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Food Poison Journal Food Poisoning Outbreaks and Litigation: Surveillance and Analysis

San Francisco E. coli Outbreak – Health Department Alert

Health Alert

August 28, 2013

Surveillance for E. coli O157

SITUATION: Eight cases of presumptive Escherichia coli O157 have been reported to the San Francisco Department of Public Health (SFDPH) during the past week. All of the reported cases have presented with bloody diarrhea, and one has progressed to hemolytic-uremic syndrome (HUS).

SFDPH is working with the California Department of Public Health (CDPH) and the California Emerging Infections Program (CEIP) to monitor the spread of disease, confirm the E. coli strain(s) involved, gather information from clinicians and interviews with patients, and determine whether the cases may be linked or share a common source. To date the cases have not been linked to each other or to a common source.

In order to identify any additional cases of E. coli O157 in San Francisco residents, SFDPH is conducting surveillance for illnesses that may be related to the outbreak.

ACTIONS REQUESTED OF CLINICIANS and LABORATORIES:

1. Remain alert for adult or pediatric patients who have HUS or acute onset of bloody diarrhea.

2. Obtain stool samples for culture from patients with bloody diarrhea and test those specimens for E. coli O157 as well as other suspect pathogens.

3. Report cases of HUS or Shiga toxin-producing E. coli (STEC) including E. coli O157 immediately (within 1 hour) to SFDPH Communicable Disease Control Unit (415) 554-2830.

4. Clinical laboratories should send E. coli O157 isolates to SFDPH Laboratory for confirmation and further characterization. Do not send specimens directly to CDPH or CDC. For laboratory-related questions, please call the SFDPH Laboratory at (415) 554-2800.

ADDITIONAL RESOURCES:

SFDPH: http://sfdph.org/cdcp

CDPH: http://www.cdph.ca.gov/HealthInfo/discond/Pages/EscherichiacoliO157H7.aspx

CDC: http://www.cdc.gov/mmwr/PDF/rr/rr5812.pdf, http://www.cdc.gov/ecoli/index.html

For clinical or general questions please call SFDPH Communicable Disease Control Unit at (415) 554-2830. For laboratory-related questions only, please call the SFDPH Laboratory at (415) 554-2800.

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Health Alert: Conveys the highest level of importance; warrants immediate action or attention. Health Advisory: Provides important information for specific incident or situation; may not require immediate action. Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.