfamethoxazole. See your health care provider to discuss alternative treatment options.

How can Cyclospora infection be prevented? Avoiding water or food that may be contaminated is advisable when traveling. Drinking bottled or boiled water and avoiding fresh ready-to-eat produce should help to reduce the risk of infection in regions with high rates of infection. Improving sanitary conditions in developing regions with poor environmental and economic conditions is likely to help to reduce exposure. Washing fresh fruits and vegetables at home may help to remove some of the organisms, but cyclospora may remain on produce even after washing.

Now that is a mouthful of some pathogens.

The California Department of Public Health (CDPH) today recommended that consumers avoid eating raw oysters harvested from Estero El Cardon in Baja California Sur, Mexico, because they are linked to an outbreak of gastrointestinal illnesses in California.

In California, 12 individuals have reported illness in February, March, and April after consuming raw oysters sold by restaurants and retailers located in Los Angeles, Orange, Santa Barbara and San Diego Counties. The raw oysters have been distributed throughout the state. Laboratory testing was performed for eight cases and multiple pathogens were identified: Vibrio parahaemolyticus (3), Vibrio albensis (1), Vibrio species unidentified (1), Shigella flexneri serotype 1 (2), and norovirus (1). One of the Vibrio parahaemolyticus cases was co-infected with non-O157 Shiga toxin-producing E. coli. The investigation is ongoing.

CDPH continues to work closely with local health jurisdictions to collect information about the cases. Traceback evidence collected to date confirms that the oysters were harvested from Estero El Cardon. Shellfish authorities in Mexico have been notified about the outbreak and are investigating. Restaurants and retailers can protect customers by checking their inventory and shellfish tags that are required to identify the source to avoid any raw oysters harvested from Estero El Cardon in Baja California Sur, Mexico. This will ensure that potentially contaminated raw oysters are not available for purchase, and any leftover contaminated products are discarded. Consumers should ask the retailer or restaurant about the source if the product is not labeled or identified.

California residents should visit their doctors if they become ill after eating raw oysters. Any illness should also be reported to the local health department. Some tips to remember include:

Avoid eating raw and undercooked shellfish, including oysters, to reduce the risk of illness.
If you do eat shellfish, cook it until it reaches an internal temperature of at least 145°F. Quick steaming isn’t sufficient to prevent gastrointestinal illness from these pathogens.”

This year marks the 25th anniversary of a massive E. coli outbreak, which hit 73 Jack in the Box restaurants in Washington, Idaho, Oregon and California; sickened 700 people; sent 171 to the hospital; and killed four. The anniversary is a somber but noteworthy milestone for accomplished food safety attorney Bill Marler ’87.

“It’s the 25th anniversary of the outbreak, but it’s also the 20th anniversary of our law firm,” he said. Seattle-based Marler Clark, which he co-founded with fellow Seattle University School of Law alumnus Bruce Clark ’84, was the nation’s first law firm to focus solely on helping victims of foodborne illnesses and grew directly from both attorneys’ experience with the 1993 outbreak.

As milestones like this come and go, Marler, who recently turned 60, wonders whether it’s time to retire. A few of his colleagues from the law firm’s early days have already done so.

“But I really love my job,” he said. “I get to make a huge difference in people’s lives, people who have lost their kidneys, lost their large intestines, are brain-injured, families that are facing millions and millions and millions of dollars in medical expenses, or a husband who’s never going to work again. And I get to help them. That’s a reason to get up and go to work every day.”

In the last two decades, Marler Clark has been involved in the aftermath of every major and minor outbreak of foodborne illness in the United States, working not only with victims but also with scientists and public health officials to make the food supply safer. Author Jeff Benedict, who chronicled the Jack in the Box story in his 2011 book, “Poisoned,” wrote that “no individual has had more influence on the shape and direction of food safety policy in the U.S.” than Marler.

Back in 1993, just a few years out of law school, he became the lead lawyer for the plaintiffs through an effective combination of hustle, hard work, personal connections, and media savvy.

His first E. coli client was a Tacoma family referred to him by a woman he had helped with a worker’s compensation claim. He rushed from his office in downtown Seattle to his old law school hangout in Tacoma (the law school was formerly affiliated with University of Puget Sound), the Poodle Dog Restaurant, met with the family, and convinced them to hire him.

“I went from obscurity to being sort of the legal face of the outbreak. I went from having one client to five clients to 10 clients to hundreds,” he said. Two years into the class-action lawsuit, when the end was finally in sight, Marler settled $25 million worth of cases in two days of mediation.

Most notably, he secured a $15.6 million settlement – the largest of its kind at the time – on behalf of Brianne Kiner, the Seattle girl who was the most severely injured victim of the outbreak, which was traced to undercooked hamburgers at 73 Jack in the Box restaurant locations. Just 9 years old, she spent several weeks in a coma, followed by a long and painful recovery. She still struggles with lifelong health effects such as infertility, asthma, and diabetes.

When the case concluded, Marler figured he would return to a general personal injury practice, possibly specializing in medical malpractice. But then another E. coli outbreak hit, again centered in Washington state. In 1996, a tainted batch of apple juice, from a juice company called Odwalla, killed one toddler and sickened 66 people. The families called Marler for help, thanks to his high profile in the Jack in the Box litigation.

“It really was at that point that I thought, ‘Hmm, clearly people think I know what I’m doing,'” Marler joked. “But candidly, I had worked really hard. I knew the law and I knew the medicine really well. I started wondering if you could create an entire practice around this.”

You could. Or rather, he could. Marler and Clark partnered with lawyers Denis Stearns and Andy Weisbecker to create the firm in 1998. (Both Clark and Stearns essentially switched sides, having represented Jack in the Box during the earlier litigation.) Two of the firm’s most recent hires are also Seattle U Law graduates – Anthony Marangon ’15 and Josh Fensterbush ’17. Stearns and Drew Falkenstein ’02 are of counsel at the firm.

Over the years, Marler has secured more than $600 million for victims of E. coli, salmonella, and other foodborne illnesses. While lawsuits often spur companies to make important changes – Jack in the Box developed the industry’s toughest safety standards after its outbreak – Marler knows there’s more to it than litigation. So he also devotes his energy and expertise to advocate for stronger food safety laws and regulations.

He petitioned the U.S. Department of Agriculture to better regulate pathogenic E. coli and successfully advocated for the passage of the 2010-2011 FDA Food Safety Modernization Act. He has spoken to countless industry groups and journalists, established science scholarships, and written extensively on all manner of foodborne pathogens.

What motivated Bill Marler back in 1993 is what continues to motivate him today. Many people who suffer the most from foodborne illness are children, and the money he earns for them is intended to take care of them for the rest of their lives.

Marler has three daughters of his own – one is a graduate of Seattle University and two are current students. The oldest was just an infant when he took on Jack in the Box.

“When you’re representing little children and you see how injured they are,” he said, “it doesn’t take much to look at your own kids and realize just how important your job is.”

(This story originally appeared in Lawyer, Spring 2018.)

It is said that it is always hard to get the first olive out of the jar and it is the same in settlements.  It was hard fought, but the resolutions of the cases were fair and my hope is that these corporate defendants and their insurers see that it is in everyone’s best interest to take care of customers who were sickened by their product sooner rather than later.

Although litigation is always my preferred option, resolving cases that are backed up by solid epidemiology and genetic fingerprinting of both E. coli and Salmonella, makes the most economic sense for the defendants and insurers and it is far fairer  to the injured.

Here was the case lineup:

The Spring 2018 E. coli O157:H7 Romaine Lettuce Outbreak:  In 2018 in the United Sates, 210 people infected with the outbreak strain of E. coli O157 were reported from 36 states. 96 people were hospitalized, including 27 people who developed a type of kidney failure called hemolytic uremic syndrome (HUS). 5 deaths were reported from Arkansas, California, Minnesota (2), and New York. In Canada, 8 cases of E. coli O157 that were genetically similar to the U.S. outbreak linked to romaine lettuce coming from the Yuma growing region in the U.S. The 8 Canadian illnesses were reported in 5 provinces: British Columbia, Alberta, Saskatchewan, Ontario and Quebec. 1 of the Canadian cases was hospitalized with HUS and no deaths were reported in Canada. Through our own traceback, we have uncovered numbers restaurant clusters which have led to processor clusters, and in some instances, farms.

The Summer 2018 E. coli O26 Ground Beef Outbreak:  As of September 19, 2018, 18 people infected with the outbreak strain of E. coli O26 were reported from 4 states. 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.

The Summer 2018 Salmonella Adelaide Cut Fruit Outbreak: As of July 24, 2018, 77 people infected with the outbreak strain of Salmonella Adelaide were reported from nine states – Arkansas 1, Florida 1, Illinois 7, Indiana 14, Kentucky 1, Michigan 39, Missouri 11, Ohio 2, Tennessee 1. Illnesses started on dates ranging from April 30, 2018, to July 2, 2018. Ill people ranged in age from less than 1 year to 97, with a median age of 67. Among ill people, 67% were female. Out of 70 people with information available, 36 (51%) were hospitalized. No deaths were reported. Epidemiologic and traceback evidence indicated that pre-cut melon supplied by the Caito Foods, LLC of Indianapolis, Indiana was the likely source of this multistate outbreak.

And, I get to fly home on my birthday.

The CDC warns:

Place chicken in a disposable bag before putting in your shopping cart or refrigerator to prevent raw juices from getting onto other foods.

Wash hands with warm soapy water for 20 seconds before and after handling chicken.

Do not wash raw chicken. During washing, chicken juices can spread in the kitchen and contaminate other foods, utensils, and countertops.

Use a separate cutting board for raw chicken.

Never place cooked food or fresh produce on a plate, cutting board, or other surface that previously held raw chicken.

Wash cutting boards, utensils, dishes, and countertops with hot soapy water after preparing chicken and before you prepare the next item.

Use a food thermometerExternal to make sure chicken is cooked to a safe internal temperature of 165°F.

If cooking frozen raw chicken in a microwavable meal, handle it as you would fresh raw chicken. Follow cooking directions carefully to prevent food poisoning.

If you think the chicken you are served at a restaurant or anywhere else is not fully cooked, send it back for more cooking.

Refrigerate or freeze leftover chicken within 2 hours (or within 1 hour if the temperature outside is higher than 90°F).

Summary

Public Health investigated an outbreak of Shiga toxin-producing E. coli (STEC) associated with I Love Sushi and Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. I Love Sushi is a food establishment that operates out of Café Mario once a week.

This outbreak appears to be over. After a thorough investigation, we do not have enough evidence to connect I Love Sushi to this outbreak.. No single food item prepared by Café Mario has been identified as the source of the illnesses. Everyone who reported illness has recovered.

Illnesses

Since July 2, 2018, we have learned of 22 people in WA (20 in King County and 2 in Snohomish County) who developed symptoms consistent with an STEC illness, including diarrhea (bloody or non-bloody) and abdominal cramps. All 22 of these ill people are adults who work at the Nintendo of America campus in Redmond. Illness onsets occurred during June 11-July 5, 2018.

The 22 people who got sick all ate food from Café Mario on multiple days before becoming ill. Only four people who got sick also ate at I Love Sushi.

We learned of two additional people from King County who tested positive for E. coli infections with the same bacterial strain as the cases associated with Café Mario. However, these two people had no known connection to Café Mario or Nintendo, and we could not identify any other potential sources of exposure in common with any of the other people who got sick. We are not including these two people in the overall case count of this outbreak.

Public Health actions

On July 3, 2018, Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.

At Café Mario, investigators identified possible risk factors for cross contamination and spread of bacteria, including improper hand washing practices and improper cold holding temperatures of food; corrective actions were addressed with Café Mario’s management. At I Love Sushi, possible risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on the July 4 holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Investigators revisited both food establishments on July 11, 2018, and both were allowed to reopen the same day. Café Mario and I Love Sushi both completed a thorough cleaning and disinfection of their facilities before reopening, and any remaining processed ready-to-eat food products were discarded.

We did not identify any employees of either restaurant who had a recent diarrheal illness. Investigators also reviewed with management of both food establishments the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

Laboratory testing

Four of the 22 people who got sick tested positive for STEC O26 with the same genetic fingerprint, suggesting that they have a common source of infection. The remaining people who got sick were not tested for STEC, but their symptoms are suggestive of STEC.

Environmental swabs were collected from both I Love Sushi and Café Mario for laboratory testing and all came back negative for STEC at the Washington State Public Health Laboratory.

Four people were killed Saturday when part of a crane fell from the construction site of a future Google building.

Investigating what caused a crane to collapse in downtown Seattle Saturday, killing four people and injuring four others, might take six months to a year.

The Washington state Department of Labor and Industries will head the investigation into GLY Construction, subcontractors Northwest Tower Crane and Omega Morgan, and Morrow Equipment Company.

In November 2006, King 5 reported that Thursday’s fatal crane accident in Bellevue is focusing a lot of attention on the industry, which has done a pretty good job in the area of safety. But went terribly and tragically wrong after the operator told firefighters he heard a cracking noise at the base of the crane.

When it happens, it’s pretty catastrophic.

Seattle Attorney Bill Marler represented a worker killed in the collapse of a crane inside the Kingdome in 1994. He says that accident was blamed on operator error. “To the extent you can figure out what happened, hopefully, one of these things won’t happen again,” he said.

The victim in the 2006 collapse was identified today as Matt Ammon, 31, a Microsoft employee for five months. The King County Medical Examiner’s Office said Ammon died of rib and pelvis injuries and other fractures.  Ammon lived in a fourth-floor apartment in the 248-unit Pinnacle BellCentre.  The Operator in crane wreck has history of drug abuse.

A decade ago, William Marler, a Seattle Attorney, sued Ness Cranes in relation to the Kingdome crane accident of 1994, which killed two men. The general contractor on that project, Pacific Components, was also sued.  His criminal background will be relevant only if operator error is at least partially responsible for the collapse, or if he did not perform an inspection properly, said Marler, the lawyer.

“You have to have some causal link between one and the other,” he said.

“The reality is that there is no public entity in inspecting cranes,” said Seattle lawyer Bill Marler. “It’s really the companies inspecting themselves.”

GAPS IN SAFETY CONTROLS

# The state does not require drug tests before crane operators are hired.

# The state did no safety inspections at the site of Thursday’s accident.

# Cranes must be inspected before each use, but it is usually done by the operator.

# A statewide crane-safety organization created after the deadly 1994 Kingdome crane accident is no longer active.

I found an interesting website on prior crane-related accidents – www.craneaccidents.com

I will be in lovely Minneapolis for the coming week meeting with defense counsel and the insurers for the manufacturers of E. coli O26-tainted ground beef, Salmonella-tainted cut fruit and E. coli O157:H7-tainted romaine lettuce who sickened dozens in 2018.  I hear the weather in Minnesota may still have some snow in it, but heck, it also will be my birthday Friday.

Here is the case lineup:

The Spring 2018 E. coli O157:H7 Romaine Lettuce Outbreak:  In 2018 in the United Sates, 210 people infected with the outbreak strain of E. coli O157 were reported from 36 states. 96 people were hospitalized, including 27 people who developed a type of kidney failure called hemolytic uremic syndrome (HUS). 5 deaths were reported from Arkansas, California, Minnesota (2), and New York. In Canada, 8 cases of E. coli O157 that were genetically similar to the U.S. outbreak linked to romaine lettuce coming from the Yuma growing region in the U.S. The 8 Canadian illnesses were reported in 5 provinces: British Columbia, Alberta, Saskatchewan, Ontario and Quebec. 1 of the Canadian cases was hospitalized with HUS and no deaths were reported in Canada. Through our own traceback, we have uncovered numbers restaurant clusters which have led to processor clusters, and in some instances, farms.

The Summer 2018 E. coli O26 Ground Beef Outbreak:  As of September 19, 2018, 18 people infected with the outbreak strain of E. coli O26 were reported from 4 states. 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.

The Summer 2018 Salmonella Adelaide Cut Fruit Outbreak: As of July 24, 2018, 77 people infected with the outbreak strain of Salmonella Adelaide were reported from nine states – Arkansas 1, Florida 1, Illinois 7, Indiana 14, Kentucky 1, Michigan 39, Missouri 11, Ohio 2, Tennessee 1. Illnesses started on dates ranging from April 30, 2018, to July 2, 2018. Ill people ranged in age from less than 1 year to 97, with a median age of 67. Among ill people, 67% were female. Out of 70 people with information available, 36 (51%) were hospitalized. No deaths were reported. Epidemiologic and traceback evidence indicated that pre-cut melon supplied by the Caito Foods, LLC of Indianapolis, Indiana was the likely source of this multistate outbreak.

Wish the parties luck in finding common ground on these strict product liability cases.

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.

On the anniversary of my 5,000th blog post (I’m n0w at 6388) I wrote:

In 2002, I wrote an Op-ed for the Denver Post entitled: “Put me out of business. Please.”

For this trial lawyer, E. coli has been a successful practice – and a heart-breaking one. I’m tired of visiting with horribly sick kids who did not have to be sick in the first place. I’m outraged with a food industry that allows E. coli and other poisons to reach consumers, and a federal regulatory system that does nothing about it…. And, with a little luck, it will force one damn trial lawyer to find another line of work.

From the Jack in the Box E. coli outbreak of 1993 until the 2002 ConAgra E. coli outbreak, at least 95% of Marler Clark revenue was E. coli cases linked to hamburger.  Today, it is nearly zero.  That is success.  To the beef industry – thank you for meeting the challenge.  The millions spent on interventions, and the countless hours of food safety professionals, made the difference.

That all being said, there is still much the industry can do.  Shiga-toxin producing E. coli will always be an issue.  Listeria and antibiotic resistant Salmonella and Campylobacter, and other bad bugs we do not even know about, lurk around the corner.  The industry cannot let up.  Even with the success there still have been isolated tragedies like Stephanie Smith who remind you the battle will likely always have to be fought.

But, for now, hats off to you.

Hopefully, it was not a premature congratulations?  Here is where we were a few moments ago:

As of April 25, 2019, 177 people infected with the outbreak strain of E. coli O103 have been reported from 10 states. CDC is reporting the 177 illnesses that the PulseNet laboratory network has confirmed are part of this outbreak. States are investigating additional illnesses that might be a part of this outbreak.

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. Of 143 people with information available, 21 (15%) have been hospitalized. No deaths and no cases of hemolytic uremic syndrome have been reported.

This multistate investigation began on March 28, 2019, when officials in Kentucky and Georgia notified CDC of this outbreak. Epidemiologic and laboratory evidence indicates that ground beef is the likely source of this outbreak.