E. coli

Escherichia coli (E. coli) are bacteria that live in human and animal intestines. Shiga toxin-producing strains of E. coli, or STECs, are responsible for most food-related E. coliinfections. E. coli O157:H7 and other STECs like E. coli O145 and E. coli O121:H19 produce a toxin called Shiga toxin, which causes illness in humans. E. coli bacteria do not make animals such as livestock and deer, which harbor the bacteria in their intestines, ill.

It is estimated that E. coli infections account for over 2,000 hospitalizations in the United States each year, according to a 2011 CDC report.

SOURCES OF E. COLI

E. coli O157:H7 is most commonly found in cows, although chickens, deer, sheep, and pigs have also been known to carry it. Meat becomes contaminated during slaughter, when infected animal intestines or feces come in contact with the carcass. Ground or mechanically tenderized meats are considered riskier than intact cuts of meat because E. coli bacteria, can be mixed throughout the meat in the grinding process or during tenderization.

Other foods that sometimes become contaminated with E. coli bacteria include unpasteurized milk and cheese, unpasteurized juices, alfalfa and radish sprouts, lettuce, spinach, and water. However, any food is at risk of becoming contaminated with E. coli through cross-contamination. One can also get E. coli bacteria from contact with feces of infected animals or people.

The breakdown of sources of E. coli bacteria from 1998-2007 was as follows:

  • Food: 69%
  • Water: 18%
  • Animals or their environment: 8%
  • Person-to-person: 6%
SYMPTOMS OF E. COLI

E. coli symptoms change as the infection progresses. Symptoms usually begin two to five days after infection. The initial symptoms include the sudden onset of cramps and abdominal pain, followed by diarrhea within 24 hours. Diarrhea will become increasingly watery, and then noticeably bloody. People with E. coli infection also often feel nauseated and experience headaches. Less common symptoms include fever and chills.

HUS: A RARE BUT SERIOUS COMPLICATION

Hemolytic Uremic Syndrome, or HUS, follows around 10 percent of E. coli O157:H7 infections. HUS occurs when Shiga toxins get into the bloodstream and cause the part of the kidney that filters toxins out of the blood to break down, causing kidney injury and sometimes kidney failure.  Some HUS patients also suffer damage to the pancreas and central nervous system impairment.

DIAGNOSIS OF E. COLI

Shiga toxin-producing E. coli infection can be diagnosed in a doctor’s office or hospital by laboratory analysis of a stool sample.

Bacteria isolated from patients’ stool samples can be compared through laboratory analysis, helping to match strains of E. coli to the food or other source it came from, a process called “fingerprinting.”

TREATMENT FOR E. COLI INFECTION

Illness from E. coli usually goes away within a week and does not cause any long-term problems.  One should make sure to remain hydrated and get proper nutrition while sick.

Antibiotics are not used as E. coli treatment, as they do not improve the illness, and some studies show that they can increase the risk of HUS.

HUS is treated by hospitalization. Since there is no way to directly cure HUS, treatment includes care to alleviate symptoms.

PREVENTING INFECTION FROM E. COLI BACTERIA

Any food that you eat has the potential to be contaminated with E. coli bacteria. This is why it is important to take precautions in preparing food and before eating at restaurants. You should also be aware that E. coli bacteria can survive for several weeks on surfaces, so keeping countertops clean is important. Other simple steps you can take to reduce your risk of E. coli infection include:

  • Wash hands thoroughly before and after eating and after going to the bathroom
  • Sanitize all fruits and vegetables before eating by skinning them if possible and washing them before eating
  • Check with your local department of health to find out which restaurants in your area have had recent problems with sanitation
  • Avoid allowing raw meats to come into contact with other foods while cooking
  • Do not allow children to share bath water with anyone who has diarrhea or symptoms of stomach flu
  • Wash hands thoroughly after any contact with farm animals
  • Wear disposable gloves when changing diapers of children with diarrhea
  • Make sure ground meat (such as hamburger patties) reaches an internal temperature of at least 160°F
  • Avoid drinking any non-chlorinated water
ADDITIONAL RESOURCES FOR E. COLI

About-ecoli.com is a comprehensive site with in-depth information about E. colibacteria and E. coli infection.

EcoliLitigation.com is a Website that provides information about lawsuits and litigation brought on behalf of victims of E. coli outbreaks nationwide.

E. coli Blog provides up-to-date news related to E. coli outbreaks, research, and more.

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.

E. coli Bacteria

On January 10, 2018, the Public Health Agency of Canada reported that an outbreak of Shiga toxin-producing E. coli O157:H7 infections (STEC O157:H7) they had identified was linked to romaine lettuce appears to be over.

In the United States, CDC, several states, and the U.S. Food and Drug Administration continue to investigate a multistate outbreak of 24 STEC O157:H7 infections in 15 states. Since CDC’s initial media statement on December 28, seven more illnesses have been added to this investigation. The last reported illness started on December 12, 2017.

The likely source of the outbreak in the United States appears to be leafy greens, but officials have not specifically identified a type of leafy greens eaten by people who became ill.  Leafy greens typically have a short shelf life, and since the last illness started a month ago, it is likely that contaminated leafy greens linked to this outbreak are no longer available for sale. Canada identified romaine lettuce as the source of illnesses there, but the source of the romaine lettuce or where it became contaminated is unknown.

Whole genome sequencing (WGS) showed that the STEC O157:H7 strain from ill people in the United States is closely related genetically to the STEC O157:H7 strain from ill people in Canada. WGS data alone are not sufficient to prove a link; health officials rely on other sources of data, such as interviews from ill people, to support the WGS link. This investigation is ongoing. Because CDC has not identified a specific type of leafy greens linked to the U.S. infections, and because of the short shelf life of leafy greens, CDC is not recommending that U.S. residents avoid any particular food at this time.

Outbreak Summary US

In the United States, a total of 24 STEC O157:H7 infections have been reported from California (4), Connecticut (2), Illinois (1), Indiana (2), Maryland (3), Michigan (1), Nebraska (1), New Hampshire (2), New Jersey (1), New York (1), Ohio (1), Pennsylvania (2), Vermont (1), Virginia (1), and Washington (1). Illnesses started on dates from November 15 through December 12, 2017. Among the 18 ill people for whom CDC has information, nine were hospitalized, including one person in California who died. Two people developed hemolytic uremic syndrome, a type of kidney failure.

The Public Health Agency of Canada identified romaine lettuce as the source of the outbreak in Canada. In the United States, the likely source of the outbreak appears to be leafy greens, but health officials have not identified a specific type of leafy greens that sick people ate in common.

State and local public health officials continue to interview sick people in the United States to determine what they ate in the week before their illness started. Of 13 people interviewed, all 13 reported eating leafy greens. Five (56%) of nine ill people specifically reported eating romaine lettuce. This percentage was not significantly higher than results from a survey of healthy people in which 46% reported eating romaine lettuce in the week before they were interviewed.  Based on this information, U.S. health officials concluded that ill people in this outbreak were not more likely than healthy people to have eaten romaine lettuce.  Ill people also reported eating different types and brands of romaine lettuce. Currently, no common supplier, distributor, or retailer of leafy greens has been identified as a possible source of the outbreak. CDC continues to work with regulatory partners in several states, at the U.S. Food and Drug Administration, and the Canadian Food Inspection Agency to identify the source.

Although the most recent illness started on December 12, there is a delay between when someone gets sick and when the illness is reported to CDC. For STEC O157:H7 infections, this period can be two to three weeks. Holidays can increase this delay. Because of these reporting delays, more time is needed before CDC can say the outbreak in the United Stated is over. This investigation is ongoing.

Advice to Consumers

CDC is not recommending that U.S. residents avoid any particular food given the short shelf life of leafy greens and because a specific type of leafy greens has not been identified.

Symptoms of E. coli Infections

Most people develop diarrhea (often bloody) and stomach cramps. People usually get sick from E. coli O157:H7 three to four days after eating food contaminated with the germ. If you are concerned that you have an E. coli infection, talk to your healthcare provider.

General Recommendations for Preventing E. coli Infections

You can protect yourself by washing your hands thoroughly before and after preparing or eating food. You can also wash counters, cutting boards, and utensils after they touch raw meat to avoid contaminating other foods. It’s also important to avoid preparing food when you are sick, particularly if you are sick with diarrhea.

Outbreak Summary Canada

As of January 10, 2018, there were 42 cases of E. coli O157 illness reported in five eastern provinces: Ontario (8), Quebec (15), New Brunswick (5), Nova Scotia (1), and Newfoundland and Labrador (13). Individuals became sick in November and early December 2017. Seventeen individuals were hospitalized. One individual died. Individuals who became ill were between the ages of 3 and 85 years of age. The majority of cases (74%) were female. It urged the public to avoid eating romaine lettuce until more is known about the contamination.

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.

The CDC, several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Shiga toxin-producing E. coli O157:H7 infections in 13 states. Seventeen illnesses have been reported from California (3), Connecticut (2), Illinois (1), Indiana (1), Michigan (1), Nebraska (1), New Hampshire (2), New York (1), Ohio (1), Pennsylvania (1), Virginia (1), Vermont (1) and Washington (1). Illnesses started on dates from November 15 through December 8, 2017. Of the 17 U.S. cases, five people have been hospitalized, one of whom has died in California. Two have developed hemolytic uremic syndrome, a type of kidney failure.

The Public Health Agency of Canada also is investigating an outbreak of E. coli O157:H7 infections in several provinces.  There are 40 sick in Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.  There is 1 reported death.

The CDC reports that whole genome sequencing is being performed on samples of bacteria making people sick in the United States to give us information about whether these illnesses are related to the illnesses in Canada. Preliminary results show that the type of E. coli O157:H7 making people sick in both countries is closely related genetically, meaning the ill people are more likely to share a common source of infection.

The Public Health Agency of Canada has identified romaine lettuce as the source of the outbreak in Canada. In the United States, state and local public health officials are interviewing sick people to determine what they ate in the week before their illness started. CDC is still collecting information to determine whether there is a food item in common among sick people, including leafy greens and romaine.

Because we have not identified a source of the infections, CDC is unable to recommend whether U.S. residents should avoid a particular food. This investigation is ongoing, and more information will be released as it becomes available.

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 KinerStephanie 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.

Thanks to Canada for telling US about what’s happening in the US

According to Alex McKeen of the Star, the Center for Disease Control is reporting 17 cases of E. coli infection across 13 American states, dating as early as Nov. 15, 2017.

While the cases extend coast-to-coast, from California, Connecticut, Illinois, Indiana, Michigan, Nebraska, New Hampshire, New York, Ohio, Pennsylvania, Virginia, Vermont, and Washington.

, the bulk of the U.S. instances of the infection were in the northeast part of the country.

Of the 17 U.S. cases, five people have been hospitalized, one of whom has died. Two have developed hemolytic uremic syndrome, a type of kidney failure, which Canada’s public health authority calls a rare life-threatening symptom of E. coli infection.

The Center for Disease Control has not yet determined whether the people sick with E. coli infection in that country have a type of food in common, but Canada has linked the cases in this country to romaine lettuce.

There are 40 sick in Canada with 1 death in Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.

Illnesses range from November through December, but authorities have yet to publicly identify where grown and by whom, or where lettuce was purchased.

The CDC, FDA and state health officials are investigating a multistate Escherichia coli O157:H7 outbreak that has sickened 17 people in 13 states, and preliminary tests by the US Centers for Disease Control and Prevention (CDC) show that the outbreak strain is closely related to one in Canada that has been associated with romaine lettuce.

The CDC said illness onsets range from Nov 15 through Dec 8, according to a press release today sent to journalists. Affected states include California, Connecticut, Illinois, Indiana, Michigan, Nebraska, New Hampshire, New York, Ohio, Pennsylvania, Virginia, Vermont, and Washington.

State and local authorities are interviewing sick people to see what they ate in the week before they became ill. Because a source of the US infections hasn’t been identified, the CDC said it is unable to recommend if US residents should avoid a particular food. “This investigation is ongoing, and more information will be released as it becomes available,” it said.

The Public Health Agency of Canada (PHAC) issued its first announcement about an E coli outbreak linked to romaine lettuce on Dec 11. In a Dec 21 update, it said it is so far investigating 41 cases from five provinces: Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador. It urged the public to avoid eating romaine lettuce until more is known about the contamination.

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.

The US Centers for Disease Control and Prevention (CDC) announced an E. coli O157:H7 outbreak that has sickened 17 people across 13 states. Although officials have not yet found the source of the outbreak, preliminary test show similarities to an ongoing outbreak in Canada linked to romaine lettuce that has sickened 41 with 1 death.

In a press release sent to journalists, the CDC stated, “this investigation is ongoing, and more information will be released as it becomes available.”

The information that they do have is that outbreak has an onset range from November 15 – December 8 and affects the states of California, Connecticut, Illinois, Indiana, Michigan, Nebraska, New Hampshire, New York, Ohio, Pennsylvania, Virginia, Vermont, and Washington.

The Public Health Agency of Canada (PHAC) issued its first announcement about an E coli outbreak linked to romaine lettuce on Dec 11. In a Dec 21 update, it said it is so far investigating 41 cases from five provinces: Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador. It urged the public to avoid eating romaine lettuce until more is known about the contamination.

A bit of history of Romaine and E. coli Outbreaks:

E. coli O157:H7 Outbreak Linked to Romaine Lettuce – Canada and California, April 2012

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy Greens, Lettuce, Romaine

An outbreak of E. coli O157 was linked to romaine lettuce grown and distributed by Amazing Coachella Inc., which is the parent company of Peter Rabbit Farms, both based in Coachella, California. Health officials in New Brunswick, Canada identified at…Read More »

Multistate Schnucks Salad Bars, College Campuses Romaine Lettuce 2011

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy Greens, Lettuce, Romaine

An outbreak of E. coli O157:H7 was first identified in the region around Saint Louis, Missouri. Cases were found in Saint Louis, Jefferson, Saint Charles, and Saint Clair counties and in the city of Saint Louis. The cases ranged in age from 1 to 94…Read More »

Church Brothers LLC/ Cafe Rio Restaurant/ Chipotle Restaurant Romaine Lettuce 2009

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy Greens, Romaine Lettuce, Iceberg Lettuce

In September, 2009, a cluster of patients who had been infected with an indistinguishable strain of E. coli O157:H7 was identified. Initially case-patients were identified in Colorado, Utah, and New York State. Additional case-patients were identif…Read More » 

2009 Multistate outbreak of E. coli O157 linked to leaf lettuce

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetables, Leafy Greens, Romaine lettuce

In September 2009 public health officials in Colorado, Minnesota, North Carolina, Iowa, Connecticut, and Missouri identified a cluster of patients with an indistinguishable strain of E. coli O157. The cluster was assigned 0910MLEXH-1. Two Colorado …Read More »

M.T. Belllies Restaurant Ontario Romaine Lettuce 2008

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Lettuce, Romaine

An outbreak of E.coli O157:H7 was associated with eating at M.T. Bellies Restaurant, Welland, Ontario, Canada. This was one of four, concurrent, restaurant-associated, outbreaks of E.coli O157:H7 that occurred in Ontario, Canada. Romaine lettuce wa…Read More »

Johnathan’s Family Restaurant Ontario Romaine Lettuce 2008

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Lettuce, Romaine

Johnathan’s Family Restaurant in Burlington, Ontario, Canada, was implicated in an outbreak of E.coli O157:H7 involving romaine lettuce. This outbreak was one of four, concurrent, restaurant-associated outbreaks in Ontario, Canada. The E.coli O157:…Read More »

Little Red Rooster Restaurant Ontario Romaine Lettuce 2008

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Lettuce, Romaine

The owners of Little Red Rooster Restaurant, in Niagara-on-the-Lake, Ontario, Canada, closed the restaurant in October after an outbreak of E.coli O157:H7 was discovered. This outbreak was one of four, concurrent, outbreaks of E.coli O157:H7 occurri…Read More »

Spokane Dance Camp Lettuce 2002

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy greens, Romaine lettuce

An outbreak of E.coli O157:H7 occurred among attendees of a dance camp held between July 11-14 on the campus of Eastern Washington University. The camp was for middle and high school girls. Attendees were from Washington, Montana, and Minnesota. S…Read More »

Multistate Retirement Facility and Private Home Romaine Lettuce 1999

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy greens, Romaine Lettuce Caesar Salad

When in November, 1999, seven residents of a Pennsylvania retirement facility were hospitalized with E. coli O157:H7 infection, an outbreak investigation began. The investigation associated eating romaine lettuce that had been prepared in one of the…Read More »

Multistate Restaurant or Private Home Romaine Lettuce 1999

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy Greens, Romaine Lettuce

An outbreak of E. coli O157:H7 was associated with eating romaine lettuce in restaurants and in private home settings.…Read More »

Romaine Lettuce 1995

  • Organism:
  • coli O157:H7
  • Vehicle:
  • Vegetable, Leafy Greens, Romaine Lettuce

An outbreak of E. coli O157:H7 occurred among people who ate romaine lettuce in Idaho. The lettuce possibly was contaminated by a food handler. No other details were available.…Read More »

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.

Federal and state health officials are investigating a multistate Escherichia coli O157:H7 outbreak that has sickened 17 people in 13 states, and preliminary tests by the US Centers for Disease Control and Prevention (CDC) show that the outbreak strain is closely related to one in Canada that has been associated with romaine lettuce.

The CDC said illness onsets range from Nov 15 through Dec 8, according to a press release today sent to journalists. Affected states include California, Connecticut, Illinois, Indiana, Michigan, Nebraska, New Hampshire, New York, Ohio, Pennsylvania, Virginia, Vermont, and Washington.

State and local authorities are interviewing sick people to see what they ate in the week before they became ill. Because a source of the US infections hasn’t been identified, the CDC said it is unable to recommend if US residents should avoid a particular food. “This investigation is ongoing, and more information will be released as it becomes available,” it said.

The Public Health Agency of Canada (PHAC) issued its first announcement about an E coli outbreak linked to romaine lettuce on Dec 11. In a Dec 21 update, it said it is so far investigating 40 cases from five provinces: Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador. It urged the public to avoid eating romaine lettuce until more is known about the contamination.

Why you should take note?

The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Escherichia coli O157, commonly called E. coli. The outbreak involves three provinces and is linked to romaine lettuce. At this time, there are no product recalls associated with this outbreak. The outbreak investigation is ongoing, and this public health notice will be updated on a regular basis as the investigation evolves.

The risk to Canadians is low. However, Canadians are reminded to follow safe food handling practices for lettuce to avoid becoming ill. Most people with an E. coli infection will become ill for a few days and then recover fully. Some E. coli infections can be life threatening, though this is rare.

How does lettuce become contaminated with E. coli?

E. coli are bacteria that live naturally in the intestines of cattle, poultry and other animals. A common source of E. coli illness is raw fruits and vegetables that have come in contact with feces from infected animals. Leafy greens, such as lettuce, can become contaminated in the field by soil, contaminated water, animals or improperly composted manure. Lettuce can also be contaminated by bacteria during and after harvest from handling, storing and transporting the produce. Contamination in lettuce is also possible at the grocery store, in the refrigerator, or from counters and cutting boards through cross-contamination with harmful bacteria from raw meat, poultry or seafood. Most E. coli strains are harmless to humans, but some varieties cause illness.

Investigation summary

Currently, there are 21 cases of E. coli O157 illness under investigation in three provinces: Quebec (3), New Brunswick (5), and Newfoundland and Labrador (13). Individuals became sick in November 2017. Ten individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between the ages of 5 and 72 years of age. The majority of cases (71%) are female.

Many individuals who became sick reported eating romaine lettuce before their illnesses occurred. The Canadian Food Inspection Agency is working with public health officials to determine the source of the romaine lettuce that ill individuals were exposed to.

Who is most at risk?

Although anyone can get an E. coli infection, pregnant women, those with weakened immune systems, young children and older adults are most at risk for developing serious complications.

What you should do to protect your health?

The following food safety tips for lettuce will help you reduce your risk of getting an E. coli infection.

  • Wash your hands thoroughly with warm water and soap for at least 20 seconds, before and after handling lettuce.
  • Discard outer leaves of fresh lettuce.
  • Wash your unpackaged lettuce under fresh, cool running water. There is no need to use anything other than water to wash lettuce. Washing it gently with water is as effective as using produce cleansers.
  • Keep rinsing your lettuce until all of the dirt has been washed away.
  • Don’t soak lettuce in a sink full of water. It can become contaminated by bacteria in the sink.
  • Ready-to-eat lettuce products sold in sealed packages and labelled as washed, pre-washed or triple washed do not need to be washed again.
  • Use warm water and soap to thoroughly wash all utensils, countertops and cutting boards before and after handling lettuce to avoid cross-contamination.
  • Store lettuce in the refrigerator for up to seven days. Discard when leaves become wilted or brown.
  • Bagged, ready-to-eat, pre-washed lettuce products should also be refrigerated and used before the expiration date.

What are the symptoms?

People infected with E. coli can have a wide range of symptoms. Some do not get sick at all, though they can still spread the infection to others. Others may feel as though they have a bad case of upset stomach. In some cases, individuals become seriously ill and must be hospitalized.

The following symptoms can appear within one to ten days after contact with the bacteria:

  • nausea
  • vomiting
  • headache
  • mild fever
  • severe stomach cramps
  • watery or bloody diarrhea

Most symptoms end within five to ten days. While most people recover completely on their own, some people may have a more serious illness that requires hospital care, or may lead to long-lasting health effects. In rare cases, some individuals may develop life-threatening symptoms, including stroke, kidney failure and seizures, which could result in death.

There is no real treatment for E. coli infections, other than monitoring the illness, providing comfort, and preventing dehydration through proper hydration and nutrition. People who develop complications may need further treatment, like dialysis for kidney failure. You should contact your health care provider if symptoms persist.

What is the Government of Canada doing?

The Government of Canada is committed to food safety. The Public Health Agency of Canada leads the human health investigation into an outbreak and is in regular contact with its federal and provincial partners to monitor the situation and to collaborate on steps to address the outbreak.

Health Canada undertakes food-related health risk assessments to determine whether the presence of a certain substance or microorganism poses a health risk to consumers.

The Canadian Food Inspection Agency conducts food safety investigations into the possible food source of an outbreak.

The Government of Canada will continue to update Canadians as new information related to this investigation becomes available.

Additional information

 

SOURCE Health Canada

BACKGROUND

In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin–producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer.

METHODS

A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples.

RESULTS

A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility.

CONCLUSIONS

This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.

Samuel J. Crowe, Ph.D., M.P.H., Lyndsay Bottichio, M.P.H., Lauren N. Shade, B.S., Brooke M. Whitney, Ph.D., Nereida Corral, M.P.H., Beth Melius, M.N., M.P.H., Katherine D. Arends, M.P.H., Danielle Donovan, M.S., Jolianne Stone, M.P.H., Krisandra Allen, M.P.H., Jessica Rosner, M.P.H., Jennifer Beal, M.P.H., Laura Whitlock, M.P.H., Anna Blackstock, Ph.D., June Wetherington, M.S., Lisa A. Newberry, Ph.D., Morgan N. Schroeder, M.P.H., Darlene Wagner, Ph.D., Eija Trees, D.V.M., Ph.D., Stelios Viazis, Ph.D., Matthew E. Wise, M.P.H., Ph.D., and Karen P. Neil, M.D., M.S.P.H. N Engl J Med 2017; 377:2036-2043November 23, 2017DOI: 10.1056/NEJMoa1615910

Haig’s Delicacies of Hayward, CA is recalling 342 cases of Taboule Salad because it may be contaminated with Escherichia coli O157:H7 bacteria (E. Coli O157:H7). E. coli O157:H7 causes a diarrheal illness often with bloody stools. Although most healthy adults can recover completely within a week, some people can develop a form of kidney failure called Hemolytic Uremic Syndrome (HUS). HUS is most likely to occur in young children and the elderly. The condition can lead to serious kidney damage and even death.

The Taboule Salad was distributed in California through retail stores.

The Taboule Salad is packaged in a 10oz plastic tub with UPC 7-08756-77055-9 as well as a 3-unit multi pack with UPC 7-08756-37055-1 and a 6-lb bulk foodservice bag with UPC 7-08756-77077-1.

The affected lot is 17298 with an expiration date of 11/16/17.

No illnesses have been reported to date.