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Food Poison Journal

Food Poisoning Outbreaks and Litigation: Surveillance and Analysis

E. coli in Seattle – What You Need To Know

e_colio157(1)E. coli O157:H7 was identified for the first time at the CDC in 1975, but it was not until seven years later, in 1982, that E. coli O157:H7 was conclusively determined to be a cause of enteric disease. Following outbreaks of foodborne illness that involved several cases of bloody diarrhea, E. coli O157:H7 was firmly associated with hemorrhagic colitis.

The Centers for Disease Control and Prevention (CDC) estimated in 1999 that 73,000 cases of E. coli O157:H7 occur each year in the United States. Approximately 2,000 people are hospitalized, and 60 people die as a direct result of E. coli O157:H7 infections and complications. The majority of infections are thought to be foodborne-related, although E.coli O157:H7 accounts for less than 1% of all foodborne illness.

E. coli O157:H7 bacteria are believed to mostly live in the intestines of cattle but have also been found in the intestines of chickens, deer, sheep, goats, and pigs. E. coli O157:H7 does not make the animals that carry it ill; the animals are merely the reservoir for the bacteria.

While the majority of foodborne illness outbreaks associated with E. coli O157:H7 have involved ground beef, such outbreaks have also involved unpasteurized apple and orange juice, unpasteurized milk, alfalfa sprouts, and water. An outbreak can also be caused by person-to-person transmission of the bacteria in homes and in settings like daycare centers, hospitals, and nursing homes.

Symptoms of E. coli O157:H7 Infection

E. coli O157:H7 infection is characterized by the sudden onset of abdominal pain and severe cramps, followed within 24 hours by diarrhea. As the disease progresses, the diarrhea becomes watery and then may become grossly bloody – bloody to naked eye. Vomiting can also occur, but there is usually no fever. The incubation period for the disease (the period from ingestion of the bacteria to the start of symptoms) is typically 3 to 9 days, although shorter and longer periods are not that unusual. An incubation period of less than 24 hours would be unusual, however. In most infected individuals, the intestinal illness lasts about a week and resolves without any long-term problems.

Hemolytic Uremic Syndrome (HUS) is a severe, life-threatening complication of an E. coli O157:H7 bacterial infection. Although most people recover from an E. coli O157:H7 infection, about 5-10% of infected individuals goes on to develop HUS. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. Some organs appear more susceptible than others to the damage caused by these toxins, possibly due to the presence of increased numbers of toxin-receptors. These organs include the kidney, pancreas, and brain. Visit the Marler Clark sponsored Web site about Hemolytic Uremic Syndrome for more information.

Thrombotic Thrombocytopenic Purpura (TTP) is a clinical syndrome defined by the presence of thrombocytopenia (low blood platelet counts) and microangiopathic hemolytic anemia. This has generally been recognized as “adult HUS.” There are many possible causes, including E. coli O157:H7, all of which act through the common mechanism of inducing endothelial cell damage. The damage triggers a cascade of biochemical events that ultimately leads to the characteristic feature of TTP – widespread dissemination of hyaline thrombi, composed predominantly of platelets and fibrin, which block the terminal arterioles and capillaries (microcirculation) of most of the major body organs, commonly, the heart, brain, kidneys, pancreas and adrenals. Other organs are involved to a lesser degree. The pathophysiology of this disease results in multisystem abnormalities and the clinical manifestations of the syndrome.

Detection and treatment of E. coli O157:H7

Infection with E. coli O157:H7 is usually confirmed by detecting the bacteria in the stool of the infected individual. Antibiotics do not improve the illness, and some medical researchers believe that medications can increase the risk of complications. Therefore, apart from good supportive care, such as close attention to hydration and nutrition, there is no specific therapy for E. coli O157:H7 infection. The recent finding that a toxin produced by E. coli O157:H7 initially greatly speeds up blood coagulation may lead to medical therapies in the future that could forestall the most serious consequences. Most individuals recover within two weeks.

Preventing E. coli O157:H7 Infection

Eating undercooked ground beef is the most important risk factor for acquiring E. coli O157:H7. Cook all ground beef and hamburger thoroughly. Because ground beef can turn brown before disease causing bacteria are killed, use a digital instant read meat thermometer to ensure thorough cooking. Hamburgers should be cooked until a thermometer inserted into several parts of the patty, including the thickest part, reads at least 160? F. Persons who cook ground beef without using a thermometer can decrease their risk of illness by not eating ground beef patties that are still pink in the middle. If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking.

Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties. Wash meat thermometers in between tests of patties that require further cooking.

Drink only pasteurized milk, juice, or cider. Commercial juice with an extended shelf life that is sold at room temperature (such as juice in cardboard boxes or vacuum-sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Most juice concentrates are also heated sufficiently to kill pathogens.

Wash fruits and vegetables thoroughly, especially those that will not be cooked. Children younger than 5 years of age, immunocompromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated.

Drink municipal water that has been treated with chlorine or other effective disinfectants, or bottled water that has be sterilized with ozone or reverse osmosis (almost all major brands use one or the other method).

Avoid swallowing lake or pool water while swimming, especially pool water in public swimming facilities.

Avoid petting zoos and other animal exhibits unless there are good hand washing facilities available and other sanitation measures have been taken. Wash your hands and your children’s hands after handling animals.

Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers. Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

References (more…)

Seattle King County Health Report E. coli Outbreak Linked to Los Chilangos

Seattle King County Public Health is currently investigating an outbreak of E. coli O157:H7 – one of the most serious foodborne illnesses you can contract. Our thoughts are with the families affected by this outbreak, and we appreciate the support of the community as we work to protect the health of the public.

A person can get an E. coli O157 infection from many different sources: by eating or drinking something contaminated with animal or human fecal matter, through animal contact, or through contact with another person who has an E. coli infection. One of our responsibilities at Public Health is to track down these sources. When there are illnesses associated with any one of the more than 12,000 food establishments in the county, we search for contaminated products, ill food workers, or improper food handling.

We follow specific steps to find clues that help us pinpoint the source(s) that may be linked to illness. Here are key steps of this current investigation.

  • We interviewed people who got sick.

At this time, we know that six people have been infected with the same strain of E. coli (three have been hospitalized). When Public Health determines that anyone is sick from a serious foodborne illness like E. coli, we interview them to determine what may have caused their illness. We do this to find the source of the outbreak and prevent others from getting infected. In this instance, through a few initial interviews with ill people, we determined that everyone who became sick had something in common – they ate food prepared by a local food vendor called Los Chilangos. Public Health took swift action and required Los Chilangos to cease operations.

  • We investigated a food business that was associated with the people who got sick.

But we didn’t stop there. Los Chilangos serves food at seven farmers markets in King and Snohomish Counties, operates two food trucks, and also caters events. Los Chilangos utilizes a shared kitchen space, called a commissary kitchen. The kitchen that they use is Eastside Commercial Kitchen, where they share space and equipment with about a dozen other food businesses.

  • We intervened at the specific site and operation.

The condition of the commissary and the potential for cross contamination were deemed an imminent health hazard, and the health officer issued a cease and desist order to the commissary on Thursday, August 27. Additionally, all of the food vendors permitted by Public Health that use this kitchen were also told to cease operations. Recognizing that this lapse in operation hurts business, our team has worked diligently with these vendors to find new places for them to resume their work and remind them about important food safety measures.

  • Next steps: tracing the source

As of today, the investigation isn’t over. We are still investigating the source of the E. coli.  If we determine that a food contained the E. coli bacteria, we will try to trace it back to stores, suppliers, and even farms to address the root of the problem with corrective actions, if possible.

But, it’s possible that the source of E. coli may never be determined. E coli is often linked to beef, but it can also be linked to produce, such as spinach and sprouts, along with a variety of other foods such as unpasteurized juices, raw milk, game meats, and other common foods.

For outbreaks such as this one, we continue to monitor the situation and look for other common factors among ill people. While we know Los Chilangos is linked, they may not be the only ones involved. For instance, the source of E. coli could be served by other vendors.

We are currently working with all of the businesses connected to this outbreak to make sure that they are not using any products that may have become contaminated and that they have food safety measures in place. This includes having the businesses address needed repairs to their equipment, providing education to their staff, and ensuring their operations are safe to open.

E. coli: Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli outbreaks and hemolytic uremic syndrome (HUS). The E. coli lawyers of Marler Clark have represented thousands of victims of E. coli and other foodborne illness infections and have recovered over $600 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our E. coli lawyers have litigated E. coli and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products. The law firm has brought E. coli lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s. We have proudly represented such victims as Brianne Kiner, Stephanie Smith and Linda Rivera.

If you or a family member became ill with an E. coli infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli attorneys for a free case evaluation.

Chipotle Linked to Norovirus Outbreak by www.iwaspoisoned.com

Graphics - iwp aug 31 2015 v2Crowdsourcing site http://www.iwaspoisoned.com was referenced recently in a CBS News report in what appears to be a food poisoning outbreak at Chipotle restaurant in Simi Valley, CA. CBS News Los Angeles reported on Aug. 22nd that a number of customers had allegedly fallen ill after dining at the Chipotle. The CBS report noted a primary source as Iwaspoisoned.com.
The Ventura County Star reported approximately 60 customers complained about feeling ill after dining Aug. 18-19, and 17 employees became ill. The restaurant briefly closed after the complaints were made, and inspectors disinfected it and threw out all the food. It reopened on Aug. 22nd and has stayed open since then.

In the report, CBS said “On the website, ‘Iwaspoisoned.com,’ more than a dozen people posted the same symptoms Kam Zreik described after eating at the same Chipotle on Wednesday.” The CBS report can be viewed here in its entirety. http://losangeles.cbslocal.com/2015/08/22/dozens-fall-ill-after-eating-at-simi-valley-chipotle/

Iwaspoisoned.com encourages consumers to report instances of suspected food poisoning. The reports are gathered to show patterns that would indicate possible food poisoning outbreaks around specific dates.

“According to the CDC, food poisoning sickens 48 million Americans every year, hospitalizes 128,000 and kills 3,000 – it’s a very important health topic, and it is very clear when a pattern emerges at a busy crowdsourcing platform like Iwaspoisoned.com,” said Patrick Quade of Iwaspoisoned.com.

Food lawyer and advocate Bill Marler (http://www.billmarler.com) encouraged the use of social media and crowdsourcing platforms as a means to stop outbreaks early. “Having a site like Iwaspoisoned.com allows for consumers to share experiences and therefore allow restaurants and health officials to see a problem and correct it early,” said Marler.

In the past consumers who became ill would have no way of knowing many others became ill the same day eating at the same restaurant. The information gathered by Iwaspoisoned.com can be used by both restaurants and health care workers to help better understand an illness outbreak. Multiple reports concerning a restaurant location can also be a signal for state or city health inspectors to investigate. “You can’t rely that every restaurant or health official will become aware of a pattern or problem, nor can we rely that every restaurant will make the information public in a timely manner. It’s up to consumers to work together to point out where there is a problem and press for a solution,” Patrick said.

Contact: Patrick Quade
patrick(at)iwaspoisoned.com

Listeria and Corn

ucm460636Bonduelle USA Inc. of Brockport, NY is recalling 9,335 cases of frozen corn because it has the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

The frozen cut corn was distributed to stores in the following states: New York, New Jersey, Pennsylvania, Vermont, Massachusetts, Indiana, Ohio, Kentucky, Maryland, Virginia, North Carolina, Florida, Mississippi and Louisiana.

The affected frozen cut corn was distributed in poly bags under the following labels and codes:

  • WYLWOOD Super Sweet Whole Kernel Corn, NET WT. 16 OZ (1 LB), UPC 051933002401, Codes: Best By June 2017 K51564 and K51574;
  • MARKET BASKET Cut Corn, NET WT. 16 OZ. (1 LB.), UPC 049705693414, Code: Best By June 2017 K51574;
  • Bountiful Harvest WHOLE KERNEL CUT CORN, NET WT. 40 OZ. (2.5 LBS.), UPC 822486120597, Code: Best By June 2017 K51574;
  • WEST CREEK FROZEN VEGETABLES Cut Corn, NET WT. 2.5 LBS., UPC 00806795285239 Code: Best By June 2017 K51574.

The company has not received any complaints in relation to this product and is not aware of any illnesses associated with the product to date.

The recall was the result of product being tested at retail by the State of Tennessee which had tested positive for Listeria monocytogenes. The company has ceased distribution of the product, and the company and US Food and Drug Administration (FDA) continue their investigation as to what caused the problem.