The Wisconsin Department of Health and Marathon County Health Department are investigating a cluster of four E. coli illnesses linked to consumption of meat processed at Zillman Meat Market in Wausau, Wisconsin. One of those sickened was hospitalized. Zillman meats is recalling its ready-to-eat, custom smoked meat products made from wild game processed between Sept. 30 and Nov. 13.
E. coli infection occurs when a person ingests Shiga toxin (Stx)-producing E. coli (e.g., E. coli O157:H7) after exposure to contaminated food, beverages, water, animals, or other persons. After ingestion, E. coli bacteria rapidly multiply in the large intestine and bind tightly to cells in the intestinal lining. This snug attachment facilitates absorption of the toxin into the small capillaries within the bowel wall, where it attaches to globotriaosylceramide (Gb3) receptors.
Inflammation caused by the toxins is believed to be the cause of hemorrhagic colitis, the first symptom of E. coli infection, which is characterized by the sudden onset of abdominal pain and severe cramps, followed within 24 hours by diarrhea (Boyce, Swerdlow, & Griffin, 1995; Tarr, 1995). Hemorrhagic colitis typically occurs within 2 to 5 days of ingestion of E. coli, but the incubation period, or time between the ingestion of E. coli bacteria and the onset of illness, may be as broad as 1 to 10 days.
As the infection progresses, diarrhea becomes watery and then may become grossly bloody, that is, bloody to the naked eye. E. coli symptoms also may include vomiting and fever, although fever is an uncommon symptom.
On rare occasions, E. coli infection can cause bowel necrosis (tissue death) and perforation without progressing to hemolytic uremic syndrome (HUS)—a complication of E. coli infection that is now recognized as the most common cause of acute kidney failure in infants and young children. In about 10 percent of E. coli cases, the Shiga toxin attachment to Gb3 receptors results in HUS.
HUS had been recognized in the medical community since at least the mid-1950’s; however, the syndrome first caught the public’s attention in 1993 following a large E. coli outbreak in Washington State that was linked to the consumption of contaminated hamburgers served at a fast-food chain. A total of 501 E. coli cases were reported; 151 were hospitalized (31 percent), 45 persons (mostly children) developed HUS (9 percent), and three died (Bell, et al., 1994).