16 STATE E. COLI OUTBREAK: BAD BEEF

E. COLI O157 - USA: 2009, TENDERIZED, NON-INTACT STEAK
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A ProMED-mail post

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International Society for Infectious Diseases


Date: Wed 6 Jan 2010
Source: CDC [edited]



The Centers for Disease Control and Prevention (CDC) is collaborating
with public health officials in several states and the United States
Department of Agriculture's Food Safety and Inspection Service (FSIS)
to investigate a multistate outbreak of human infections due to _E.
coli_ 0157:H7.

As of 5:00 PM EDT, Mon 4 Jan 2010, 21 persons infected with the
outbreak strain of _E. coli_ O157:H7 had been reported from 16
states. The number of ill persons who were identified resides in each
state as follows: CA (1), CO (1), FL (1), HI (1), IA (1), IN (1), KS
(1), MI (1), MN (3), NV (1), OH (2), OK (1), SD (2), TN (1), UT (2),
and WA (1).

Known illness onset dates range from 3 Oct 2009 through 14 Dec 2009.
Most patients became ill between mid-October and late November.
Patients range in age from 14 to 87 years and the median age of
patients is 34 years (which means half are younger than 34 years). 43
percent of patients are females. There have been 9 reported
hospitalizations, 1 case of hemolytic uremic syndrome (HUS), and no deaths.

The outbreak can be visually described with a chart showing the
number of persons who became ill each day. This chart is called an
epidemic curve or epi curve. Illnesses that occurred after 22 Dec
2009 might not yet be reported due to the time it takes between when
a person becomes ill and when the illness is reported. This takes an
average of 2 to 3 weeks.

In early December 2009, CDC's PulseNet staff identified a multistate
cluster of 14 _E. coli_ O157:H7 isolates with a particular DNA
fingerprint or pulsed-field gel electrophoresis (PFGE) pattern
reported from 13 states. The CDC's OutbreakNet team began working
with state and local partners to gather epidemiologic information
about persons in the cluster to determine if any of the ill
individuals had been exposed to the same food source(s). Health
officials in several states who were investigating reports of _E.
coli_ O157:H7 illnesses in this cluster found that most ill persons
had consumed beef, many in restaurants. CDC is continuing to
collaborate with state and local health departments in an attempt to
gather additional epidemiologic information and share this
information with FSIS. At this time, at least some of the illnesses
appear to be associated with products subject to a recent FSIS recall.

On 24 Dec 2009, FSIS issued a notice about a recall of 248 000 pounds
of beef products from National Steak and Poultry that may be
contaminated with _E. coli_ O157:H7. The recall was issued after FSIS
determined there was an association between non-intact steaks (blade
tenderized prior to further processing) and illnesses in Colorado,
Iowa, Kansas, Michigan, South Dakota and Washington.

--
Communicated by:
ProMED Rapporteur Brent Barrett


[A discussion regarding the issue of non-intact steaks and roasts,
pieces of meat that have be tenderized by needle or blade which can
introduce pathogens (especially _E. coli_ O157:H7) to the internal
aspect of the meat where it may survive better than its "surface"
cousins can be found at the previous ProMED posting on this small but
epidemiologically significant cluster at
.
- Mod.LL]

[see also:
2009
----
E. coli O157 - USA (09): tenderized, non-intact steak 20091230.4389
E. coli O157 - USA (08): ground beef 20091103.3794
E. coli O157 - USA (07): refrigerated cookie dough 20090710.2473
E. coli O157 - USA (06): beef, recall, RFI 20090702.2389
E. coli O157 - USA (05): refrigerated cookie dough, CDC 20090701.2381
E. coli O157 - USA (04): refrigerated cookie dough 20090630.2371
E. coli O157 - USA (03): beef, recall 20090629.2354
E. coli O157 - USA (02): refrigerated cookie dough 20090623.2291
E. coli O157 - USA: refrigerated cookie dough 20090619.2259
2008
----
E. coli O157 - USA (09): (WA), susp. 20081021.3336
E. coli O157 - USA (08): (CA), cooked beef 20081007.3181
E. coli O157, university students - USA (06): California lettuce 20081015.3266
E. coli O157, university students - USA: (MI) 20080922.2987
E. coli O157 - USA (07): (MA) alert 20080811.2475
E. coli O157 - USA: (OH, MI), unknown source 20080624.1947
E. coli O157, lettuce - USA: (WA) 20080606.1807
E. coli O157, restaurant - USA: (HI) 20080228.0811
2007
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E. coli O157, ground beef - USA (multistate) (09) 20071126.3823
E. coli O157, ground beef - USA (multistate) (08): Canada 20071029.3511
E. coli O157, ground beef - USA (multistate) (04): 2nd
manufacturer 20071007.3304
E. coli O157, ground beef - USA (multistate) (03): CDC report 20071003.3272
E. coli O157, ground beef - USA (multistate): alert, recall 20070927.3201
E. coli O157, ground beef - USA (NY): alert, recall 20070926.3190
E. coli O157, ground beef - USA (WA, OR): alert 20070830.2855
E. coli O157, ground beef - USA (NY) 20070725.2387
E. coli VTEC, prisoners - USA (CO) (02) 20070714.2263
E. coli VTEC, prisoners - USA (CO): RFI 20070712.2236
E. coli O157, ground beef - USA (west) (03): expanded recall 20070611.1902
E. coli O157, ground beef - USA (west): recall 20070606.1831
E. coli O157, ground beef - USA (multistate): recall 20070514.1532
E. coli O157, steak - USA (PA): recall 20070426.1362
E. coli O157, restaurant - USA (CA) (03) 20070410.1204
E. coli O157, restaurant - USA (CA) 20070403.1131
E. coli O157, spinach - USA (multistate): 2006, FDA report 20070326.1051
E. coli O157, bagged salad greens - USA (multistate) 20070121.0288
E. coli O157, lettuce - USA (multistate): 2006 20070112.0158]
2003
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E. coli O157, frozen steaks - USA (Midwest): recall 20030701.1617]
.................................ll/ejp/dk

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