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Authors: Amelia Keaton, R. Hassan, S. Luna, I. Lee, R. Magalhaes, M. Bidlack, L. Smith, R. Maves, D. Freer, K. Flinn, G. Monk, P. Graf, K. Trinh, J. Crandall, D. Noveroske, G. Fortenberry, L. Ramos, R. Recio, C. Peak, E. McDonald, T. Waltz, K. Patel, D. Wagner, J. Espiritu, L. Christensen, L. Gieraltowski

Background: Shiga toxin-producing Escherichia coli (STEC) infections are a substantial cause of foodborne illness and a cause of hemolytic-uremic syndrome (HUS). In November 2017, CDC assisted the US Navy in a response to an outbreak of STEC illnesses in recruits at a Marine Corps Recruit Depot in San Diego (MCRD). We investigated to determine the source of this outbreak and identify prevention and mitigation measures.

Methods: In October 2017, medical providers identified a high number of gastrointestinal (GI) illnesses at MCRD. Recruits with diarrhea submitted stool specimens for culture and/or culture-independent diagnostic testing (CIDT) for GI pathogens. We performed pulsed-field gel electrophoresis (PFGE) on culture isolates. Case-patients were then defined as follows: confirmed (PFGE-confirmed STEC infection matching outbreak strains), probable (diagnosis of HUS and/or CIDT evidence of STEC), and suspected (bloody diarrhea). We conducted environmental evaluations of facilities, training areas, and barracks. A case-control study was performed using PFGE-confirmed case-patients and platoon-matched controls. We performed product traceback for foods identified as exposure risks by interview or case-control study.

Results: We identified 62 confirmed, 62 probable, and 120 suspected case-patients. Thirty case-patients required hospitalization and 15 had HUS. Case-patient ages ranged from 17-28 years (median: 18 years). Poor hygiene practices among recruits and inconsistent cooking temperatures within dining facilities were noted. Forty-three case-patients and 135 controls were interviewed about food, hygiene, and environmental exposures. Consumption of undercooked beef was found to be significantly associated with illness, (mOR 2.40, CI 1.04-5.72, p=0.04). We identified a single ground beef supplier for MCRD, but MCRD records did not document which specific lots of ground beef were used.

Conclusions: Case-control analysis and environmental observations suggested undercooked ground beef as a potential source for this outbreak. We recommended the Navy and Marine Corps retain lot information, address food handling concerns, and improve hygiene among recruits.

REF:  https://www.cdc.gov/eis/downloads/eis-conference-2018-508.pdf, page 117

MINNEAPOLIS, Minnesota – A lawsuit will be filed today in Minnesota District Court against Markon Cooperative, Inc., and Reinhart Foodservice LLC. on behalf of Linda Miller who was diagnosed E. coli O157:H7 after consuming romaine lettuce distributed by Markon Cooperative and produced by Reinhart Foodservice. Ms. Miller is represented by Marler Clark, the food safety law firm, and Jardine, Logan, and O’Brien, a respected local firm. Complaint

Prior to her E. coli O157:H7 infection, Ms. Miller lived at Andrew Residence, a long-term care facility for adults. Markon Cooperative supplied lettuce sourced from the Yuma, Arizona region to Reinhart Foodservice which provided the lettuce to the Andrew Residence where Ms. Miller consumed it. Reinhart Foodservice was the only supplier to Andrew Residence during the time period of Ms. Miller’s E. coli O157:H7 infection.  Ms. Miller has been linked to the outbreak by the CDC and the Minnesota Department of Health.

On April 28, 2018, Ms. Miller began experiencing symptoms of nausea, vomiting, diarrhea, stomach cramps, muscle aches, and fatigue. Her symptoms were so severe, that she required hospitalization at Abbot Northwestern Hospital. At the hospital she tested positive for E. coli O157:H7 and developed a complication called hemolytic uremic syndrome (HUS). Ms. Miller developed central nervous system involvement, resulting in seizures and other neurological injury. Ms. Miller remained in the hospital for six weeks requiring intubation to breathe, and a feeding tube. On June 13, Ms. Miller was transferred to the Ebenezer Care Center in Minneapolis for further care. She continues to struggle with injuries as a result of her infection.

On April 10, 2018, the CDC announced an investigation into an E. coli O157:H7 outbreak stemming from romaine lettuce grown in the Yuma region of Arizona. There were a total of 210 confirmed cases across 36 states, with 96 hospitalizations and 5 deaths.  California was hardest hit with 49 sickened.  Minnesota had 12 illnesses, including Ms. Miller.  The five deaths were reported in Arkansas, California, New York and Minnesota.  Two of the five deaths were from Minnesota.

Marler Clark currently represents 87 people affected in the outbreak and has filed 10 lawsuits associated with the outbreak.

“Although the CDC and FDA declared the outbreak officially over on June 28, 2018 many of our clients are still struggling medically,” said Marler Clark managing partner, William Marler. “In addition, federal authorities have been less than forthcoming about where the E. coli O157:H7 – tainted romaine was sold,” continued Marler.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli O157:H7 outbreaks and hemolytic uremic syndrome (HUS). The  E. coli O157:H7 lawyers of Marler Clark have represented thousands of victims of E. coli O157:H7 and other foodborne illness infections and have recovered over $650 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 O157:H7 lawyers have litigated E. coli O157:H7 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 O157:H7 lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s.  We have proudly represented such E. coli O157:H7 victims as Brianne Kiner, Stephanie Smith and Linda Rivera.

For more information contact Lauren Fricke at lfricke@marlerclark.com or 1-206-346-1888.

f you or a family member became ill with an E. coli O157:H7 infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli O157:H7 attorneys for a free case evaluation.

SAN DIEGO, California – A lawsuit was filed today in the Southern District Court of California against Sodexo Inc. on behalf of Illinois resident, Vincent Grano who developed an E. coli O157:H7 infection from food served at the cafeteria and mess hall at a Marine Corps Recruit Depot in San Diego. Sodexo, a Delaware company, provides food and facility management services for the United States Marine Corps Depo in San Diego. Mr. Grano is represented by Marler Clark, the food safety law firm, and Gordon and Holmes, a local San Diego firm.

“I want to make clear that this is not a claim against the Marine Corps,” said Bill Marler, managing partner at Marler Clark.  “We intend to hold Sodexo and the supplier of the tainted meat responsible for the devastating injuries caused to Mr. Grano and the other young service members who have contacted us,” added Marler.

On August 7, 2017, Mr. Grano reported for recruit training at MCRD in San Diego, California. During the ten-day period before his symptoms began, Mr. Grano exclusively consumed food provided by Sodexo, Inc. On October 23, 2017, the day before he was to begin the final training challenge of boot camp, called “The Crucible,” at Camp Pendleton, Mr. Grano began to experience symptoms of stomach cramps, nausea, diarrhea, and vomiting. Three days later, Mr. Grano informed his senior drill instructor that his diarrhea had turned bloody and was subsequently taken to the emergency room by paramedics. He was discharged the same day.

On October 29, Mr. Grano lost consciousness and was hospitalized at Balboa Naval Medical Center. While hospitalized, he tested positive for E. coli O157:H7 and diagnosed with hemolytic uremic syndrome (HUS), acute kidney failure. Over the next month, Mr. Grano underwent numerous procedures and tests at Balboa. His HUS condition resulted in dialysis and central nervous system involvement characterized by the sudden onset of seizures.

Mr. Grano was discharged from Balboa medical center on December 3, 2017 and transferred to Alvarado Hospital to begin rehabilitation. On February 13, 2018, Mr. Grano was diagnosed with epilepsy as a result of HUS. As a result of his illness, he was discharged from the Marine Corps and has suffered permanent brain and kidney damage.

The Marine Corps San Diego and Camp Pendleton E. coli O157:H7 outbreak was reported in a CDC report by Amelia Keaton. In total, there were 62 confirmed cases, 62 probable, and 120 suspected cases. 30 people were hospitalized and 15 were diagnosed with HUS. Consumption of undercooked beef was found to be the probable cause of the outbreak.

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 $650 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.  We have proudly represented such victims as Brianne Kiner, Stephanie Smith and Linda Rivera.

Authors: Amelia Keaton, R. Hassan, S. Luna, I. Lee, R. Magalhaes, M. Bidlack, L. Smith, R. Maves, D. Freer, K. Flinn, G. Monk, P. Graf, K. Trinh, J. Crandall, D. Noveroske, G. Fortenberry, L. Ramos, R. Recio, C. Peak, E. McDonald, T. Waltz, K. Patel, D. Wagner, J. Espiritu, L. Christensen, L. Gieraltowski

Background: Shiga toxin-producing Escherichia coli (STEC) infections are a substantial cause of foodborne illness and a cause of hemolytic-uremic syndrome (HUS). In November 2017, CDC assisted the US Navy in a response to an outbreak of STEC illnesses in recruits at a Marine Corps Recruit Depot in San Diego (MCRD). We investigated to determine the source of this outbreak and identify prevention and mitigation measures.

Methods: In October 2017, medical providers identified a high number of gastrointestinal (GI) illnesses at MCRD. Recruits with diarrhea submitted stool specimens for culture and/or culture-independent diagnostic testing (CIDT) for GI pathogens. We performed pulsed-field gel electrophoresis (PFGE) on culture isolates. Case-patients were then defined as follows: confirmed (PFGE-confirmed STEC infection matching outbreak strains), probable (diagnosis of HUS and/or CIDT evidence of STEC), and suspected (bloody diarrhea). We conducted environmental evaluations of facilities, training areas, and barracks. A case-control study was performed using PFGE-confirmed case-patients and platoon-matched controls. We performed product traceback for foods identified as exposure risks by interview or case-control study.

Results: We identified 62 confirmed, 62 probable, and 120 suspected case-patients. Thirty case-patients required hospitalization and 15 had HUS. Case-patient ages ranged from 17-28 years (median: 18 years). Poor hygiene practices among recruits and inconsistent cooking temperatures within dining facilities were noted. Forty-three case-patients and 135 controls were interviewed about food, hygiene, and environmental exposures. Consumption of undercooked beef was found to be significantly associated with illness, (mOR 2.40, CI 1.04-5.72, p=0.04). We identified a single ground beef supplier for MCRD, but MCRD records did not document which specific lots of ground beef were used.

Conclusions: Case-control analysis and environmental observations suggested undercooked ground beef as a potential source for this outbreak. We recommended the Navy and Marine Corps retain lot information, address food handling concerns, and improve hygiene among recruits.

REF:  https://www.cdc.gov/eis/downloads/eis-conference-2018-508.pdf, page 117

Win Opportunity Knocks, doing business as Ottomanelli Wholesale Meats Inc., a St. Petersburg, Fla. establishment, is recalling approximately 6,020 pounds of fresh and frozen, raw ground beef products that may be contaminated with Shiga toxin-producing E. coli (STEC) O45, O103 and O145, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The fresh and frozen, raw ground beef products were produced from June 18, 2018 through July 11, 2018. The following products are subject to recall:

  • 5-lb boxes of (20/4oz.) frozen, raw “Packers Plus Patties” with  “Approved JUN 18 2018” through “Approved JUL 11 2018”
  • 10-lb. boxes of (8-oz.) frozen, raw “Debren Foods Inc. BEEF PATTIES” with “Approved JUN 18 2018” through “Approved JUL 11 2018”
  • 10-lb. boxes of (40/4-oz.) frozen, raw “Nu Vista Foods Group Inc. BEEF PATTIES” with “Approved JUN 18 2018” through “Approved JUL 11 2018”
  • 10-lb. boxes of (40/4-oz, 30/5-oz, 28/6-oz) of frozen, raw “Ottomanelli Beef Patties” with  “Approved JUN 18 2018” through “Approved JUL 11 2018”
  • 10 lb. bulk bag of fresh raw “Beef Patty Mix Ottomanelli Wholesale Meats Inc.” with “Approved JUN 18 2018” through “Approved JUL 11 2018”

The products subject to recall bear establishment number “EST. 11167” inside the USDA mark of inspection. The items were distributed for institutional use in Florida.

The problem was discovered when FSIS was notified that the product was tested by the establishment and found positive for E. coli under their sampling program.

People can become ill from STECs 2-8 days (average of 3-4 days) after consuming the organism. Most people infected with STEC O45, O103 and O145 develop diarrhea (often bloody) and vomiting. Some illnesses last longer and can be more severe. Infection is usually diagnosed by testing of a stool sample. Vigorous rehydration and other supportive care is the usual treatment; antibiotic treatment is generally not recommended. Most people recover within a week, but, rarely, some develop a more severe infection. Hemolytic uremic syndrome (HUS), a type of kidney failure, is uncommon with STEC O45, O103 and O145 infection. HUS can occur in people of any age but is most common in children under 5 years old, older adults and persons with weakened immune systems. It is marked by easy bruising, pallor and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately.

FSIS is concerned that some product may be in institutions’ refrigerators or freezers. Institutions who have purchased these products are urged not to serve or sell them. These products should be thrown away or returned to the place of purchase.

The Sky Valley Chronicle reports that the King County Health Department announced Friday afternoon it had closed two Redmond restaurants – I Love Sushi and Sodexo’s Café Mario both located at Nintendo of America at 4600 150th Ave NE, Redmond, WA.

The eateries were “Closed by a Public Health food inspector on July 5, 2018 at 5:30 pm due to the imminent health hazard of an ongoing suspected foodborne illness investigation,” said a news release from the health dept.

The health department, in a posting on its web page said that since July 2nd, “We have learned that four people (two King and two Snohomish County residents) have tested positive for STEC. All four consumed food from Café Mario in King County and work at the Nintendo of America campus in Redmond. Symptoms included abdominal cramps and bloody diarrhea. Illness onsets occurred during June 25–28, 2018. The four ill people consumed food from Café Mario on multiple days during June 18–22, 2018; one ill person also ate at I Love Sushi on June 19 and June 26, 2018, which is a food establishment that operates out of Café Mario once a week.”

On July 3rd, Seattle & King County Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.

“At Café Mario, potential risk factors were identified, and corrective actions discussed with Café Mario’s management, including inadequate hand washing practices and improper cold holding temperatures of food,” said the statement. “At I Love Sushi, potential risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on July 4 due to it being a holiday.”

On July 5th investigators closed Café Mario and the onsite I Love Sushi food services. Both restaurants will remain closed until approved to reopen by Public Health.

Both food establishments will be required to complete a thorough cleaning and disinfection before reopening. Remaining food products are being held and environmental swabs were collected for laboratory testing.

“We are currently investigating whether any employees of these restaurants had a recent diarrheal illness. Investigators also reviewed with Café Mario’s management the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea,” said the Health Dept. statement.

Three of the four people who got sick tested positive for STEC by a healthcare provider. Further testing at the Washington State Public Health Laboratory is pending, including determining the genetic fingerprint and specific strain of STEC that caused the illnesses. The health dept. says the investigation is ongoing and it will provide more information as it becomes available.

The health dept. says STEC can cause serious illness. Anyone who ate at Café Mario and I Love Sushi at Nintendo of America during June 11, 2018 to July 5, 2018 and developed diarrhea (especially bloody diarrhea) within 10 days, should consult with their healthcare provider promptly to determine if testing is necessary.

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 $650 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.

Raw Milk and Petting Animals.  See, www.realrawmilkfacts.com and www.fair-safety.com.

The Knox County Health Department (KCHD) is concluding its investigation into a cluster of Escherichia coli (E. coli) O157 infections. Fifteen confirmed cases of E. coli O157 were reported to KCHD recently. All cases were among children, nine were hospitalized and seven developed a complication of the infection called Hemolytic Uremic Syndrome (HUS). Of the children who were hospitalized, one remains in fair condition at East Tennessee Children’s Hospital. Lab results from the Tennessee Department of Health have confirmed two different strains of E. coli O157 caused the children to become ill.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan. “The investigation revealed no definitive connections between the two sources or the two groups of ill children. And this is now supported by the state’s lab results confirming it was two different strains of E. coli O157.”

Ten of the 15 children consumed raw milk from French Broad Farm, Knox County, Tenn., the only common link among all ten children. The lab results have confirmed these children had the same strain of E. coli O157. The lab also confirmed that this strain is a DNA fingerprint match to the E. coli O157 found in cow manure samples collected from French Broad Farm.

To date, the lab did not find E. coli O157 in the raw milk samples. This is not uncommon, and it does not mean the milk consumed was free of contamination. E. coli bacterium do not distribute themselves uniformly in milk, meaning a portion of even the same glass of milk can be contaminated while another portion is not. This is one reason why raw milk is inherently risky. Due to the nature of E. coli and other pathogens that can be present, and even with the strictest safety precautions in place at a dairy, including testing the milk, there is no way to guarantee raw milk is safe for consumption. This is why health officials recommend the public consume only pasteurized milk and dairy products. Based on the dates when the children became ill (i.e., onset of symptoms) and allowing time for the milk to be distributed and time for incubation of the illness, officials believe the contamination event occurred in mid-May.

The only common link among the other five ill children was attending the same child care facility, Kids Place, Inc., Mascot, Tenn., where goats, a type of ruminant animal, are present. The lab results confirmed these five children had the same strain of E. coli O157. Additionally, the lab results showed this strain was a DNA fingerprint match to the E. coli O157 found in the goat fecal samples and one hay sample collected from the child care facility. To date, the lab did not find E. coli O157 in the other environmental samples from inside the facility. Again, this is not uncommon, and one reason testing environmental samples is only part of the disease investigation process.

E. coli O157 is naturally found in the intestinal tracts of many farm animals (ruminants), including healthy cattle, sheep and goats. Animals can carry E. coli O157 and shed it in their stool while still appearing healthy and clean. E. coli can contaminate the animals’ skin, fur, and the areas where they live and roam.

Both Kids Place, Inc. and French Broad Farm have fully cooperated throughout KCHD’s investigation, including sharing contact information of those who may be at risk, supporting sample collection and ceasing operations as requested. KCHD lifted the directive for Kids Place, Inc. on June 8, 2018, by following existing state and national procedures for infection control and mitigation at a permitted, regulated facility. KCHD lifted the health directive requesting French Broad Farm temporarily cease operations on June 14, 2018. While the investigation thus far has revealed no specific problems with French Broad Farm, the risk in consuming raw milk cannot be mitigated. The E. coli outbreak appears to be over as KCHD is not seeing ongoing transmission.

Following national epidemiological standards and methodology, the health department’s investigation included standardized and in-depth interviews; examination of all potential sources; analysis of symptom onset and incubation to aid in determining the timeline, potential exposures and the type of outbreak; and testing samples.

Most people become infected with E. coli O157 from contaminated food, such as undercooked ground beef, but E. coli O157 can also be passed directly to people from the stool of ruminant animals. Historically, the major source for human illness is cattle, which can carry E. coli O157 but show no signs of illness. E. coli O157 can also be spread from person to person via a fecal-to-oral route as these bacteria are invisible to the human eye.

While it is possible to get sick from many other foods, raw milk is one of the riskiest. As stated in the American Academy of Pediatrics policy statement on unpasteurized dairy, only an estimated 1 to 3 percent of dairy products consumed in the U.S. are unpasteurized. Yet between 1973 and 2009, these products accounted for 82 percent of the milk- or milk product-associated foodborne outbreaks reported to the Centers for Disease Control and Prevention. Health officials recommend the public consume only pasteurized milk, dairy products, juices and ciders.

Symptoms of E. coli infection vary for each person, but often include severe stomach cramps, diarrhea (often bloody) and vomiting. Some may have a low fever (less than 101˚F). Some infections are mild, but others can be severe. E. coli O157 can cause disease by making a Shiga toxin; these are referred to as Shiga toxin-producing E. coli or STEC. This can cause severe diarrhea and even life-threatening complications, especially in children, older adults, pregnant women and those with compromised immune systems. Approximately 5 to 10 percent of those diagnosed with a STEC infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS).

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 $650 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 reported yesterday that 210 people in 36 states have become ill with the outbreak strain of E. coli O157:H7. These people reported becoming ill in the time period of March 13, 2018 to June 6, 2018. There have been 96 hospitalizations and five deaths. There are cases in 36 states: Alabama (3) Alaska (8), Arkansas (1), Arizona (9), California (49), Colorado (3), Connecticut (2), Florida (3), Georgia (5), Idaho (12), Illinois (2), Iowa (1), Kentucky (1), Louisiana (1), Massachusetts (4), Michigan (5), Minnesota (12), Mississippi (1), Missouri (1), Montana (9), Nebraska (1), New Jersey (8), New York (11), North Carolina (1), North Dakota (3), Ohio (7), Oklahoma (1), Oregon (1), Pennsylvania (24), South Dakota (1), Tennessee (3), Texas (4), Utah (1), Virginia (1), Washington (8), and Wisconsin (3).

(PHAC) identified eight ill people in several Canadian provinces infected with the same DNA fingerprint of E. coli O157:H7. On June 22, 2018, PHAC reported that the outbreak in Canada appears to be over.

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak. To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli 0157:H7 with the same genetic fingerprint as the outbreak strain.

Below it the Yuma growing region which straddles the Colorado River and the California and Arizona border and Gila River.

On April 19, 2018, Alaska health partners announced that eight persons with E. coli O157:H7 infections from a correctional facility have been confirmed as part of the outbreak. These individuals ate whole-head romaine lettuce from the Yuma growing region. Following this announcement the FDA advised consumers to avoid all romaine lettuce from the Yuma growing region. In the following weeks FDA continued its traceback investigation, part of which was able to trace the Alaskan correctional facility back to Harrison Farms.

Note above the location of Harrison Farms to the West Main Canal.  Although the FDA did not name the canal where the positive E. coli O157:H7 samples were drawn, the location of the canal to Harrison Farms in more than coincidental.

By the way, this is what the FDA has given us so far:

Seriously, should we be leaving filing in the blanks to a lawyer in Seattle?

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. coli infections. 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. coliinfections 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. coli bacteria 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.

What you need to know during an E. coli outbreak – https://www.youtube.com/watch?v=_85Myb9Y3OA

Bill Marler on E. coli– https://www.youtube.com/watch?v=ajjfhTSRZyc

As of June 28, 2018, this outbreak appears to be over.

As of June 27, 2018, 210 people infected with the outbreak strain of E. coli O157:H7 were reported from 36 states. A list of the states and the number of cases in each can be found on the Case Count Map page. Illnesses started on dates ranging from March 13, 2018 to June 6, 2018. Ill people ranged in age from 1 to 88 years, with a median age of 28. Sixty-seven percent of ill people were female. Of 201 people with information available, 96 (48%) were hospitalized, including 27 people who developed hemolytic uremic syndrome, a type of kidney failure. Five deaths were reported from Arkansas, California, Minnesota (2), and New York.

WGS analysis of isolates from 184 ill people identified antibiotic resistance to chloramphenicol, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Standard antibiotic resistance testing of eight clinical isolates by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these findings. Isolates from four of those ill people also contained genes for resistance to ampicillin and ceftriaxone. These findings do not affect treatment guidance since antibiotics are not recommended for patients with E. coli O157 infections.

Epidemiologic, laboratory, and traceback evidence indicated that romaine lettuce from the Yuma growing region was the likely source of this outbreak.

The FDA and state and local regulatory officials traced the romaine lettuce to many farms in the Yuma growing region. The FDA, along with CDC and state partners, started an environmental assessment in the Yuma growing region and collected samples of water, soil, and manure. CDC laboratory testing identified the outbreak strain of E. coli O157:H7 in water samples taken from a canal in the Yuma growing region. WGS showed that the E. coliO157:H7 found in the canal water is closely related genetically to the E. coli O157:H7 from ill people. Laboratory testing for other environmental samples is continuing. FDA is continuing to investigate to learn more about how the E. coli bacteria could have entered the water and ways this water could have contaminated romaine lettuce in the region.

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 $650 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.