Marler Clark represents two families sickened in the Brookshire Farms E. coli O157 outbreak in San Luis Obispo, and the family of one of the nine children sickened in the Capitola Beach E. coli O157 outbreak in Santa Cruz County. We have sent notices of the claims to Brookshire Farms and to the City of Capitola. We have also sent California Public Records Act requests to the city, county and state health departments in both investigations.

Santa Cruz County’s health officer says the two outbreaks do not appear to be linked. They share three things all the same: the same pathogen, children in the hospital, and no named source.

Brookshire Farms: what we know

  • Five people confirmed with E. coli O157 visited the farm on October 17 or 18. Three are children and two are adults, the county told ABC News.
  • Ten more people who visited between October 16 and 26 are suspect cases. The county has said it will release nothing further about them.
  • The county’s October 30 release reported three people with hemolytic uremic syndrome (HUS).
  • One person has died. The county confirmed the death on November 10, and The Tribune reports she was an 18-month-old girl.
  • On November 14 the county announced a sixth confirmed case: a person who never visited the farm, infected at a San Luis Obispo preschool by one of the five. That person developed HUS, was hospitalized and is recovering at home. I wrote about secondary cases earlier today.
  • The county took food, water and environmental samples at the farm. None was positive for E. coli O157. Other types of E. coli were found. The exposures the patients had in common included edible corn cups, pumpkins, hay and non-potable water.
  • The county closed its investigation on November 6, saying the risk had passed. The farm reopened the same day.

Brookshire Farms: what we do not know

  • The source. The county named four shared exposures and tied none of them to the illnesses.
  • What was sampled, how many samples were taken, and how many days after October 17 and 18 the first one was collected. The county itself cites the delay between exposure and sampling as a limit on its testing.
  • Whether the patients’ bacteria were sequenced, and how closely they match.
  • Whether any of the ten suspect cases was ever tested.
  • What is uphill. A co-owner told The Tribune that bacteria were found in an old cow pie on the hill above the farm. Which bacteria, whose cattle, and whether runoff or the non-potable water reached areas open to visitors are all unanswered.
  • Whether there are more secondary cases at the preschool.
  • Whether the county will reopen a file it closed four days before it confirmed a death and eight days before it confirmed a new case.

Capitola Beach: what we know

  • Nine children, all 12 or younger, became ill with E. coli O157 between September 10 and October 25, Santa Cruz County Health Officer Dr. Lisa Hernandez told SFGATE. Four live in Santa Cruz County and five in other Bay Area counties, according to the county’s release.
  • Genetic testing linked the cases, and most of the children had been at Capitola Beach.
  • Two children were hospitalized and one developed HUS. Dr. Hernandez says all have recovered. Our client developed acute kidney failure.
  • The City of Capitola closed the beach on November 10 on the health officer’s recommendation. It remains closed.
  • Samples were taken at four sites: upstream near Nob Hill, the jetty, Soquel Creek Lagoon and the flume. Dr. Hernandez told KSBW that samples went to CDC and that she cannot promise a source will be found.
  • Soquel Lagoon has been on California’s list of waters impaired by pathogens since 1996, according to the regional water board. More of that history is in my earlier post.

Capitola Beach: what we do not know

  • How E. coli O157 got into the water: a sewer line, a storm drain, animals or something else.
  • Whether the water samples were tested for E. coli O157 itself, and what they showed.
  • Why two months passed between the first illness on September 10 and the closure on November 10, and when the county first recognized a cluster.
  • On what dates the children were at the beach or in the creek, and what warning signs were posted on those days.
  • Whether there were sewer spills or leaks in the watershed in August, September or October.
  • What standard the water will have to meet before the beach reopens.

What the two have in common

In both outbreaks the sampling came weeks after the exposure. In San Luis Obispo it found no outbreak strain. In Santa Cruz County the health officer has already warned that it may not. I told The Tribune that failing to find the bacteria at a site weeks later is common and does not clear the site. The epidemiology, meaning who got sick, where they were and when, is evidence too, and in both outbreaks it points to a place.

That is why the records matter. An outbreak file typically holds the line list of cases, the laboratory and sequencing reports, the sampling logs, the interview forms and the correspondence with the venue. Patient names are redacted, as they should be. When the records arrive, I will write about what they show.

If your family was there

If your child had diarrhea, especially bloody diarrhea, after a visit to Brookshire Farms in mid-October or to Capitola Beach or Soquel Creek this fall, and was never tested, tell the doctor and the county health department. There is more on HUS at about-hus.com.

Questions and answers

How many people are sick in the Brookshire Farms E. coli outbreak? Six confirmed, including one secondary case at a preschool, and ten suspect cases. One child has died.

How many are sick in the Capitola Beach E. coli outbreak? Nine children, two of them hospitalized, according to Santa Cruz County.

Has a source been found in either outbreak? No. San Luis Obispo County closed its investigation without one, and Santa Cruz County’s investigation is open.