Category Archives: E.coli O157:H7

USA – FDA to Implement Sampling Effort for Lettuce Grown in Salinas Valley, California

FDA

The U.S. Food and Drug Administration will be collecting and testing samples of lettuce grown in California’s Salinas Valley from local commercial coolers from May through November 2021. The agency will test the samples for Shiga toxin-producing Escherichia coli (STEC), including E. coli O157:H7, and Salmonella spp. as part of ongoing surveillance efforts following reoccurring outbreaks linked to this region, including most recently in the fall of 2020.

The FDA assignment will direct sampling to be conducted at commercial cooling and cold storage facilities where field heat is removed from harvested lettuce and where product is cold-stored before processing. Sampling may include pre-cooled product (preferred) or post-cooled product. Sample collection at commercial coolers helps the FDA efficiently obtain samples from multiple farms at centralized locations and facilitates prompt traceback and follow-up if contamination is detected.

The agency plans to collect and test a total of approximately 500 post-harvest samples of iceberg, leaf and romaine lettuce. Each sample will consist of 10 subsamples, each made up of one head of lettuce (trimmed, cored and possibly wrapped), or in the case of romaine lettuce, loose leaves or one package of hearts.  FDA laboratories will conduct all testing.

During this sampling assignment, the FDA will take extra precautions to help ensure the safety of agency investigators and firm employees during the COVID-19 pandemic. FDA investigators will preannounce their visits to firms per the Agency’s COVID-19 safety practices. They will be outfitted with personal protective equipment (PPE) and will carry out their work while adhering to local, state and applicable CDC guidance.

Helping to ensure the safety of leafy greens remains a high priority of the FDA. This assignment adds to other work underway in collaboration with stakeholders in the California Central Coast growing region to identify where the recurring strain of pathogenic E. coli is persisting and the likely routes of leafy green contamination with STECs.  This includes continued implementation of actions identified in the recently updated Leafy Greens Action Plan, including a multi-year longitudinal  study to assess the environmental factors impacting the presence of foodborne pathogens in this region. Consistent with the action plan, if the FDA detects a pathogen such as E. coli O157:H7, the agency will conduct a follow-up investigation to identify potential sources and routes of contamination. Such investigations are designed to inform what additional preventive measures may be needed to help prevent outbreaks of foodborne illness.

USA – Fresh, organic produce common source of E. coli O157 infections in 7 children

Food Poison Journal

Public Health is investigating a new cluster of seven children infected with Shiga toxin-producing E. coli (also known as STEC) in King County. All cases are currently under 15 years of age, and three are under 5 years of age. Cases have been reported during April 22–May 1, 2021.

Our investigation is ongoing. We have identified multiple types of fresh produce, mostly organic, in common among the majority of cases but cannot yet rule out other possibilities. We are still uncertain if these cases share the same source of their infection or not. Updates will continue to be posted when more information is available.

Research – In-Plant Validation of Novel On-Site Ozone Generation Technology (Bio-Safe) Compared to Lactic Acid Beef Carcasses and Trim Using Natural Microbiota and Salmonella and E. coli O157:H7 Surrogate Enumeration

MDPI

The purpose of this study was to evaluate the antimicrobial efficacy of an aqueous ozone (Bio-Safe) treatment andtech lactic acid solutions on natural microbiota and E. coli O157:H7 and Salmonella surrogates on beef carcasses and trim in a commercial beef processing plant. For every repetition, 40 carcass and 40 trim swabs (500 cm2) were collected. Samples were taken using EZ-ReachTM swabs, and plated into aerobic plate count (APC), coliform, and E. coli PetrifilmTM for enumeration. In addition, a five-strain cocktail (MP-26) of E. coli surrogates was inoculated onto trim. For every trim surrogate repetition, 30 trim pieces were sampled after attachment and after ozone intervention. Samples were diluted and counts were determined using the TEMPO® system for E. coli enumeration. Ozone and lactic acid interventions significantly reduced (p < 0.003) bacterial counts in carcasses and trim samples. Moreover, lactic acid further reduced APC and coliforms in trim samples compared to ozone intervention (p < 0.009). In the surrogate trials, ozone significantly reduced (p < 0.001) surrogate concentration. Historical data from the plant revealed a reduction (p < 0.001) of presumptive E. coli O157:H7 in trim after a full year of ozone intervention implementation. The novel technology for ozone generation and application as an antimicrobial can become an alternative option that may also act synergistically with existing interventions, minimizing the risk of pathogens such as Salmonella and E. coli O157:H7. View Full-Text

USA – Factors Potentially Contributing to the Contamination of Leafy Greens Implicated in the Fall 2020 Outbreak of E. coli O157:H7

FDA

Executive Summary

Between August and December 2020, the U.S. Food and Drug Administration (FDA) and multiple state and federal partners were involved in an outbreak investigation related to E. coli O157:H7 illnesses and the consumption of leafy greens. The outbreak, which caused 40 reported domestic illnesses, was linked via whole genome sequencing (WGS) and geography to outbreaks traced back to the California growing region associated with the consumption of leafy greens in 2019 and 2018. FDA, alongside state and federal partners, investigated the outbreak to identify potential contributing factors that may have led to leafy green contamination with E. coli O157:H7. The E. coli O157:H7 outbreak strain was identified in a cattle faeces composite sample taken alongside a road approximately 1.3 miles upslope from a produce farm with multiple fields tied to the outbreaks by the traceback investigations. In addition, several potential contributing factors to the 2020 leafy greens outbreak were identified.

Isolates within this cluster of illnesses are part of a reoccurring strain of concern and are associated with outbreaks that have occurred in leafy greens each fall since 2017. The two most recent outbreaks associated with this strain were an outbreak in 2018 (linked to romaine lettuce from the Santa Maria growing region of California) and an outbreak in 2019 (linked to romaine lettuce from the Salinas growing region of California). Clinical isolates from cases in this 2020 outbreak appear more closely related to those from the 2019 outbreak than the 2018 outbreak. In addition, several specific food and environmental isolates that appear to be highly related to this 2020 outbreak include a faecal-soil composite sample collected by FDA in February 2020 from the Salinas growing region and two leafy green samples collected in 2019 by state partners as a part of the 2019 investigation that traced back to the Salinas growing region.

As part of this investigation, tracebacks of leafy greens consumed by ten ill individuals from eleven points of service were conducted. Although that traceback investigation was based on a relatively small number of the total cases, it was based on those cases which presented the strongest evidence via purchase card information, invoices, bills of lading, and electronic data. The traceback investigation identified the Salinas growing region of California as a geographical region of interest.

In light of this most recent finding, combined with previous outbreak investigation findings in the region, FDA has identified key trends regarding the issues of a reoccurring strain, a reoccurring region, and reoccurring issues around adjacent and nearby land use of primary importance in understanding the contamination of leafy greens by E. coli O157:H7 that occurred in 2020 and previous years.

FDA also recognizes the interconnection between people, animals, plants, and their shared environment when it comes to public health outcomes. As such, we strongly encourage collaboration among various groups in the broader agricultural community (i.e. livestock owners; leafy greens growers, state and federal government agencies, and academia) to address this issue. With this collaboration, the agricultural community, alongside academic and government partners, can work to identify and implement measures to prevent contamination of leafy greens. FDA recommends that these parties participate in efforts to understand and address the challenge of successful coexistence of various types of agricultural industries to ensure food safety and protect consumers against foodborne illnesses.

Download the Full Report (PDF 563KB)

Research – Prevalence and Epidemiology of Non-O157 Escherichia coli Serogroups O26, O103, O111, and O145 and Shiga Toxin Gene Carriage in Scottish Cattle, 2014–2015

ASM

ABSTRACT

Cattle are a reservoir for Shiga toxin-producing Escherichia coli (STEC), zoonotic pathogens that cause serious clinical disease. Scotland has a higher incidence of STEC infection in the human population than the European average. The aim of this study was to investigate the prevalence and epidemiology of non-O157 serogroups O26, O103, O111, and O145 and Shiga toxin gene carriage in Scottish cattle. Fecal samples (n = 2783) were collected from 110 herds in 2014 and 2015 and screened by real-time PCR. Herd-level prevalence (95% confidence interval [CI]) for O103, O26, and O145 was estimated as 0.71 (0.62, 0.79), 0.43 (0.34, 0.52), and 0.23 (0.16, 0.32), respectively. Only two herds were positive for O111. Shiga toxin prevalence was high in both herds and pats, particularly for stx2 (herd level: 0.99; 95% CI: 0.94, 1.0). O26 bacterial strains were isolated from 36 herds on culture. Fifteen herds yielded O26 stx-positive isolates that additionally harbored the intimin gene; six of these herds shed highly pathogenic stx2-positive strains. Multiple serogroups were detected in herds and pats, with only 25 herds negative for all serogroups. Despite overlap in detection, regional and seasonal effects were observed. Higher herd prevalence for O26, O103, and stx1 occurred in the South West, and this region was significant for stx2 at the pat level (P = 0.015). Significant seasonal variation was observed for O145 prevalence, with the highest prevalence in autumn (P = 0.032). Negative herds were associated with Central Scotland and winter. Herds positive for all serogroups were associated with autumn and larger herd size and were not housed at sampling.

IMPORTANCE Cattle are reservoirs for Shiga toxin-producing Escherichia coli (STEC), bacteria shed in animal feces. Humans are infected through consumption of contaminated food or water and by direct contact, resulting in serious disease and kidney failure in the most vulnerable. The contribution of non-O157 serogroups to STEC illness was underestimated for many years due to the lack of specific tests. Recently, non-O157 human cases have increased, with O26 STEC of particular note. It is therefore vital to investigate the level and composition of non-O157 in the cattle reservoir and to compare them historically and by the clinical situation. In this study, we found cattle prevalence high for toxin, as well as for O103 and O26 serogroups. Pathogenic O26 STEC were isolated from 14% of study herds, with toxin subtypes similar to those seen in Scottish clinical cases. This study highlights the current risk to public health from non-O157 STEC in Scottish cattle.

Research – Outbreak of Shiga toxin-producing Escherichia coli O157 linked with consumption of a fast-food product containing imported cucumbers, United Kingdom, August 2020

IJID Online

Background

In August 2020, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred in the United Kingdom. Whole genome sequencing revealed these cases formed a genetically distinct cluster.

Methods

Hypotheses generated from case interviews were tested in analytical studies, and results informed environmental sampling and food chain analysis. A case-case study used non-outbreak ‘comparison’ STEC cases; a case-control study used a market research panel to recruit controls.

Results

A total of 36 cases were identified; all cases reported symptom onset between 3rd and 16th August 2020. The majority of cases (83%) resided in the Midlands region of England or Wales. A high proportion of cases reported eating out, with one fast-food restaurant chain mentioned by 64% (n = 23) of cases. Both case-case (adjusted odds ratio (aOR) 31.8, 95% confidence interval (CI) 1.6 – 624.9) and case-control (aOR 9.19, 95% CI 1.0 – 82.8) studies provided statistically significant results that consumption of a specific fast-food product was independently associated with infection.

USA – JBS USA Food Company Recalls Imported Boneless Beef Products Due to Possible E. coli O157:H7 Contamination

USDA

JBS USA Food Company, a Greeley, Colo. firm and Importer of Record, is recalling approximately 4,860 pounds of imported boneless 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 raw, frozen, boneless beef products were imported on or around Nov. 10, 2020 and distributed for further processing. The following products are subject to recall [View Label (PDF Only)]:

  • 60-lb. cardboard boxes containing “95CL BONELESS BEEF PRODUCT OF AUSTRALIA” with “PACKED ON: 02-SEP-20” and Australian “EST. 4” on the packaging label.

The products were shipped to distributors and further processors in New York and Pennsylvania.

The problem was discovered when FSIS collected a routine product sample that confirmed positive for the presence of E. coli O157:H7. There have been no confirmed reports of adverse reactions due to consumption of these products.

Anyone concerned about an illness should contact a healthcare provider. E. coli O157:H7 is a potentially deadly bacterium that can cause dehydration, bloody diarrhea and abdominal cramps 2–8 days (3–4 days, on average) after exposure the organism. While most people recover within a week, some develop a type of kidney failure called hemolytic uremic syndrome (HUS). This condition can occur among persons of any age but is most common in children under 5-years old and older adults. It is marked by easy bruising, pallor, and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately.

FSIS is concerned that some product may be frozen and in cold storage at distributor or further processor locations. Distributors and further processors who received these products are urged not to utilize them.

FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers. When available, the retail distribution list(s) will be posted on the FSIS website at www.fsis.usda.gov/recalls.

FSIS advises all consumers to safely prepare their raw meat products, including fresh and frozen, and only consume whole cuts of beef that have been cooked to a temperature of 145 °F with a 3-minute rest time and ground beef to 160 °F. The only way to confirm that beef is cooked to a temperature high enough to kill harmful bacteria is to use a food thermometer that measures internal temperature, https://www.fsis.usda.gov/safetempchart.

Consumers with questions about the recall can contact Mr. Kim Holzner, Head of JBS Imports, at Kim.Holzner@jbssa.com. Members of the media with questions about the recall can contact Ms. Nikki Richardson, Director of Communications for JBS USA Food Company, at Nikki.Richardson@jbssa.com.

Research – An Overview of Traceback Investigations and Three Case Studies of Recent Outbreaks of Escherichia coli O157:H7 Infections Linked to Romaine Lettuce

Journal of Food Protection

Eurofins Food Testing UK

Leafy greens contaminated with Shiga toxin-producing Escherichia coli (STEC) have continued to cause foodborne illness outbreaks in recent years and present a threat to public health. An important component of foodborne illness outbreak investigations is determining the source of the outbreak vehicle through traceback investigations. The Food and Drug Administration is home to traceback investigation experts that employ a standardized process to initiate, execute, and interpret the results of traceback investigations in collaboration with the Centers for Disease Control and Prevention and state and local partners. Traceback investigations of three outbreaks of STEC infections linked to romaine lettuce in 2018 and 2019 were examined to demonstrate challenges, limitations, and opportunities for improvement. The three outbreaks resulted in a total of 474 illnesses, 215 hospitalizations, and five deaths. These illnesses were linked to the consumption of romaine lettuce from three distinct growing regions in Arizona and California. Some of the challenges encountered included the time it took to initiate a traceback, limited product-identifying information throughout the supply chain, lack of interoperability in record keeping systems, and co-mingling of product from multiple suppliers. These challenges led to time delays in the identification of the farm source of the leafy greens and the inability to identify the root cause of contamination. Implementation of technology enabled traceability systems, testing of these systems, and future regulations to incentivize adoption of traceability systems are some of the initiatives that will help address these challenges by improving traceback investigations and ultimately preventing foodborne illnesses and future outbreaks from occurring.

USA – FDA Releases Investigation Report Following Fall 2020 Outbreak of E. coli O157:H7 Illnesses Linked to Leafy Greens

FDA

As part of our ongoing efforts to combat foodborne illness, today the U.S. Food and Drug Administration published a report on the investigation into the Fall 2020 outbreak of Shiga Toxin-Producing E. coli (STEC) O157:H7 illnesses linked to the consumption of leafy greens grown in the California Central Coast. The report describes findings from the investigation, as well as trends that are key to understanding leafy green outbreaks that are linked to the California Central Coast growing region, specifically encompassing the Salinas Valley and Santa Maria growing areas every fall since 2017.

We released our preliminary findings earlier this year that noted this investigation found the outbreak strain in a sample of cattle feces collected on a roadside about a mile upslope from a produce farm. This finding drew our attention once again to the role that cattle grazing on agricultural lands near leafy greens fields could have on increasing the risk of produce contamination, where contamination could be spread by water, wind or other means. In fact, the findings of foodborne illness outbreak investigations since 2013 suggest that a likely contributing factor for contamination of leafy greens has been the proximity of cattle. Cattle have been repeatedly demonstrated to be a persistent source of pathogenic E. coli, including E. coli O157:H7.

Considering this, we recommend that all growers be aware of and consider adjacent land use practices, especially as it relates to the presence of livestock, and the interface between farmland, rangeland and other agricultural areas, and conduct appropriate risk assessments and implement risk mitigation strategies, where appropriate. Increasing awareness around adjacent land use is one of the specific goals of the Leafy Greens Action Plan we released last March, which we’re also announcing is being updated today to include new activities for 2021.

During our analysis of outbreaks that have occurred each fall since 2017, we have determined there are three key trends in the contamination of leafy greens by E. coli O157:H7 in recent years: a reoccurring strain, reoccurring region and reoccurring issues with activities on adjacent land. The 2020 E. coli O157:H7 outbreak associated with leafy greens represents the latest in a repeated series of outbreaks associated with leafy greens that originated in the Central Coast of California (encompassing Salinas Valley and Santa Maria) growing region.

In the investigation, the FDA recommends that growers of leafy greens in the California Central Coast Growing Region consider this reoccurring E. coli strain a reasonably foreseeable hazard, and specifically of concern in the South Monterey County area of the Salinas Valley. It is important to note that farms covered by the Food Safety Modernization Act (FSMA) Produce Safety Rule are required to implement science and risk-based preventive measures in the rule, which includes practices that prevent the introduction of known or reasonably foreseeable hazards into or onto produce.

The FDA also recommends that the agricultural community in the California Central Coast growing region work to identify where this reoccurring strain of pathogenic E. coli is persisting and the likely routes of leafy green contamination with STEC. Specifically, we have outlined specific recommendations in our investigation report for growers in the California Central Coast leafy greens region. Those recommendations include participation in the California Longitudinal Study and the California Agricultural Neighbors workgroup. When pathogens are identified through microbiological surveys, pre-harvest or post-harvest testing, we recommend growers implement industry-led root cause analyses to determine how the contamination likely occurred and then implement appropriate prevention and verification measures.

We issued the Leafy Green Action Plan last year to foster a more urgent and collaborative approach to preventing leafy greens outbreaks caused by STEC. We have updated our plan for 2021 to include a renewed emphasis on actions to help prevent contamination from adjacent land, to include new actions that build on the accomplishments and learnings from the 2020 plan, and to renew our commitment to actions that were difficult to accomplish in 2020 due to challenges presented by the COVID-19 pandemic.

The FDA has made significant progress on our Leafy Greens Action Plan this year by enhancing prevention strategies, improving response activities by the agency and other entities, and identifying and addressing the knowledge gaps that exist around STEC contamination of leafy greens. We launched the California Longitudinal Study, developed an efficacy protocol for the development and registration of antimicrobial treatments for pre-harvest agricultural water and took critical steps to advance traceability of leafy greens. We have also conducted several focused inspections, follow-up investigations and sampling assignments.

Although the FDA is keenly focused on taking steps to help mitigate recurring leafy green contamination events, we alone cannot fix this issue. Industry leadership and collaboration among growers, processors, retailers, state partners and the broader agricultural community is critical to reducing foodborne illnesses. At the FDA, the safety of leafy greens remains a top priority, and we are committed to working with all stakeholders to address this significant public health issue and further protect consumers.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Canada -CBC – B.C. boy permanently brain damaged after eating lettuce contaminated with E. coli – STEC

CBC

E. coli outbreaks used to mainly be linked to hamburgers, but the last decade has seen recall after recall of tainted romaine lettuce coming into Canada from the United States. At least seven people have died, and hundreds have been sickened or hospitalized in both countries.

Toddler Lucas Parker was one of them.

In the fall of 2018, his parents, Nathan Parker and Karla Terry of Richmond, B.C., took Lucas and his siblings to Disneyland, their first trip outside Canada. But what they couldn’t know at the time was that a few bites of romaine salad Lucas ate one night at a small California roadside restaurant would change their lives forever.

Soon after that dinner, an outbreak of E. coli O157: H7 contamination spread across both Canada and the United States — eventually leaving 35 people hospitalized.

Like most people who get sick from this strain of E. coli, Lucas, then two years old, didn’t show symptoms right away. When he started feeling unwell, the family headed out for the long drive home. By the time he was in a Canadian hospital, the E. coli had shut down one of his kidneys and led to two brain injuries. There are no current treatments for E. coli that can help alleviate infections or prevent complications.

Lucas can no longer walk, talk or see.