E. Coli Outbreaks Becoming More Common in US

Last year, officials at EMMPAK Foods, Inc. voluntarily recalled almost 3 million pounds of fresh and frozen ground beef products after the US Department of Agriculture’s Food Safety and Inspection Service (FSIS) found traces of E. coli O157:H7 in the meat. The meat packing company, doing business under the name of Peck Meats in Milwaukee, began the recall after public health officials found a possible association between an E. coli outbreak in Minnesota and meat from EMMPAK.

The company first recalled about 400,000 pounds of ground beef products that had been distributed to retail markets in Wisconsin, Illinois, Michigan and Minnesota and to restaurants, hotels and other food service customers nationwide. Subsequently, the recall was expanded to encompass approximately 2.8 million pounds of ground beef products, following a review of plant practices and company records by the FSIS. The investigation indicated that the additional products might be contaminated with E. coli O157:H7. As many as 56 people are reported to have fallen ill from eating the contaminated meat.

What is E. coli O157:H7?
E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless and live in the intestines of healthy humans and animals, this particular strain can make us sick. E. coli O157:H7 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, most infections have come from eating undercooked ground beef.

According to the CDC, an estimated 73,000 cases of E. coli infection and 61 deaths occur in the United States each year and most of the cases have been associated with eating undercooked, contaminated ground beef.

Symptoms
Dr. Mohammad Almoujahed is an Assistant Professor of Medicine in the Medical College of Wisconsin’s Division of Infectious Diseases. Dr. Almoujahed told HealthLink that symptoms of illness from E. coli can include bloody and non-bloody diarrhea, vomiting and abdominal cramps. The symptoms usually start 3-8 days after consuming the contaminated food, and illness usually resolves within 1-12 days.

A small group of patients (2% to 7%), particularly the young and the elderly, will develop kidney and blood disease or what is known as hemolytic uremic syndrome (HUS), which can be fatal. “Because of the potential fatal consequences,” says Dr. Almoujahed, “any E. coli food contamination needs to be taken very seriously.” People who experience sudden bouts of diarrhea, especially if it contains blood, should be tested for E. coli O157:H7. Your health care provider will test a stool sample for the bacterium.

Precautions
Meat can become contaminated during slaughter and bacterial organisms can be thoroughly mixed into beef when it is ground. Preventive measures on cattle farms and during meat processing are currently being investigated, but until E. coli can be eliminated from meat processing systems, Dr. Almoujahed says that consumers should protect themselves by using safe food practices. He offers sound advice for those who eat ground beef:

• Frozen ground beef should be thawed in the refrigerator rather than at room temperature.
• While thawing and preparing ground beef, keep raw meat separate from ready-to-eat foods.
• It is important to remember that contaminated meat looks and smells normal. All ground beef should be cooked thoroughly to internal temperatures of at least 160 degrees F. Use a thermometer, because color is not a reliable indicator that ground beef has been cooked to a temperature high enough to kill harmful bacteria such as E. coli O157:H7.
• Use soap and hot water to wash hands, utensils, and other surfaces that might have come into contact with raw or undercooked ground beef.

Simply avoiding ground beef might not keep the E. coli organism at bay. “In addition to beef as a possible source for E. coli infection,” warns Dr. Almoujahed, “other foods including lettuce, apple cider, alfalfa sprouts, venison and salami have occasionally been contaminated.” To that end, the US Centers for Disease Control and Prevention (CDC) suggests that only pasteurized milk, juice and cider be consumed. Fruits and vegetables must be washed thoroughly, especially those that will not be cooked.

Children under 5 years of age, immune-compromised persons and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated. Venison and salami will most likely come under any new meat processing guidelines.

The CDC also reminds the public to 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 or preparing food for others.

Treatment
As is the case in any diarrheal illness, sufficient fluids need to be consumed to avoid dehydration. “Antimicrobials are not indicated in the treatment, as recent research has shown worse outcome when they are used for this infection,” reports Dr. Almoujahed. Fortunately, most people who become ill from a food-borne illness recover within a few days. But Dr. Almoujahed advocates keeping a vigilant watch over those who do not recover quickly. “Patients need to be evaluated expectantly for the development of hemolytic uremic syndrome, which often requires blood transfusion, renal dialysis and prolonged intensive care.”

Infection with the E. coli bacterium can be very unpleasant, but in most people the illness won't last for more than a few days. The key factor in avoiding illness comes in the preparation stages. Wash food thoroughly and repeatedly, keep raw meat separate from other foods and cook meat thoroughly. By taking the proper precautions against food-borne illness caused by E. coli, you can enjoy the healthful foods available to you in stores and restaurants.

P.J. Early
HealthLink Contributing Writer

This story includes information from:
The US Centers for Disease Control and Prevention (CDC)
Food Safety and Inspection Service (FSIS), United States Department of Agriculture

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.