Chanteau Orr

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• Chanteau Orr

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What is E.coli O157H7?

• E. coli O157H7 is a one of hundreds of strains
  of the bacterium Escherichia coli and is a
  leading cause of foodborne illness.
• Although most strains of the bacterium are
  harmless, this strain produces a powerful toxin
  that can cause severe illness.

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What is E.coli O157H7?

• E. coli O157H7 was first recognized as a cause
  of illness in 1982 during an outbreak of severe
  bloody diarrhea the outbreak was traced to
  contaminated hamburgers.
• Since then, more infections in the United States
  have been caused by eating undercooked ground
  beef than by any other food.

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What is E.coli O157H7?

• Approximately 73,000 cases of infection and 61
  deaths occur in the United States each year (CDC,
  1999).
• The combination of letters and numbers in the
  name of the bacterium refers to the specific
  markers found on its surface and distinguishes it
  from other types of E. coli.

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How is E. coli O157H7 spread?

• The organism can be found on most cattle farms,
  and it is commonly found in petting zoos and can
  live in the intestines of healthy cattle, deer,
  goats, and sheep.

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How is E. coli O157H7 spread?

• Meat can become contaminated during slaughter,
  and organisms can be accidentally mixed into meat
  when it is ground.
• Bacteria present on the cows udders or on
  equipment may get into raw milk.
• In a petting zoo, E. coli O157H7 can contaminate
  the ground, railings, feed bins, and fur of the
  animals.

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How is E. coli O157H7 spread?

• Eating meat, especially ground beef, that has not
  been cooked sufficiently to kill E. coli O157H7
  can cause infection. Contaminated meat looks and
  smells normal.
• Other known sources of infection are consumption
  of sprouts, lettuce, spinach, salami,
  unpasteurized milk and juice, and by swimming in
  or drinking sewage-contaminated water.

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How is E. coli O157H7 spread?

• Bacteria in loose stool of infected persons can
  be passed from one person to another if hygiene
  or hand washing habits are inadequate.
• This is particularly likely among toddlers who
  are not toilet trained.
• Young children typically shed the organism in
  their feces for a week or two after their illness
  resolves. Older children and adults rarely carry
  the organism without symptoms.

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What illness does E. coli O157H7 cause?

• People generally become ill from E.coli O157H7
  two to eight days (average of 3-4) after being
  exposed to the bacteria.
• E.coli O157H7 infection often causes severe
  bloody diarrhea and abdominal cramps.
• Sometimes the infection causes non-bloody
  diarrhea, vomiting, or no symptoms.
• Usually little or no fever is present, and the
  illness resolves in 5 to 10 days.

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What illness does E. coli O157H7 cause?

• In some persons, particularly children under 5
  years of age and the elderly, the infection can
  also cause a complication called hemolytic uremic
  syndrome (HUS), in which the red blood cells are
  destroyed and the kidneys fail.
• About 8 of persons whose diarrheal illness is
  severe enough develop this complication.

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How is the illness treated?

• Most people recover without antibiotics or other
  specific treatment within 5 to 10 days.
• Antibiotics should not be used to treat this
  infection. There is no evidence that antibiotics
  improve the course of the disease, and it is
  thought that treatment with some antibiotics
  could lead to many serious complications i.e.
  HUS.
• Antidiarrheal agents such as Imodium should also
  be avoided.

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How is the illness treated?

• In some people, E. coli O157H7 infection can
  cause a complication called hemolytic uremic
  syndrome (HUS), a life-threatening condition that
  is usually treated in an intensive care unit.
• Blood transfusions and kidney dialysis are often
  required. Kidney transplants may also be
  required. With intensive care, the death rate for
  HUS is 3-5.

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How is E.coli O157H7 infection diagnosed?

• Infection with E.coli O157H7 is diagnosed by
  detecting the bacterium in the stool.
• All persons who suddenly have diarrhea with blood
  should get their stool tested for E. coli O157H7.

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What are the long term consequences of infection?

• Persons who have diarrhea only usually recover
  completely.
• A small proportion of person with hemolytic
  uremic syndrome (HUS) have immediate
  complications with lifelong problems such as
  blindness, paralysis, persistent kidney failure,
  and the effects of having part of their bowel
  removed. Many people with HUS have mild
  abnormalities in kidney function many years later.

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What can be done to prevent the infection?

• Cattle are the primary source of E. coli O157H7
  infection they carry the organism in their
  intestines.
• Changes in the preparation of animals for
  slaughter and in slaughter and processing of
  animals could decrease the contamination of
  carcasses with E. coli O157H7 and the subsequent
  contamination of meat.
• Testing ground meat for E. coli O157H7 and
  withholding it from the market until the test is
  negative.

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What can YOU do to prevent E. coli O157H7
infection?

• Cook all ground meat and hamburger thoroughly.
• Use a thermometer to ensure that the thickest
  part of the patty reads at least 155 degrees (F).
• If you are served an undercooked hamburger or
  other ground beef product in a restaurant, send
  it back for further cooking. (You may want to ask
  for a new and a clean plate, too).

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What can YOU do to prevent E. coli O157H7
infection?

• Avoid spreading harmful bacteria in your kitchen.
• Keep raw meat separate from ready-to-eat foods.
• Wash hands, counters and utensils with hot, soapy
  water after they touch raw meat.
• Avoid placing cooked hamburgers or ground beef on
  the unwashed plate that held raw patties.
• Wash meat thermometers in between tests of
  patties that require more cooking.

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What can YOU do to prevent E. coli O157H7
infection?

• Drink only pasteurized milk, juice, or cider.
• Commercial juice with an extended shelf-life that
  is sold at room temperature has been pasteurized,
  even if not noted on the container.
• Juice concentrates are also heated sufficiently
  to kill pathogens.

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What can YOU do to prevent E. coli O157H7
infection?

• Wash fruits and vegetables under running water,
  especially those that will not be cooked.
• Be aware that bacteria are sticky, so even
  thorough washing may not remove all
  contamination.
• Remove the outer leaves of leafy vegetables.
• Children under age 5 years of age,
  immunocompromised persons, and the elderly should
  avoid eating alfalfa sprouts until their safety
  can be assured.
• Persons at high risk of complications from
  foodborne illness may choose to consume cooked
  vegetables and peeled fruits.

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What can YOU do to prevent E. coli O157H7
infection?

• Drink municipal water that has been treated with
  chlorine or another effective disinfectant.
• Avoid swallowing lake or pool water while
  swimming.
• Make sure that persons with diarrhea, especially
  children, wash their hands carefully with soap
  after bowel movements to reduce the risk of
  spreading infection, and that persons wash hands
  after changing soiled diapers.
• Anyone with a diarrheal illness should avoid
  swimming in public pools or lakes, sharing baths
  with others, and preparing food for others.

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Recent Outbreaks

• 2006 Spinach outbreak
• 199 persons from 26 states
• 102 (51) hospitalized
• 31 (16) developed HUS
• 3 deaths in confirmed cases
• 1998 Cheese Curds in Wisconsin
• 55 persons
• Linked to fresh curd but not other cheese
  products
• 1500-lb vat of raw milk cheddar cheese used to
  make fresh curd and incorrectly labeled
  pasteurized cheddar cheese curd.

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Recent Outbreaks

• 1997 Alfalfa Sprouts
• 60 persons
• 2 developed HUS
• All implicated alfalfa sprouts were produced by a
  single sprouter
• No unsanitary sprout-manufacturing practices
  identified
• 1993 Jack in the Box Hamburger outbreak
• Seattle physician noticed spike in number of
  children with bloody diarrhea
• 73 restaurants from 4 states involved in the
  recall
• Seven hundred persons ill
• 4 children died
• Errors in meat processing and cooking identified

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Recent Outbreaks Spinach Outbreak
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Resources

• For local disease statistics, please contact
  Tulsa Health Departments Epidemiology Program _at_
  918/595-4505.
• Center for Disease Control and Prevention, CDC _at_
  www.cdc.gov
• Oklahoma State Department of Health _at_
  www.health.ok.gov

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Questions?