E. coli Lawyer. E. coli Attorney

Statement from FDA Commissioner Scott Gottlieb, M.D., on the current romaine lettuce E. coli O157:H7 outbreak investigation

The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention and state authorities, continues to investigate a multistate outbreak of E. coli O157:H7 infections associated with consumption of romaine lettuce in the U.S. As of Nov. 26, 2018, this outbreak has resulted in 43 people becoming ill in 12 states, with the last reported illness onset date being Oct. 31, 2018. An additional 22 people in Canada have become ill, and the FDA and our partners are also coordinating the investigation with Canadian health and food safety authorities.

As we continue to investigate this outbreak, today the FDA is announcing new steps to help consumers better identify where their romaine is grown through voluntary labeling.

To prevent additional cases of E. coli O157:H7, on Nov. 20, 2018 the CDC advised the public not to consume romaine lettuce and to destroy any romaine lettuce in their homes. At the same time, the FDA requested that all romaine lettuce on the market, including in restaurants and other commercial establishments, should be withdrawn and destroyed. The FDA made this request because initial information available at that time had not identified a likely source for the outbreak that would allow a targeted request, it was likely romaine lettuce contaminated with E. coli O157:H7 that could cause illness was still available on the market, and a market withdrawal was the fastest way to remove potentially contaminated product. The romaine lettuce industry agreed to comply with the FDA’s request to withdraw any romaine lettuce on the market on that date, and available information suggests this action was effective in removing potentially contaminated romaine lettuce from retail establishments.

Over the Thanksgiving holiday, the FDA continued to investigate the outbreak. Our investigation at this point suggests that romaine lettuce associated with the outbreak comes from areas of California that grow romaine lettuce over the summer months, and that the outbreak appears to be related to “end of season” romaine lettuce harvested from these areas. The involved areas include the Central Coast growing regions of central and northern California.

The FDA is continuing tracebacks of romaine lettuce from locations where impacted consumers purchased or consumed romaine lettuce before they became ill in order to identify specific locations that are the likely source of the outbreak and to determine the factors that resulted in contamination. Through laboratory studies we have identified that the E. coliO157:H7 strain causing the outbreak is similar to one that produced an outbreak of E. coli O157:H7 in the fall of 2017 that also occurred in the U.S. and Canada, which was associated with consumption of leafy greens in the U.S. and specifically romaine lettuce in Canada.

Based on further discussions with the leafy greens industry and with agricultural authorities, we have begun to narrow the location in which we believe the contaminated romaine in the current outbreak was grown. At the time of the outbreak, the vast majority of the romaine on the market was being grown in the Central Coast region of California. Since, then harvesting of romaine lettuce from this region has ended for the year. Growing and harvesting of romaine lettuce is now shifting to the winter growing regions of the U.S., which include mainly the California desert region of the Imperial Valley, the desert region of Arizona in and around Yuma, and Florida. Romaine lettuce grown in Mexico is exported to the U.S. during the winter months. Smaller quantities of romaine lettuce are grown in other states. At this time, the FDA has no information to suggest any of these growing areas are involved in the current outbreak, which began well before any romaine lettuce from these winter growing locations was available for harvest. In addition, hydroponic romaine lettuce and romaine lettuce grown in green-houses is also marketed in the U.S., but there is no information to suggest these products are implicated in any identified E. coli O157:H7 outbreak.

The FDA believes it was critically important to have a “clean break” in the romaine supply available to consumers in the U.S. in order to purge the market of potentially contaminated romaine lettuce related to the current outbreak. This appears to have been accomplished through the market withdrawal request of Nov. 20, 2018.

Knowing the growing origin of produce will continue to play an important role in allowing consumers to avoid contaminated products and facilitating market withdrawals and tracebacks. That’s why we previously called on the romaine lettuce industry to provide unambiguous and clear information to consumers regarding where their lettuce was grown and when it was harvested.

To this end, the FDA recently participated in discussions with the major producers and distributors of romaine lettuce in the U.S. and with the major trade associations representing the produce industry regarding product labeling and dating to assure consumers that any romaine lettuce that will come onto the market is not associated with the current outbreak of E. coli O157:H7. The labeling will identify the origin of the romaine based on harvest region, along with the date of harvest. This can improve the ability of the FDA to provide more targeted information to consumers in the event of a future outbreak of illness. The FDA also has commitments from the romaine lettuce industry that such labeling will continue into the future and become the standard for their products.

In addition, the leafy greens industry has agreed to establish a task force to find solutions for long term labeling of romaine lettuce and other leafy greens for helping to identify products and to put in place standards for traceability of product. The task force will also examine information from this outbreak to identify measures that led to its occurrence and how to prevent ongoing safety problems with romaine lettuce. One outcome could be to extend the commitment for labeling for origin and date of harvest to other leafy greens.

Therefore, the FDA is issuing the following updated advice as part of our investigation and public warning:

Based on discussions with major producers and distributors, romaine lettuce entering the market will now be labeled with a harvest location and a harvest date. Romaine lettuce entering the market can also be labeled as being hydroponically or greenhouse grown. If it does not have this information, you should not eat or use it.

If consumers, retailers, and food service facilities are unable to identify that romaine lettuce products are not affected – which means determining that the products were grown outside the California regions that appear to be implicated in the current outbreak investigation — we urge that these products not be purchased, or if purchased, be discarded or returned to the place of purchase.

Romaine lettuce that was harvested outside of the Central Coast growing regions of northern and central California does not appear to be related to the current outbreak. Hydroponically- and greenhouse-grown romaine also does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these sources.

The FDA has urged growers, processors, distributors and retailers to:
• clearly and prominently label all individually packaged romaine products to identify growing region and harvest date for romaine; and
• clearly and prominently label at the point of sale the growing region when it is not possible for romaine lettuce suppliers to label the package (e.g. individual unwrapped whole heads of romaine lettuce available in retail stores).

We hope that growers, processors, distributors and retailers will join us in our effort to protect consumers by applying these labeling recommendations to their products. We remain committed to identifying ways to decrease the incidence and impact of food borne illness outbreaks, and will continue to provide updates on our investigation and changes to our advice on romaine lettuce as more information 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 $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.

Mauna Loa Macadamia Nut products produced at the company’s facility located at 16-701 Macadamia Road in Kea‘au, Hawai‘i between Sept. 6-21 have been voluntarily recalled due to potential contamination of Eschericia coli (E. coli). The recall follows a detection of E. coli in the well water and distribution system that supplies the Kea‘au facility.

No illnesses related to the water have been reported to the state.

All retailers of Mauna Loa Macadamia Nut products are to remove from sale products received after Sept. 6, as these products may have been contaminated with E. coli andare adulterated. Hawai‘i Revised Statutes (HRS), Section §328-9 (1)(D) definesadulterated as a food “produced, prepared, or packed or held under insanitary conditions whereby it may have become contaminated…”

“There is clear evidence that food produced at the Kea‘au facility may be contaminatedand consumers may be at risk,” said Peter Oshiro, Sanitation Branch chief. “TheDepartment of Health is working with the facility to ensure the safety of their drinking water and food production.”

On Sept. 5, samples taken from facility’s water distribution system passed testing andshowed no contamination. On Sept. 21, the DOH was notified that a water distribution system sample at the production center tested positive for E. coli and the food
production operations were closed by order of DOH. DOH is working with the facility to ensure their drinking water is safe and their facility is cleared before operations are allowed to resume. The Mauna Loa macadamia nut facility will remain closed until it meets all DOH Sanitation Branch and Safe Drinking Water Branch requirements and standards.

As of April 26, 2018, 98 people infected with the outbreak strain of E. coli O157:H7 have been reported from 22 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 April 20, 2018. Ill people range in age from 1 to 88 years, with a median age of 31. Sixty-five percent of ill people are female. Of 87 people with information available, 46 (53%) have been hospitalized, including 10 people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Illnesses that occurred after April 7, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

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.

I clearly need to update my chart.

E. coli outbreaks associated with lettuce, specifically the “pre-washed” and “ready-to-eat” varieties, are by no means a new phenomenon. In fact, the frequency with which this country’s fresh produce consuming public has been hit by outbreaks of pathogenic bacteria is astonishing. Here are just a sample of E. coli outbreaks based on information gathered by the Center for Science in the Public Interest, Kansas State University and the Centers for Disease Control and Prevention:

Date Vehicle Etiology Confirmed
Cases
States/Provinces
July 1995 Lettuce (leafy green; red; romaine) E. coliO157:H7 74 1:MT
Sept. 1995 Lettuce (romaine) E. coliO157:H7 20 1:ID
Sept. 1995 Lettuce (iceberg) E. coliO157:H7 30 1:ME
Oct. 1995 Lettuce (iceberg; unconfirmed) E. coliO157:H7 11 1:OH
May-June 1996 Lettuce (mesclun; red leaf) E. coliO157:H7 61 3:CT, IL, NY
May 1998 Salad E. coliO157:H7 2 1:CA
Feb.-Mar. 1999 Lettuce (iceberg) E. coliO157:H7 72 1:NE
Oct. 1999 Salad E. coli O157:H7 92 3:OR, PA, OH
Oct. 2000 Lettuce E. coli O157:H7 6 1:IN
Nov. 2001 Lettuce E. coli O157:H7 20 1:TX
July-Aug. 2002 Lettuce (romaine) E. coliO157:H7 29 2:WA, ID
Nov. 2002 Lettuce E. coli O157:H7 13 1:Il
Dec. 2002 Lettuce E. coli O157:H7 3 1:MN
Oct. 2003-May 2004 Lettuce (mixed salad) E. coliO157:H7 57 1:CA
Apr. 2004 Spinach E. coli O157:H7 16 1:CA
Nov. 2004 Lettuce E. coli O157:H7 6 1:NJ
Sept. 2005 Lettuce (romaine) E. coli O157:H7 32 3:MN, WI, OR
Sept. 2006 Spinach (baby) E. coli O157:H7 and other serotypes 205 Multistate and Canada
Nov./Dec. 2006 Lettuce E. coli O157:H7 71 4:NY, NJ, PA, DE
Nov./Dec. 2006 Lettuce E. coli O157:H7 81 3:IA, MN, WI
July 2007 Lettuce E. coli O157:H7 26 1:AL
May 2008 Romaine E. coli O157:H7 9 1:WA
Oct. 2008 Lettuce E. coli O157:H7 59 Multistate and Canada
Nov. 2008 Lettuce E. coli O157:H7 130 Canada
April 2010 Romaine E. coli O145 33 5:MI, NY, OH, PA, TN
Oct. 2011 Romaine E. coli O157:H7 60 Multistate

 

The U.S. Food & Drug Administration has become aware that recalled I.M Healthy Soy Nut Butter products are being offered for sale through online vendors and in storefront locations. All flavors of I.M. Healthy Soy Nut Butter spreads and granolas were recalled in March 2017 after the product was found to be the source of a multistateShiga toxin-producing Escherichia coli (E. coli) outbreak that sickened 32 people in 12 states.

Retailers cannot legally offer for sale and consumers should not purchase any flavors of I.M. Healthy Soy Nut Butter products, including spreads and granolas.

The FDA learned that some distributors are still selling the products in their possession and these products are being sold through online retailers and in storefront locations. As it learns of these products being offered for sale, the FDA notifies the retailer that these products cannot legally be sold. The agency is working swiftly to locate any remaining products to ensure they are no longer available to consumers.

The SoyNut Butter Company, distributor of I.M. Healthy products, has ceased to operate. On March 30, 2017, the FDA suspended the food facility registration of Dixie Dew, Inc., the manufacturer of the products, meaning that no food may leave the facility for sale or distribution.

The FDA will continue to monitor this situation closely and follow up with retailers as we become aware of recalled products being offered for sale. Additionally, the public is urged to report any product being offered for sale to the FDA Consumer Complaint Coordinator in their region. More information about the recall can be found at FDA.gov.

For more information:

The CDC reports that thirty-eight people infected with the outbreak strain of STEC O121 have been reported from 20 states – Alabama 1, Arkansas 1, Arizona 2, California 1, Colorado 4, Iowa 1, Illinois 4, Massachusetts 2, Maryland 1, Michigan 4, Minnesota 3, Missouri 1, Montana 1, New York 1, Oklahoma 2, Pennsylvania 2, Texas 2, Virginia 2, Washington 2 and Wisconsin 1.  Illnesses started on dates ranging from December 21, 2015 to May 3, 2016. Ill people range in age from 1 year to 95, with a median age of 18. Seventy-eight percent of ill people are female. Ten ill people have been hospitalized.

large-map-6-2-2016

WGS showed that isolates from ill people are closely related genetically. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.

Collaborative investigative efforts of state, local, and federal health and regulatory officials indicate that flour produced at General Mills’ Kansas City, Missouri facility is a likely source of this outbreak. This investigation is ongoing.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Sixteen (76%) of 21 people reported that they or someone in their household used flour in the week before they became ill. Nine (41%) of 22 people reported eating or tasting raw homemade dough or batter. Twelve (55%) of 22 people reported using Gold Medal brand flour. Three ill people reported eating or playing with raw dough at restaurants.

These investigations indicated that the flour used by ill people or used in restaurant locations was produced in the same week in November 2015 at the General Mills facility in Kansas City, Missouri. General Mills produces Gold Medal brand flour. On May 31, 2016, General Mills recalled several sizes and varieties of Gold Medal Flour, Gold Medal Wondra Flour, and Signature Kitchens Flour due to possible E. coli contamination. The recalled flours were produced in the Kansas City facility during a time frame identified by traceback and sold nationwide. CDC recommends that consumers, restaurants, and retailers do not use, serve, or sell the recalled flours.

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.

Alfalfa-SproutsState health and agriculture officials are investigating an outbreak of foodborne illness associated with alfalfa sprouts produced by Jack & The Green Sprouts. Retailers and restaurants should not sell or serve alfalfa sprouts produced by Jack & The Green Sprouts, and consumers should not eat them at this time.

Routine disease monitoring by the Minnesota Department of Health (MDH) identified seven E. coli O157:NM cases in January and early February; E. coli bacteria from those cases all had the same DNA fingerprint. The ill individuals range in age from 18 to 84 years, and five are female. Four of the cases are residents of the Twin Cities metro area, and three live in greater Minnesota. Two were hospitalized, and both have recovered.

Two additional cases of E. coli O157 infection, considered part of this outbreak, were identified by the Wisconsin Department of Health Services (WDHS) in Wisconsin residents. Neither case was hospitalized.

Minnesota officials are working with investigators at the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), WDHS, and the Wisconsin Department of Agriculture, Trade and Consumer Protection (WIDATCP). Jack & The Green Sprouts is located in River Falls, Wis., and distributes alfalfa sprouts to states in the upper Midwest and possibly other states. The seven Minnesota cases and at least one of the Wisconsin cases were exposed to implicated alfalfa sprouts from a variety of locations, including grocery/cooperative stores, restaurants, salad bars and commercial food service.

This is an ongoing investigation, and the extent of the product contamination is unknown. Based on the information collected to date, health officials recommend not eating any alfalfa sprouts produced by Jack & The Green Sprouts. Currently, there is no evidence that other products produced by Jack & The Green Sprouts are contaminated.

Jack & The Green Sprouts alfalfa sprouts may be packaged in a plastic clamshell with a brightly colored round label on top that notes the sprout variety. The alfalfa sprouts may be mixed in the same package with other sprout varieties.

The FDA is working with state officials to collect samples and determine the source of the outbreak. State officials urge consumers not to eat alfalfa sprouts produced by Jack & The Green Sprouts and retailers and restaurants not to sell or serve them. More information will become available as the investigation proceeds.

Sprouts are a known source of foodborne illness. Children, the elderly, pregnant women and persons with weakened immune systems should avoid eating raw sprouts of any kind (including alfalfa, clover, radish and mung bean sprouts). You can reduce your risk of illness by requesting that raw sprouts not be added to your food.

Symptoms of illness caused by E. coli O157 typically include stomach cramps and diarrhea, often with bloody stools, but only a low-grade or no fever. People typically become ill two to five days after exposure, but this period can range from one to eight days. Most people recover in five to 10 days. However, E. coli O157 infections sometimes lead to a serious complication called hemolytic uremic syndrome (HUS), which can cause kidney failure and other severe problems, including death. Those most at risk of developing complications from E. coli O157 include children younger than 10, the elderly, and those with weakened immune systems.

Diarrhea associated with E. coli O157 infections should NOT be treated with antibiotics, as this practice might promote the development of HUS. Anyone who believes they may have developed an E. coli O157 infection should contact their health care provider.

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.

index-small-mapCDC, the U.S. Food and Drug Administration, the U.S. Department of Agriculture Food Safety and Inspection Service, and public health officials in several states are investigating an outbreak of Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) infections.

A total of 19 people infected with the outbreak strain of Shiga toxin-producing STEC O157:H7 have been reported from 7 states. The majority of illnesses have been reported from states in the western United States. The number of ill people reported from each state is as follows: California (1), Colorado (4), Missouri (1), Montana (6), Utah (5), Virginia (1), and Washington (1).

image-of-labelAmong people for whom information is available, illnesses started on dates ranging from October 6, 2015 to November 3, 2015. Ill people range in age from 5 years to 84, with a median age of 18. Fifty-seven percent of ill people are female. Five (29%) people reported being hospitalized, and two people developed hemolytic uremic syndrome (HUS), a type of kidney failure. No deaths have been reported..

The epidemiologic evidence available to investigators at this time suggests that rotisserie chicken salad made and sold in Costco stores is a likely source of this outbreak. The ongoing investigation has not identified what specific ingredient in the chicken salad is linked to illness.

State and local public health officials are interviewing ill people to obtain information about foods they might have eaten and other exposures in the week before their illness started. Fourteen (88%) of 16 people purchased or ate rotisserie chicken salad from Costco.

On November 20, 2015, Costco reported to public health officials that the company had removed all remaining rotisserie chicken salad from all stores in the United States and stopped further production of the product until further notice.

E. coli: 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.

First, see www.fair-safety.com – this is nothing new.

The North Dakota Department of Health is investigating a possible cluster of Shiga toxin-producing E. coli (STEC) infections in eastern North Dakota.

Three cases have been reported, all are less than 18 years of age and all reported attending the Red River Valley Fair in West Fargo which was held July 7 through 12.

One of the cases has been diagnosed with hemolytic uremic syndrome (HUS), a severe complication of STEC infections, in which red blood cells are damaged and can cause kidney damage and kidney failure.

“We are in the early stages of this investigation and are asking people who became sick with diarrhea or bloody diarrhea for more than 24 hours within ten days of attending the fair to let us know,” said Michelle Feist, a health department epidemiologist. “Although the cases reported having contact with animals while at the fair, we are looking into other possible exposures as well.”

STEC is a bacterial infection that can cause abdominal cramping, nausea, vomiting, diarrhea and bloody diarrhea. Symptoms can be severe resulting in dehydration and electrolyte imbalances. People usually get sick within 3 to 4 days from the time of infection, but it can take as long as 10 days for symptoms to appear.

People who have symptoms of STEC should consult with their health care provider.

STEC is shed in the stool of infected animals and people. STEC infections can result from eating contaminated food, drinking contaminated water, coming into contact with animals that are carrying STEC and can be spread from person to person through inadequate hygiene. Undercooked meats, especially ground beef, contaminated produce or sprouts and attending petting zoos have all been implicated in STEC outbreaks in the U.S. Animals may be infected and not have symptoms but can shed the bacteria.

Livestock exhibitions, petting zoos, county and state fairs, frankly any “farm experience,” are “as American as apple pie.”

Unfortunately, these same places have been the source of large outbreaks of zoonotic diseases over the last decades. And, just as unfortunately, despite the severe illnesses and a death attributed to these activities, little seems to be learned from outbreak to outbreak despite previously existing standards for safer exhibition of animals being encoded more forcefully into law. After each outbreak it is hoped that future exhibitors will, one hopes, heed the calls previously issued by the Centers for Disease Control and Prevention (CDC) and by veterinarians: to take steps to reduce the likelihood of zoonotic-disease transmission to animal exhibition patrons – and to young children in particular.

Now we see another one. During April’s Milk Maker’s Fest at the Washington Fairgrounds at least 25 were sickened by E. coli O157:H7 with 10 hospitalized and six developing hemolytic uremic syndrome (HUS). The cause of this outbreak is clearly set forth in recommendations for future event organizers:

  • Evaluate and update plans for cleaning and disinfection before, during, and after events, particularly surfaces with high levels of hand contact (such as seats, door or fence handles, and hand railings).
  • Evaluate and update measures to restrict access to areas more likely to be contaminated with animal manure.
  • Ensure access to hand washing facilities with soap, running water, and disposable towels.
  • Display signs and use other reminders to attendees to wash hands when leaving animal areas.
  • Store, prepare, or serve food and beverages only in non-animal areas.

Seeing this I feel a bit frustrated since I gave a speech 10 years ago to the Washington State Fair Association about the risks of animal contact in these types of settings and recommendation on how to avoid outbreaks.

The risk of transmission in exhibition settings of zoonotic diseases in general and E. coli O157:H7 in particular is not – or should not be – news. A survey as far back as 2003 of the literature, including CDC’s Morbidity and Mortality Weekly Report (MMWR), revealed at least 23 outbreaks of zoonotic disease, including illnesses from E. coli O157:H7, associated with animal exhibitions in the United Kingdom and the United States. These prior outbreaks included an E. coli O157:H7 outbreak associated with a county fair in Medina, Ohio, in August, 2000; two E. coli O157:H7 outbreaks in Pennsylvania in 2000 and 2001 associated with farm animals; 92 E. coli O157:H7 cases associated with the Wyandot County Fair in Ohio in September 2001; and the largest E. coli O157:H7 outbreak in Oregon history at the Lane County Fair in September 2002. And, over the last decade there is not a year that has gone by that many other outbreaks have left hundreds and hundreds sickened.

In addition, research has shown that E. coli O157:H7 is prevalent even among the prize livestock exhibited at agricultural fairs. A 2003 study on the prevalence of E. coli O157: H7 in livestock at 29 county and three large state agricultural fairs in the United States found that E. coli O157:H7 could be isolated from 13.8 percent of beef cattle, 5.9 percent of dairy cattle, 3.6 percent of pigs, 5.2 percent of sheep, and 2.8 percent of goats. Over 7 percent of pest-fly pools also tested positive for E. coli O157:H7.

Against this backdrop, the CDC published recommendations for reducing the risk that enteric pathogens will be transmitted at petting zoos, open farms, and animal exhibits. The most updated version of these recommendations can be found on CDC’s MMWR Web site. These recommendations arise out of several documented outbreaks in which enteric pathogens were passed to humans in such settings. Draft recommendations were published in MMWR on April 20, 2001; readers were invited to submit comments and suggestions; and the final recommendations were posted on the Internet on October 26, 2001. The recommendations encapsulated on the CDC Web site and in MMWR were created by the National Association of State Public Health Veterinarians (NASPHN). Many of the recommendations are common sense and most, if not all were likely ignored by those involved with the Milk Maker’s Fest:

Venue operators should take the following steps:

  • Become familiar with and implement the recommendations in this compendium.
  • Consult with veterinarians, state and local agencies, and cooperative extension personnel on implementation of the recommendations.
  • Become knowledgeable about the risks for disease and injury associated with animals and be able to explain risk-reduction measures to staff members and visitors.
  • Be aware that direct contact with some animals is inappropriate in public settings, and this should be evaluated separately for different audiences.
  • Develop or obtain training and educational materials and train staff members.
  • Ensure that visitors receive educational messages before they enter the exhibit, including information that animals can cause injuries or carry organ- isms that can cause serious illness.
  • Provide information in a simple and easy-to-under- stand format that is age and language appropriate.
  • Provide information in multiple formats (eg, signs, stickers, handouts, and verbal information) and languages.
  • Provide information to persons arranging school field trips or classroom exhibits so that they can educate participants and parents before the visit.

Venue staff members should take the following steps:

  • Become knowledgeable about the risks for dis- ease and injury associated with animals and be able to explain risk-reduction recommendations to visitors.
  • Ensure that visitors receive educational messages regarding risks and prevention measures.
  • Encourage compliance by the public with risk- reduction recommendations, especially compliance with hand-washing procedures as visitors exit animal areas.

Recommendations for nonanimal areas are as follows:

  • Do not permit animals, except for service animals, in nonanimal areas.
  • Store, prepare, serve, or consume food and beverages only in nonanimal areas.
  • Provide hand-washing facilities and display hand- washing signs where food or beverages are served.
  • Entrance transition areas should be designed to facilitate education.
  • Post signs or otherwise notify visitors that they are entering an animal area and that there are risks associated with animal contact.
  • Instruct visitors not to eat, drink, smoke, and place their hands in their mouth, or use bottles or pacifiers while in the animal area.
  • Establish storage or holding areas for strollers and related items (eg, wagons and diaper bags).
  • Control visitor traffic to prevent overcrowding.
  • Exit transition areas should be designed to facilitate hand washing.
  • Post signs or otherwise instruct visitors to wash their hands when leaving the animal area.
  • Provide accessible hand-washing stations for all visitors, including children and persons with disabilities. Position venue staff members near exits to encourage compliance with proper hand washing.

Recommendations for animal areas are as follows:

  • Do not allow consumption of food and beverages in these areas.
  • Do not allow toys, pacifiers, spill-proof cups, baby bottles, strollers, or similar items to enter the area.
  • Prohibit smoking and other tobacco product use.
  • Supervise children closely to discourage hand-to- mouth activities (eg, nail biting and thumb sucking), contact with manure, and contact with soiled bedding. Children should not be allowed to sit or play on the ground in animal areas. If hands become soiled, supervise hand washing immediately.
  • Ensure that regular animal feed and water are not accessible to the public.
  • Allow the public to feed animals only if contact with animals is controlled (eg, with barriers).
  • Do not provide animal feed in containers that can be eaten by humans (eg, ice cream cones) to decrease the risk of children eating food that has come into contact with animals.
  • Promptly remove manure and soiled animal bedding from these areas.
  • Assign trained staff members to encourage appropriate human-animal interactions, identify and reduce potential risks for patrons, and process reports of injuries and exposures.
  • Store animal waste and specific tools for waste removal (eg, shovels and pitchforks) in designated areas that are restricted from public access.
  • Avoid transporting manure and soiled bedding through nonanimal areas or transition areas. If this is unavoidable, take precautions to prevent spillage.
  • Where feasible, disinfect the area (eg, flooring and railings) at least once daily.
  • Provide adequate ventilation both for animals and humans.
  • Minimize the use of animal areas for public activities (eg, weddings and dances). • If areas previously used for animals must be used for public events, they should be cleaned and disinfected, particularly if food and beverages are served.

In addition, the Pennsylvania legislature enacted a law mandating standards for animal exhibition sanitation. The Pennsylvania law requires animal exhibit operators to “promote public awareness of the risk of contracting a zoonotic disease” by posting notices. The law further requires adequate hand-cleansing facilities and prohibits the exhibition of any animal not properly cared for by a veterinarian.

Thus, even before the outbreaks in North Carolina and Florida in the fall and winter of 2004-2005, the risk of disease transmission and the means of reducing that risk were well known. This common knowledge forms the basis of legal liability for both the private and governmental entities that operate animal exhibitions. While laws vary from state to state, the liability of these entities to those sickened through exposure to animals on site would be based in the premises of both liability and negligence.

Under premises liability law, the entity or entities responsible for managing an animal exhibition have a duty of care to those it invites onto the premises. This duty includes the responsibility to adequately reduce risks the entity is or should be aware of. The duty also carries a responsibility to warn fairgoers of risks present at the exhibition.

The principles of negligence also revolve around the risks to fairgoers that animal exhibitors know of or reasonably should know of. To successfully bring a negligence claim, a sickened person would need to show that the actions of an animal exhibitor fell below a reasonable standard of care in the operation of the exhibit. Failing to implement the well-established recommendations of the CDC and NASPHV constitutes falling below that standard of care.

Both bases for liability on the part of animal exhibitors-premises liability and negligence-carry with them a burden of education on the part of the exhibitor. Because the law holds people to a standard of what they reasonably should know, ignorance of the risks involved is not an effective defense. The law thus provides no impetus to stray from the course of action that is best for both customers and exhibitors in the first place-recognizing the risk and taking steps to reduce it.

Following the E. coli O157:H7 outbreak in North Carolina, the Terry Sanford Institute of Public Policy at Duke University contracted with the North Carolina Department of Health and Human Services to develop recommendations on regulating petting zoos. The researchers concluded:

In response to the largest outbreak of Escherichia coli (E. coli) in North Carolina history, we recommend that the North Carolina Department of Health and Human Services (DHHS) issue guidelines and pursue legislation that will control public contact with animals, inform the public of risks related to animal contact, provide transition areas, regulate animal care, and license petting zoos.

The North Carolina Legislature subsequently adopted “Aedin’s Law,” named after a young child who was severely injured in the outbreak. According to the preamble of the bill, the child was hospitalized for 36 days and will suffer lifelong injury from complications of HUS. Aedin’s Law requires that animal exhibitors acquire a public permit. The bill further requires the North Carolina State Board of Agriculture to adopt regulations in line with those of the Duke University study and CDC.

There are benefits to continuing the tradition of animal exhibits – it is a recreational and educational link to our country’s ongoing agricultural heritage. Slowly heeding the hard lessons learned, private, public, and legal forces are at work to reduce the risks associated with this pastime. Animal exhibitors are unwise to view these changes as a threat, or those working for change as enemies. Likewise, it is shortsighted to resist the recommendations and guidelines offered to make the animal exhibits safer. The long-term existence of animal exhibits to the public cannot be assured in an environment that permits the possibility of large-scale, life-threatening disease outbreaks like those that occurred in North Carolina and Florida. And, the best way to keep the lawyers out of it is to keep the children safe.

References

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.

mechanical-tenderizerLombardi Brothers Meats, a Denver, Colo. establishment, is recalling approximately 26,975 pounds of tenderized steak and ground beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The tenderized steak and ground beef products with generic labeling were produced between June 12 and June 30, 2015. The following products are subject to recall:

Various catch weights of “BEEF BALL TIP STK CAB”
Various catch weights of “BEEF TOP SIRLOIN STK CAB”
Various catch weights of “BEEF TOP SIRLOIN STK CAB BASEBALL”
Various catch weights of “BEEF COUNTRY CLUB SIRLOIN CAB”
Various catch weights of “BEEF TOP SIRLOIN CHATEAU CAB”
Various catch weights of “BEEF PATTY CAB 85/15 2/1R”
Various catch weights of “BEEF GROUND CAB 75/25”
Various catch weights of “BEEF GROUND CAB”
Various catch weights of “BEEF GROUND CAB 80/20”
Various catch weights of “BEEF GROUND CAB 90/10”
Various catch weights of “BEEF GROUND CAB 75/25”
Various catch weights of “BEEF PATTY CAB 85/15 2/1R”
Various catch weights of “BEEF PATTY CAB 80/20 3-1 RND”
Various catch weights of “BEEF PATTY CAB 80/20”
Various catch weights of “BEEF GROUND 80/20  EMP”
Various catch weights of “BEEF PATTY CAB 75/25”
Various catch weights of “BEEF PATTY CAB 80/20 2-1 RND”
Various catch weights of “BEEF PATTY CAB 80/20 2-1 THK”
Various catch weights of “BEEF PATTY CAB 80/20 8-1”
Various catch weights of “BEEF PATTY CAB 80/20 3-1 THK”
Various catch weights of “BEEF PATTY CAB 80/20 4-1 RND”
Various catch weights of “BEEF PATTY CAB 80/20 4-1 NO U BOARDS”
Various catch weights of “BEEF PATTY CAB 80/20 2-1 NO UBOARDS”

The products subject to recall bear the establishment number “EST. 772” inside the USDA mark of inspection. The products were shipped for hotel, restaurant and institutional use in Colorado, New Mexico, Utah and Wyoming.

The problem was discovered June 30 when the firm received a positive result for E. coli as part of its in-house sampling program. Some products made from the same source material as the positive sample were shipped into commerce.

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.