Updated 8/29/97. Send mail to Food Resource, Oregon State University, Corvallis, OR.
EXCERPTED FROM Russell, Jeremy. 1999September 20. E. coli O157:H7 Outbreaks. Lean Trimmings National Meat Association
Last week it was reported that an outbreak of E. coli O157:H7 in New York State may be the largest in the history of the U.S. Subsequently, the CDC reported that fair attendees infected with Campylobacter jejuni also were identified. Laboratories were asked by the New York State Department of Health (NYSDOH) to culture all diarrheal stool specimens for E. Coli O157:H7 and subsequently for Campylobacter spp. As of September 18th, 1,013 persons reported diarrhea after attending the Washington County Fair. Stool cultures yielded E. coli O157:H7 from 116 persons; 13 of these persons were co-infected with C. jejuni. Stool cultures from 32 additional persons yielded only Campylobacter. Sisty-five persons have been hospitalized; 11 children have developed hemolytic uremic syndrome (HUS); and two persons died: a 3 year-dold girl from HUS and a 79-year-old man from HUS/thrombotic thrombocytopenic purpura. Cases of diarrheal illness among fair attendees have been reported from 14 New York counties and four states. Contaminated well water was determined to be the most likely source of the outbreak. Pulsed-field gel electrophoresis testing by the Wadsworth Center showed that the DNA "fingerprints" of E. coli O157:H7 isolates from the well, the water distribution system, and most patients were similar. Water sampling for Campylobacter spp. is ongoing.
Meanwhile, the Illinois Department of Public Health continues to investigate the E. coli O157:H7 outbreak that has been linked to a private party held in a cow pasture. 281 persons are ill at last count. laboratory test have confirmed that 27 of those who are ill were positive for the pathogen. An in yet another outbreak, public health investigators have isolated E. coli O157:H7 bacteria from water, sediment and duck droppings taken from the beach at Battle Ground Lake in Washington. DNA tests match the samples conlucsively to the outbreak that has sickened at least 32 people.
Authrities have begun to organize ways to avoid these types of outbreaks. On September 13, the state health commissioner issued an order requiring county fairgrounds to use disinfected water when hosting public events; the commissioner also is reviewing laws and regulations applicable to fairs. State and county authorities, who closed the Battle Ground Lake on August 28, said they planned to continue the ban against swimming, boating and fishing at the lake until Spring while they and state public health investigators decide what needs to be done to make sure the water is safe.
Nevertheless, it is important to keep in mind tht the best prevention is responsible individual sanitation. The reason why this bacteria is such a problem as compared with other food-borne microbes like Salmonella is that the number of bacteria one needs to ingest to become sick is relatively small. Estimates are that as few as 50 or 100 bacteria of E. coli O157:H7 is all that it takes for a person to become infected. What can happen is that those persons who are infected inadvertently pass it on to others with whom they come in close contact. "It is like a domino effect," states Dr. David Acheson, director. The Food Safety Initiative at New England Medical Center, Boston, "often occurring in the same family environment or in group social settings."
The best way to prevent infection from occurring is to pay close attention to personal hygiene when dealing with gastroenteritis.