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E. coli Outbreak Canada, US, and Organic Food

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                                                                                 INTRODUCTION


Recently, there is a lot of attention being placed on Ecoli 0157 outbreak. So let us learn more about E. coli 0157 and get updates on what is going on.


                                                               E. COLI


What is E. coli?

“Escherichia coli (E. coli) is a bacterium that is commonly found in the gut of humans and warm-blooded animals. Most strains of E. coli are harmless. Some strains however, such as Shiga toxin-producing E. coli (STEC), can cause severe foodborne disease. It is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat products, raw milk, and contaminated raw vegetables and sprouts.

STEC produces toxins, known as Shiga-toxins because of their similarity to the toxins produced by Shigella dysenteriae. STEC can grow in temperatures ranging from 7 °C to 50 °C, with an optimum temperature of 37 °C. Some STEC can grow in acidic foods, down to a pH of 4.4, and in foods with a minimum water activity (aW) of 0.95.

STEC is destroyed by thorough cooking of foods until all parts reach a temperature of 70 °C or higher. E. coli O157:H7 is the most important STEC serotype in relation to public health; however, other serotypes have frequently been involved in sporadic cases and outbreaks.”[1]


What are the symptoms of E. coli?

“Symptoms of the diseases caused by STEC include abdominal cramps and diarrhoea that may in some cases progress to bloody diarrhoea (haemorrhagic colitis). Fever and vomiting may also occur. The incubation period can range from 3 to 8 days, with a median of 3 to 4 days. Most patients recover within 10 days, but in a small proportion of patients (particularly young children and the elderly), the infection may lead to a life-threatening disease, such as haemolytic uraemic syndrome (HUS). HUS is characterized by acute renal failure, haemolytic anaemia and thrombocytopenia (low blood platelets).

It is estimated that up to 10% of patients with STEC infection may develop HUS, with a case-fatality rate ranging from 3 to 5%. Overall, HUS is the most common cause of acute renal failure in young children. It can cause neurological complications (such as seizure, stroke and coma) in 25% of HUS patients and chronic renal sequelae, usually mild, in around 50% of survivors.

Persons who experience bloody diarrhoea or severe abdominal cramps should seek medical care. Antibiotics are not part of the treatment of patients with STEC disease and may possibly increase the risk of subsequent HUS.”[2]

Other symptoms are:

*  "gas

*  loss of appetite or nausea

*  vomiting (uncommon)

*  fatigue

*  fever

Symptoms can last anywhere from a few days to more than a week.

Symptoms of a severe E. coli infection may include:

*  bloody urine

*  decreased urine output

*  pale skin

*  bruising

*  dehydration”[3]


                                             VITAMINS, JOINT PAIN RELIEF, ETC.



How can you be infected with E. coli?

“Most available information on STEC relates to serotype O157:H7, since it is easily differentiated biochemically from other E. coli strains. The reservoir of this pathogen appears to be mainly cattle. In addition, other ruminants such as sheep, goats, deer are considered significant reservoirs, while other mammals (such as pigs, horses, rabbits, dogs, and cats) and birds (such as chickens and turkeys) have been found infected.

E. coli O157:H7 is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat products and raw milk. Faecal contamination of water and other foods, as well as cross-contamination during food preparation (with beef and other meat products, contaminated surfaces and kitchen utensils), will also lead to infection. Examples of foods implicated in outbreaks of E. coli O157:H7 include undercooked hamburgers, dried cured salami, unpasteurized fresh-pressed apple cider, yogurt, and cheese made from raw milk.

An increasing number of outbreaks are associated with the consumption of fruits and vegetables (including sprouts, spinach, lettuce, coleslaw, and salad) whereby contamination may be due to contact with faeces from domestic or wild animals at some stage during cultivation or handling. STEC has also been isolated from bodies of water (such as ponds and streams), wells and water troughs, and has been found to survive for months in manure and water-trough sediments. Waterborne transmission has been reported, both from contaminated drinking-water and from recreational waters.

Person-to-person contact is an important mode of transmission through the oral-faecal route. An asymptomatic carrier state has been reported, where individuals show no clinical signs of disease but are capable of infecting others. The duration of excretion of STEC is about 1 week or less in adults, but can be longer in children. Visiting farms and other venues where the general public might come into direct contact with farm animals has also been identified as an important risk factor for STEC infection.”[4]


Other ways you may be infected with “bad” E. coli are:

  • “failing to wash hands completely before preparing or eating food
  • using utensils, cutting boards, or serving dishes that aren’t clean, causing cross-contamination
  • consuming dairy products or food containing mayonnaise that have been left out too long
  • consuming foods that haven’t been stored at the right temperature
  • consuming foods that aren’t cooked to the right temperature or duration of time, especially meats and poultry
  • consuming raw seafood products
  • drinking unpasteurized milk

*  consuming raw produce that hasn’t been properly washed” [5]

*  consuming processed food such as poultry and meat that got the E. coli bacteria from the animals’ intestines

*  drinking or swimming in water contaminated by human waste

*  coming into contact with someone who did not wash their hands properly after having a bowel movement

*  working with animals such as cows, goats and sheep and not washing your hands properly

Circumstances for higher risks of E. coli infection are:


*  “Age

Older adults and young children are more likely to experience serious complications

from E. coli.


*  A weakened immune system

People with weakened immune systems are more susceptible to E. coli infections.


*  Season

E. coli infections are more likely to occur during the summer months, June to

September, for unknown reasons.


*  Low stomach acid levels

Medications used to decrease stomach acid levels can increase your risk of E.

coli infection.


*  Certain foods

Drinking unpasteurized milk or juices and eating undercooked meat can increase your

risk of E. coli.”[6]


How can you prevent yourself from being infected with “bad” E. coli?

“The prevention of infection requires control measures at all stages of the food chain, from agricultural production on the farm to processing, manufacturing and preparation of foods in both commercial establishments and household kitchens.


Industry

The number of cases of disease might be reduced by various mitigation strategies for ground beef (for example, screening the animals pre-slaughter to reduce the introduction of large numbers of pathogens in the slaughtering environment). Good hygienic slaughtering practices reduce contamination of carcasses by faeces, but do not guarantee the absence of STEC from products.

Education in hygienic handling of foods for workers at farms, abattoirs and those involved in the food production is essential to keep microbiological contamination to a minimum. The only effective method of eliminating STEC from foods is to introduce a bactericidal treatment, such as heating (for example, cooking or pasteurization) or irradiation.


Household

Preventive measures for E. coli O157:H7 infection are similar to those recommended for other foodborne diseases. Basic good food hygiene practice, as described in the WHO “Five keys to safer food”, can prevent the transmission of pathogens responsible for many foodborne diseases, and also protect against foodborne diseases caused by STEC.

The five keys to safer food are:

  • Keep clean.
  • Separate raw and cooked.
  • Cook thoroughly.
  • Keep food at safe temperatures.
  • Use safe water and raw materials.

You may download the Five Keys to Safer Food Manual HERE

Such recommendations should in all cases be implemented, especially "cook thoroughly" so that the centre of the food reaches at least 70 °C. Make sure to wash fruits and vegetables carefully, especially if they are eaten raw. If possible, vegetables and fruits should be peeled. Vulnerable populations (such as small children and the elderly) should avoid the consumption of raw or undercooked meat products, raw milk, and products made from raw milk.

Regular hand washing, particularly before food preparation or consumption and after toilet contact, is highly recommended, especially for people who take care of small children, the elderly or immunocompromised individuals, as the bacterium can be passed from person to person, as well as through food, water and direct contact with animals.

A number of STEC infections have been caused by contact with recreational water. Therefore, it is also important to protect such water areas, as well as drinking-water sources, from animal waste (4).


Producers of fruits and vegetables

WHO’s "Five keys to growing safer fruits and vegetables" provides rural workers who grow fresh fruits and vegetables for themselves, their families and for sale in local markets, with key practices to prevent microbial contamination of fresh produces during planting, growing, harvesting and storing.

The five keys to growing safer fruits and vegetables are:

  • Practice good personal hygiene.
  • Protect fields from animal faecal contamination.
  • Use treated faecal waste.
  • Evaluate and manage risks from irrigation water.
  • Keep harvest and storage equipment clean and dry.”[7]

You may download Five Keys to Growing Safer Fruits and Vegetables HERE

Other ways to prevent E. coli infections are:

*  “washing fruits and vegetables thoroughly

*  avoiding cross-contamination by using clean utensils, pans, and serving platters

*  keeping raw meats away from other foods and away from other clean items

*  not defrosting meat on the counter

*  always defrosting meat in the refrigerator or microwave

*  refrigerating leftovers immediately

* drinking only pasteurized milk products (avoiding raw milk)

* not preparing food if you have diarrhea

You can use a meat thermometer to check that meat is cooked to these temperatures:


poultry: 165˚F (74˚C)

ground meat, eggs: 160˚F (71˚C)

steaks, pork chops, roasts, fish, shellfish: 145˚F (63˚C)


One of the easiest things you can do to prevent an E. coli infection is to regularly wash your hands. You should wash your hands before handling, serving, or eating food, and especially after touching animals, working in animal environments, or using the bathroom. Practicing good hygiene and following food safety guidelines can go a long way to decreasing your risk of infection.”[8]


How are E. coli infections treated?

“Are antibiotics safe for treating an E. coli infection?

Treatment for an E. coli intestinal infection involves resting and drinking a lot of water to replenish fluids lost from diarrhea and vomiting.

Antibiotics aren't recommended because they can triple your risk of developing hemolytic uremic syndrome (HUS), a disease in which Shiga toxin destroys red blood cells and platelets (which assist in blood clotting), eventually causing kidney failure, according to a 2012 article in the journal Toxins.

Antimotility (antidiarrheal) medications may also increase your risk of developing HUS, according to a 2011 article in the journal Clinical Infectious Diseases.

However, antibiotics and antimotility agents may be useful for other types of E. coli, such as enterotoxigenic E. coli, which causes traveler's diarrhea.

In the absence of severe symptoms, such as bloody diarrhea or intense abdominal pain, some doctors believe it's acceptable to use antimotility medication.


Treating Hemolytic Uremic Syndrome (HUS)

About 5 to 15 percent of STEC infections lead to the life-threatening syndrome HUS, which is more common among young children, the elderly, and people with weakened immune systems, the Toxins article notes.

Left untreated, HUS can cause numerous skin symptoms, such as bruising, petechia (red or purple spots on the skin), pale skin, and jaundice. Other signs of HUS include decreased urination and, sometimes, seizures.

HUS requires prompt medical treatment. This may include:

  • IV fluid and electrolyte replacement
  • Red blood cell transfusion
  • Platelet transfusion (to help the blood clot normally)
  • Kidney dialysis to temporarily take over your kidney's job of filtering waste and extra fluid from the body

If your kidneys become permanently damaged, you may need to switch to a low-protein diet and take medications such as angiotensin-converting enzyme (ACE) inhibitors, which lower your blood pressure to help prevent further kidney damage.

You may also need long-term dialysis or a kidney transplant.


Treating Urinary Tract Infections

Some strains of E. coli are a normal part of microbial communities in your gut, but can cause a uninary tract infection (UTI) if they make their way into your urinary system.

Doctors typically treat UTIs with a wide range of different antibiotics, such as ciprofloxacin (Cipro) and trimethoprim-sulfamethoxazole (Bactrim).

However, some strains of E. coli, called extended-spectrum beta-lactamase (ESBL) E. coli, are resistant to most antibiotic treatments.

There are now only a few classes of oral antibiotics that remain effective at treating UTIs from ESBL E. coli, such as fosfomycin (Monural) and nitrofurantoin (Macrobid).”[9]

“When you start to feel better, stick to low-fiber foods at first such as:

  • Crackers
  • Toast
  • Eggs
  • Rice

Dairy products and foods that are high in fat or fiber can make your symptoms worse.”[10]


                                             VITAMINS, JOINT PAIN RELIEF, ETC.



SO WHAT IS BEING DONE ABOUT THE RECENT E. coli 0157 INFECTION?


                                                        IN CANADA


                                             The Government of Canada


“The Government of Canada's food safety partners (Canadian Food Inspection Agency [CFIA], Public Health Agency of Canada [PHAC], Health Canada [HC]) are aware of the new information shared by the United States Food and Drug Administration (U.S. FDA) and the United States Centers for Disease Control and Prevention (CDC) with respect to their investigation into the current outbreak of E. coli O157.

As per the USFDA's statement, preliminary trace back information points to romaine lettuce harvested in parts of California during the month of November 2018 as the potential source of the outbreak of E. coli O157 that has resulted in illnesses on both sides of the border.

Food safety is a top priority for the Government of Canada.

The Government of Canada, working in collaboration with industry, is taking the following immediate actions in order to give Canadians confidence that the produce they buy remains safe:

  • The CFIA is advising the food industry, including importers, not to import romaine lettuce from the suspect areas identified in the U.S. FDA's investigation, until further notice.
  • The CFIA will implement additional control measures to verify that products from the areas identified in the U.S. FDA's investigation are not being admitted to Canada. This includes, for example, greater scrutiny of product destined for Canada.

Working with PHAC and HC, the CFIA also continues its food safety investigation into the current outbreak of E. coli O157 illnesses associated with the consumption of romaine lettuce. Information on the Canadian trace back activities is shared with the investigation's partners in both Canada and the United States and aids American authorities with more data to inform their follow up activities.

In addition, the CFIA continues sampling of all produce through its ongoing microbiological surveillance programs for imported fresh vegetables and salads. Samples from these programs are analyzed for pathogens, including E. coli O157. Romaine lettuce and pre-packaged salads containing romaine lettuce are included within this surveillance program.

The Government of Canada is committed to keeping Canadians informed as more information becomes available.”[11]


                                    The Public Health Agency of Canada


“The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency, Health Canada, as well as the United States Centers for Disease Control and Prevention (U.S. CDC) and the United States Food and Drug Administration (U.S. FDA), to investigate an outbreak of E. coli infections in Ontario, Quebec, New Brunswick, and several U.S. states.

In Canada, based on the investigation findings to date, exposure to romaine lettuce has been identified as a source of the outbreak, but the cause of contamination has not been identified. Laboratory analysis indicates that the illnesses reported in this outbreak are genetically related to illnesses reported in a previous E. coli outbreak from December 2017 that affected consumers in both Canada and the U.S. This tells us that the same strain of E. coli is causing illness in Canada and the US as was seen in 2017 and it suggests there may be a reoccurring source of contamination. Investigators are using evidence collected in both outbreaks to help identify the possible cause of the contamination in these events.

The current outbreak appears to be ongoing as illnesses linked to romaine lettuce continue to be reported. These recent illnesses indicate that contaminated romaine lettuce may still be on the market, including in restaurants, grocery stores and any establishments that serve food. At this time, the investigation evidence in Ontario, Quebec, and New Brunswick suggests that there is a risk of E. coli infections associated with eating romaine lettuce.

As the risk is ongoing, the Public Health Agency of Canada is advising individuals in Ontario, Quebec, and New Brunswick to avoid eating romaine lettuce and salad mixes containing romaine lettuce until more is known about the outbreak and the cause of contamination. Residents in impacted provinces are also advised to discard any romaine lettuce in their home, and to properly wash and sanitize any containers or bins that have come in contact with romaine lettuce.

Currently, there is no evidence to suggest that residents in other parts of Canada are affected by this outbreak. The U.S. CDC has also issued communications with similar advice for U.S individuals. The outbreak investigation is ongoing, and this public health notice will be updated as the Canadian investigation evolves.


How does lettuce become contaminated with E. coli

E. coli are bacteria that live naturally in the intestines of cattle, poultry and other animals. A common source of E. coli illness is raw fruits and vegetables that have come in contact with feces from infected animals. Leafy greens, such as lettuce, can become contaminated in the field by soil, water, animals or improperly composted manure. Lettuce can also be contaminated by bacteria during and after harvest from handling, storing and transporting the produce. Contamination in lettuce is also possible at the grocery store, in the refrigerator, or from counters and cutting boards through cross-contamination with harmful bacteria from raw meat, poultry or seafood. Most E. coli strains are harmless to humans, but some varieties cause illness.


Investigation summary

In Canada, as of November 23, 2018, there have been 22 confirmed cases of E. coli illness investigated in Ontario (4), Quebec (17), and New Brunswick (1). Individuals became sick between mid-October and early November 2018. Eight individuals have been hospitalized, and one individual suffered from hemolytic-uremic syndrome (HUS), which is a severe complication that can result from an E. coli infection. No deaths have been reported. Individuals who became ill are between 5 and 93 years of age. The cases are evenly distributed among male and female individuals.

Most of the individuals who became sick reported eating romaine lettuce before their illnesses occurred. Individuals reported eating romaine lettuce at home, as well as in prepared salads purchased at grocery stores, or from menu items ordered at restaurants and fast food chains.

The Canadian Food Inspection Agency (CFIA) is working with public health officials and the U.S. FDA to determine the source of the romaine lettuce that ill individuals were exposed to. As part of the food safety investigation, romaine lettuce is being sampled and tested. To date, all products that have been tested have been negative for E. coli. As no contaminated product has been found in the marketplace and the source of the contamination has not been identified, there have been no product recalls in Canada or the U.S associated with this outbreak. If a specific brand or source of romaine lettuce is identified in Canada the CFIA will take the necessary steps to protect the public, including recalling the product as required.”[12]

https://www.canada.ca/content/dam/phac-aspc/images/services/public-health-notices/2018/outbreak-salmonella-infections-under-investigation/2018-299%20epicurve%20eng%202018-11-23-1213.png

                                                       Figure 1: Number of people infected with E. coli O157

                                                             SOURCE: Public Health Agency of Canada

Table 1 - Number of people confirmed to be infected with E. coli O157 by week of illness onset or specimen collection
Week of symptom onset or specimen collection Number of cases
2018-10-07 0
2018-10-14 4
2018-10-21 9
2018-10-28 8
2018-11-04 1
2018-11-11 0

                                                           SOURCE: Public Health Agency of Canada

                                                            IN THE UNITED STATES OF AMERICA (USA)


                                                             The U.S. Food and Drug Administration (FDA)


“The FDA, along with CDC, state and local agencies, is investigating a multistate outbreak of E. coli O157:H7 illnesses likely linked to romaine lettuce grown in California this fall. The Public Health Agency of Canada (PHAC) and Canadian Food Inspection Agency are also coordinating with U.S. agencies as they investigate a similar outbreak in Canada.

The FDA has been conducting a traceback investigation, reviewing shipping records and invoices to trace the supply of romaine from the place where ill people were exposed to the place where that romaine was grown.

Preliminary traceback information indicates that ill people in several areas across the country were exposed to romaine lettuce harvested in California. Specifically, current evidence indicates this romaine was harvested in the Central Coast growing regions of northern and central California.

Romaine harvested from locations outside of the California regions identified by the traceback investigation does not appear to be related to the current outbreak.

There is no recommendation for consumers or retailers to avoid using romaine lettuce that is certain to have been harvested from areas outside of the Central Coast growing regions of northern and central California. For example, romaine lettuce harvested from areas that include, but are not limited to the desert growing region near Yuma, the California desert growing region near Imperial County and Riverside County, the state of Florida, and Mexico, does not appear to be related to the current outbreak. Additionally, there is no evidence hydroponically- and greenhouse-grown romaine is related to the current outbreak.

During this new stage of the investigation, it is vital that consumers and retailers have an easy way to identify romaine lettuce by both harvest date and harvest location. Labeling with this information on each bag of romaine or signage in stores where labels are not an option would easily differentiate for consumers romaine from unaffected growing regions.


Recommendation:

Based on discussions with producers and distributors, romaine lettuce entering the market will now be labeled with a harvest location and a harvest date or labeled as being hydroponically- or greenhouse-grown. If it does not have this information, you should not eat or use it.

If romaine lettuce does have this labeling information, we advise avoiding any product from the Central Coast growing regions of northern and central California. Romaine lettuce from outside those regions need not be avoided.

Romaine lettuce that was harvested outside of the Central Coast growing regions of northern and central California does not appear to be related to the current outbreak. Hydroponically- and greenhouse-grown romaine also does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these sources.”[13]


What is the Problem and What is Being Done?

“On November 20, 2018, FDA announced an investigation of a multistate outbreak of E. coli O157:H7 illnesses likely linked to romaine lettuce. The Public Health Agency of Canada (PHAC), and Canadian Food Inspection Agency, are also coordinating with U.S. agencies as they investigate a similar outbreak in Canada. In that announcement, FDA recommended that people should not eat romaine lettuce until more is known about the source of the contaminated lettuce and the status of the outbreak.

Genetic analysis of the E. coli O157:H7 strains tested to date from patients in this current outbreak are similar to strains of E. coli O157:H7 associated with a previous outbreak from the Fall of 2017 that also affected consumers in both Canada and the U.S. The 2017 outbreak of E. coli O157:H7 was associated with leafy greens in the U.S. and romaine in Canada. This year, romaine lettuce is the suspected vehicle for both the U.S. and Canadian outbreaks. There is no genetic link between the current outbreak and the E.coli O157:H7 outbreak linked to romaine that occurred in the Spring of 2018.

The FDA is conducting a traceback investigation to determine the source of the romaine lettuce eaten by people who became sick. Additionally, FDA and states are conducting laboratory analysis of romaine lettuce samples potentially linked to the outbreak.

As of November 26, the most recent illness onset in the U.S. among these cases was October 31, 2018. At the time, for this outbreak investigation, the average interval between when a person became ill and when the illness was reported to CDC was 20 days.


What Products are Recalled?

Currently, the FDA does not have enough traceback information to identify the source of the contamination that would allow us to request a targeted recall from specific suppliers. On November 20, FDA recommended that the most efficient way to ensure that contaminated romaine is off the market would be for industry to voluntarily withdraw product from the market, and to withhold distribution of romaine until public health authorities can ensure the outbreak is over and/or until FDA can identify a specific source of contamination.

On November 20, the United Fresh Produce Association and the Leafy Greens Marketing Agreement issued statements committing to withdraw the potentially contaminated romaine from the market.”[14]


     Centers for Disease Control and Prevention (CDC)


“CDC, public health and regulatory officials in several states, Canada, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (E. coli O157:H7) infections linked to romaine lettuce from the Central Coastal growing regions in northern and central California.

Advice to Consumers, Restaurants, and Retailers

Based on new information, CDC is narrowing its warning to consumers. CDC is advising that U.S. consumers not eat and retailers and restaurants not serve or sell any romaine lettuce harvested from the Central Coastal growing regions of northern and central California. If you do not know where the romaine is from, do not eat it.

  • Romaine lettuce products will be labeled with a harvest location by region. It may take some time before these labels are available.
    • If the romaine lettuce is not labeled with a harvest growing region, do not buy, serve, sell, or eat it.
  • Check bags or boxes of romaine lettuce for a label indicating where the lettuce was harvested. Romaine lettuce labeled with a harvest region outside of the Central Coastal growing regions of northern and central California (such as the desert growing region near Yuma, the California desert growing region near Imperial County and Riverside County, the state of Florida, and Mexico) is not linked to this outbreak.
  • If you do not know where your romaine lettuce was harvested, do not eat it and throw it away.
    • This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.
    • If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.
    • Wash and sanitize drawers or shelves in refrigerators where romaine was stored. Follow these five steps to clean your refrigerator. Click HERE for the five steps
  • Restaurants and retailers should check the label on bags or boxes of romaine lettuce, or ask their suppliers about the source of their romaine lettuce.
    • Do not sell or serve any romaine lettuce harvested from the Central Coastal growing regions of northern and central California.
    • If you do not know where your romaine lettuce was harvested, do not sell or serve it.
  • Hydroponically or greenhouse-grown romaine lettuce has not been linked to this outbreak.
  • Take action if you have symptoms of an E. coli infection:
    • Talk to your healthcare provider.
    • Write down what you ate in the week before you started to get sick.
    • Report your illness to the health department.
    • Assist public health investigators by answering questions about your illness.

Advice to Clinicians

  • Antibiotics are not recommended for patients with E. coli O157 infections. Antibiotics are also not recommended for patients in whom E.coli O157 infection is suspected, until diagnostic testing rules out this infection.
  • Some studies have shown that administering antibiotics to patients with E. coli O157 infections might increase their risk of developing hemolytic uremic syndrome (a type of kidney failure), and the benefit of antibiotic treatment has not been clearly demonstrated.


Latest Outbreak Information


At A Glance

  • Since the last update on November 20, an additional 11 ill people have been included in this investigation.
  • Forty-three people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 have been reported from 12 states.
    • Illnesses started on dates ranging from October 8, 2018 to October 31, 2018.
    • Sixteen people have been hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.
  • The Public Health Agency of Canada has identified ill people infected with the same DNA fingerprint of E. coli O157:H7 bacteria in Canada.
  • Epidemiologic and traceback evidence from the United States and Canada indicates that romaine lettuce harvested from the Central Coastal growing regions of northern and central California is a likely source of the outbreak.
  • Ill people in this outbreak were infected with E. coli bacteria with the same DNA fingerprint as the E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada. The current outbreak is not related to a spring 2018 multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce.
  • CDC is advising that consumers not eat any romaine lettuce harvested from the Central Coastal growing regions of northern and central California. No common grower, supplier, distributor, or brand of romaine lettuce has been identified.
  • This investigation is ongoing, and CDC will provide more information as it becomes available.”[15]


     ORGANIC FOOD AND OTHER FOODS SAFETY TIPS


“Whether you go totally organic or opt to mix conventional and organic foods, be sure to keep these tips in mind:


*  Select a variety of foods from a variety of sources

This will give you a better mix of nutrients and reduce your likelihood of exposure to a single pesticide.


*  Buy fruits and vegetables in season when possible

To get the freshest produce, ask your grocer what is in season or buy food from your local farmers market.


*  Read food labels carefully

Just because a product says it's organic or contains organic ingredients doesn't necessarily mean it's a healthier alternative. Some organic products may still be high in sugar, salt, fat or calories.


  • Wash and scrub fresh fruits and vegetables thoroughly under running water

Washing helps remove dirt, bacteria and traces of chemicals from the surface of fruits and vegetables, but not all pesticide residues can be removed by washing. Discarding outer leaves of leafy vegetables can reduce contaminants. Peeling fruits and vegetables can remove contaminants but may also reduce nutrients.”[16]


  • Grow your own food

One of the surest ways of ensuring your food is organic is to grow it yourself. This also increases food safety as you will be harvesting and washing them so you can ensure they are not contaminated.


  • Buy directly from your organic farmer

Buying directly from your organic farmer helps to reduce the many channels that the food travels through before reaching you. This helps to reduce contamination.


[1] http://www.who.int/news-room/fact-sheets/detail/e-coli

[2] http://www.who.int/news-room/fact-sheets/detail/e-coli

[3] https://www.healthline.com/health/e-coli-infection#symptoms

[4] http://www.who.int/news-room/fact-sheets/detail/e-coli

[5] https://www.healthline.com/health/e-coli-infection#causes

[6] https://www.healthline.com/health/e-coli-infection#risk-factors

[7] http://www.who.int/news-room/fact-sheets/detail/e-coli

[8] https://www.healthline.com/health/e-coli-infection#prevention

[9] https://www.everydayhealth.com/e-coli/treatment/

[10] https://www.webmd.com/food-recipes/food-poisoning/what-is-e-coli#2

[11] http://inspection.gc.ca/food/information-for-consumers/food-safety-investigations/outbreak-of-e-coli-infections-linked-to-romaine-le/2018-11-26/eng/1543278722230/1543278773703

[12] https://www.canada.ca/en/public-health/services/public-health-notices/2018/outbreak-ecoli-infections-linked-romaine-lettuce.html#a1

[13] https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm626330.htm

[14] https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm626330.htm

[15] https://www.cdc.gov/ecoli/2018/o157h7-11-18/index.html

[16] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/organic-food/art-20043880