Category Archives: HUS

Research – The serious and long-term effects of foodborne illness

MSU

Campylobacter kswfoodworld

Many people think if they eat something “bad” they might spend some uncomfortable time in the restroom then go on with their lives in a day or two. Actually, foodborne illness can lead to chronic disease, permanent disability and even death. Here are some of the lesser-known facts about the long term effects of food borne pathogens.

Reactive arthritis, a type of joint inflammation that affects the knees, ankles or feet can develop after being exposed to Campylobacter jejuni  or Salmonella. Reactive arthritis usually lasts fewer than 6 months, but this condition may recur or become chronic arthritis. Campylobacter is found in raw and undercooked poultry, unpasteurized milk and contaminated water. Salmonella is also found in eggs, undercooked meat and poultry, and can be transferred to other foods through feces. Campylobacter infection afflicts millions of Americans annually and hospitalizes more than 10,000. Campylobacter is associated with Guillain-Barré syndrome (GBS). GBS patients can become permanently disabled and paralyzed; many require hospital care. Campylobacter also can trigger arthritis, heart infections and blood infections.

Foodborne illnesses caused by bacteria also increase the risk of developing irritable bowel syndrome (IBS). IBS is a disorder of unknown cause that is associated with abdominal pain, bloating, and diarrhea or constipation or both. There is no cure for IBS.

Children are the most likely to be infected and have the most serious complications from E. coli O157:H7. They can develop hemolytic uremic syndrome (HUS), HUS can lead to death, or in some cases t long-term or permanent health problems, including end-stage kidney disease, neurological complications, and insulin-dependent diabetes. Adults who had recovered from E. coli O157:H7 infections had increased risks of high blood pressure, kidney problems and cardiovascular disease. E. Coli is found in undercooked ground beef, unpasteurized (raw) milk and juice, soft cheeses made from raw milk, and raw fruits and vegetables (such as sprouts). It can also be found in contaminated water and feces of infected people.

Listeria monocytogenes infects thousands of Americans every year and has been associated with infections of the brain and spinal cord, resulting in serious neurological dysfunctions or death. Most reported cases occur in children under the age of 4, and about 1 in 5 people afflicted die as a result of the infection. In pregnant women, listeriosis can cause miscarriage, premature birth or stillbirth.

Listeriosis survivors often are left with serious neurological dysfunctions, including seizures, paralysis and impaired ability to see, hear, swallow or speak. Severe cases often result in partial to total impairment and can require life-long residential care with no possibility of work. Listeria is found in ready-to-eat deli meats and hot dogs, refrigerated pâtés or meat spreads, unpasteurized (raw) milk and dairy products, soft cheese made with unpasteurized milk, such as queso fresco, feta, brie, camembert, refrigerated smoked seafood and raw sprouts.

The long-term effects of foodborne disease are still not fully understood. New findings unfold as research is performed, but until then, taking foodborne illness seriously can go a long way in protecting health. This is another instance where prevention truly is the best medicine.

Research – Shiga Toxin–Associated Hemolytic Uremic Syndrome in Adults, France, 2009–2017

CDC

We conducted a retrospective study on hemolytic uremic syndrome caused by Shiga toxin–producing Escherichia coli (STEC) in 96 adults enrolled in the cohort of the National Reference Center for Thrombotic Microangiopathies network in France during 2009–2017. Most infections were caused by STEC strains not belonging to the O157 or O104 serogroups. Thirty (31.3%) patients had multiple risk factors for thrombotic microangiopathy. In total, 61 (63.5%) patients required dialysis, 50 (52.1%) had a serious neurologic complication, 34 (35.4%) required mechanical ventilation, and 19 (19.8%) died during hospitalization. We used multivariate analysis to determine that the greatest risk factors for death were underlying immunodeficiency (hazard ratio 3.54) and severe neurologic events (hazard ratio 3.40). According to multivariate analysis and propensity score-matching, eculizumab treatment was not associated with survival. We found that underlying conditions, especially immunodeficiency, are strongly associated with decreased survival in adults who have hemolytic uremic syndrome caused by STEC.

USA – Maquoketa Iowa children stricken by E. coli – some with HUS

Food Poison Journal

MAQUOKETA, Iowa — Several Maquoketa children are receiving care at University of Iowa Stead Family Children’s Hospital in Iowa City after developing serious complications from E. coli.

But local health officials have not yet identified the source.

Multiple Maquoketa children developed hemolytic uremic syndrome, prompting the treatment in Iowa City. HUS is a serious complication that can be caused by shiga toxin-producing E. coli, also known as STEC.

The Jackson County Health Department, through Genesis VNA, is working to determine what might have caused the outbreak. Community Health Manager Michele Cullen said Monday that this process involves contact tracing, but a source has not yet been identified.

USA – E. coli Outbreak likely linked to fresh produce expands to Benton, King, Snohomish and Walla Walla counties – As many as 11 sickened, some with acute kidney failure

Food Poison Journal

The Washington State Department of Health (DOH) is working with local health jurisdictions to respond to a multi-county outbreak of E. coli O157:H7 that may be linked to fresh produce.

The outbreak currently includes six confirmed cases across Benton County (1), King County (3), Snohomish County (1) and Walla Walla County (1). DOH is only reporting confirmed cases infected with bacteria that have been genetically linked, but local health officials may report higher numbers for their counties that include cases still under investigation.

There is one case in the outbreak between ages 0-9, two cases age 10-19, one case age 20-29, one age 30-39, and one case age 70-79. Three cases have been hospitalized and one case developed hemolytic uremic syndrome (HUS). HUS is a serious complication of E. coli O157:H7 infection that can damage the kidneys and other organs. The earliest case in the outbreak started having symptoms March 9, and the most recent case had symptoms starting April 21.

USA – New E. coli outbreak hits children; investigation ongoing with no source yet

Food Safety News

ecoli

At least seven children are sick with E. Coli infections in a new outbreak involving an unknown source. All of the sick children are younger than 14, with three of them younger than five years old, according to an outbreak announcement by King County, WA, health officials.

“Our investigation is ongoing, and we have not identified any foods, restaurants, or other sources in common among all cases. It is not yet known whether these cases share the same source or not,” officials reported in the announcement.

The children became ill between April 22 and May 1. Six of the seven children have been so sick they had to be admitted to hospitals. One of the sick children is confirmed as having developed a life-threatening kidney complication called hemolytic uremic syndrome (HUS) and is recovering. A second child is suspected to have HUS.

hus

USA – Researchers describe outbreaks in Brazil, Pakistan and Malaysia

Food Safety News

Abstracts from a cancelled event have been issued on outbreaks in Brazil, Pakistan and Malaysia.

The conference abstracts were scheduled to be presented at the International Congress on Infectious Diseases in September 2020 in Kuala Lumpur, Malaysia, but the gathering was called off because of the coronavirus pandemic.

Studies in the International Journal of Infectious Diseases supplement involve E. coli O157, Staphylococcus aureus and Brucella.

The first study involves a deadly Shiga toxin-producing E. coli (STEC) O157:H7 outbreak with hemolytic uremic syndrome (HUS) cases in Brazil.

Research – Escherichia coli in flour – sources, risks and prevention

Click to access escherichia-coli-in-flour-sources-risks-and-prevention.pdf

UK – Investigation – STEC E.coli O157- 2017 Frozen Beef Burgers

Cambridge Press

In November 2017, Public Health England identified an outbreak of Shiga toxin-producing Escherichia coli O157:H7 in England where whole genome sequencing results indicated cases were likely to be linked to a common source, and began investigations.

Hypothesis generation included a review of enhanced surveillance data, a case-case study and trawling interviews. The hypothesis of interest was tested through the administration of focussed questionnaires and review of shopping history using loyalty card data. Twelve outbreak cases were detected, eight were hospitalised and four developed haemolytic uraemic syndrome. Frozen beef burgers supplied by a national retailer were identified as the vehicle of the outbreak. Testing of two left-over burger samples obtained from the freezers of two separate (unlinked) cases and a retained sample from the production premises were tested and found to be positive for the outbreak strain. A voluntary recall of the burgers was implemented by the retailer. Investigations at the production premises identified no contraventions of food safety legislation. Cooking guidance on the product packaging was deemed to be adequate and interviews with the cases/carers who prepared the burgers revealed no deficiencies in cooking practices at home. Given the long-shelf life of frozen burgers, the product recall likely prevented more cases.

USA – Marler Clark, The Nation’s Food Safety Law Firm, relaunches www.about-listeria.com – www.about-HUS.com – www.about-ecoli.com

Food Poison Journal

With another Listeria outbreak just announced, this one sickening 10 with 1 dead likely linked to deli meat , Marler Clark, The Nation’s Food Safety Law Firm, relaunches www.about-listeria.com.

Food Poison Journal

In the beginning of yet another – in fact two E. coli Outbreaks that have sickened dozens, Marler Clark, The Nation’s Food Safety Law Firm, relaunches www.about-hus.com.

Food Poison Journal

In the beginning of yet another – in fact two E. coli Outbreaks that have sickened dozens, Marler Clark, The Nation’s Food Safety Law Firm, relaunches www.about-ecoli.com.

Research – Lessons Learned from a Decade of Investigations of Shiga Toxin–Producing Escherichia coli Outbreaks Linked to Leafy Greens, United States and Canada

CDC

Abstract

Shiga toxin–producing Escherichia coli (STEC) cause substantial and costly illnesses. Leafy greens are the second most common source of foodborne STEC O157 outbreaks. We examined STEC outbreaks linked to leafy greens during 2009–2018 in the United States and Canada. We identified 40 outbreaks, 1,212 illnesses, 77 cases of hemolytic uremic syndrome, and 8 deaths. More outbreaks were linked to romaine lettuce (54%) than to any other type of leafy green. More outbreaks occurred in the fall (45%) and spring (28%) than in other seasons. Barriers in epidemiologic and traceback investigations complicated identification of the ultimate outbreak source. Research on the seasonality of leafy green outbreaks and vulnerability to STEC contamination and bacterial survival dynamics by leafy green type are warranted. Improvements in traceability of leafy greens are also needed. Federal and state health partners, researchers, the leafy green industry, and retailers can work together on interventions to reduce STEC contamination.