Nov 18, 2005 (CIDRAP News) – Numerous Escherichia coli O157:H7 outbreaks have occurred in Great Britain, France, and the United States in the past 2 months.
According to news sources, approximately 200 infections and one death have been reported to health authorities. In most cases, local outbreak control teams have found mass-produced contaminated meat to be the cause, and they are working to set strict guidelines to limit the contagion.
The most serious and widespread outbreak has been reported in Wales, where 168 cases, most of them children of school age, were recorded between September and the first week of November.
The Food Standards Agency Wales issued a food alert Sep 21 calling for the removal of ready-to-eat foods (foods not cooked on the premises) from schools, the cancellation of educational activities that facilitate person-to-person spread, and mandatory testing for both children and parents.
To date, 42 schools have been affected, but a number of the latest cases are believed to have been acquired in the community. The BBC News reported on Nov 6 that among these latest cases are those that emerged in two south Wales' valleys schools and Mason Jones, a 5-year-old boy who died as a result of the infection.
In a Nov 7 article, BBC News reported that the Welsh Assembly Government promised a "no-holds-barred inquiry" into the outbreak. On Nov 9, Assembly Chairman Hugh Pennington told BBC News, "The figures [on E coli cases] looked quite good a few years ago but we've had a setback and we have to find out why. . . . As we know, sadly, from the outbreak, we have to be ever-vigilant."
BBC News reported Nov 13 that another E coli eruption forced a private nursery in Powys, mid-Wales, to close. Officials said no connection with the outbreak in south Wales could be established or ruled out at this time.
Another instance of contaminated meat was recorded recently in southwest France, where 13 children between 15 months and 9 years of age were diagnosed with hemolytic uremic syndrome (HUS). Thirteen possible cases of acute gastroenteritis were reported as well. Overall, the Institut National de Veille Sanitaire identified E coli in 10 of the patients.
According to the Nov 3 issue of Eurosurveillance Weekly, this is the first community-wide outbreak of E coli to be reported in France. The article added that the epidemic, publicly recognized on Oct 25, was confirmed when the affected people were found to have eaten minced beef burgers available in many LeClerc supermarkets in this region. All of the meat came from the same producer, Chantegrill, and it has now been recalled for further testing.
The French Department of Health told the Associated Press on Oct 31 that some of the meat "had been exported to other countries of the European Union" and that "a warning is being issued to the European Commission."
Similar recalls are taking place in several areas of the United States, where analogous outbreaks have been recorded in three states in the past few weeks.
For example, on Nov 1 the US Department of Agriculture (USDA) reported an outbreak in New York state, where the state health commissioner advised consumers not to eat ground beef patties made by the Philly-Gourmet Meat Company. These have been linked to an E coli contamination discovered when three Saratoga County residents became ill after consuming hamburger. As a result, the corporation voluntarily recalled about 94,400 pounds of frozen beef patties.
Investigations are continuing in central Oregon as well, where an E coli outbreak has been reported in the McGrath's Fish House restaurant. According to several news sources, two cases of the infection have been confirmed, and 21 additional patients, including five restaurant workers, have reported symptoms. No specific food item stands out as a likely source at this time. The Deschutes County Public Health, the Deschutes County Environmental Health, and the Oregon Department of Human Services are examining the site for additional information.
E coli infections produce a powerful toxin and can cause severe symptoms, such as severe abdominal cramps and diarrheathat may be watery and bloody. Other symptoms include vomiting and nausea accompanied by a low-grade fever. E coli O157:H7 can be spread person-to-person, primarily within households. It can also come from a variety of food products, most commonly undercooked ground beef, unpasteurized milk and apple cider, foods cross-contaminated with raw beef, and untreated water.
See also:
Committee report on outbreak in Wales
http://www.wales.gov.uk/keypubassemecoli/content/EColi-2-01-05-Minutes-e.html
Eurosurveillance Weekly report on outbreak in France
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2825
USDA recall notice on Pennsylvania meat company
http://www.fsis.usda.gov/News_&_Events/Recall_046_2005_release/index.asp
