I'm guessing this sort of information does help determine where it comes from:
E. COLI VTEC - USA (12): (MISSOURI), O157, MORE STATES, LETTUCE
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A ProMED-mail post
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International Society for Infectious Diseases
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Date; Wed 7 Dec 2011
Source: CDC [edited]
<
http://www.cdc.gov/ecoli/2011/ecoliO157 ... index.html>
The United States Centers for Disease Control and Prevention (CDC) is
collaborating with public health and agriculture officials in
Missouri, other states, and the Food and Drug Administration to
investigate a multistate outbreak of _Escherichia coli_ serotype
O157:H7 infections linked to romaine lettuce. Public health
investigators are using DNA "fingerprints" of _E. coli_ O157:H7
bacteria obtained through diagnostic testing with pulsed-field gel
electrophoresis (PFGE) to identify cases of illness that may be part
of this outbreak. They are using data from PulseNet, the national
subtyping network made up of state and local public health
laboratories and federal food regulatory laboratories that performs
molecular surveillance of foodborne infections.
As of 4 Dec 2011, 60 people infected with the outbreak strain of _E.
coli_ O157:H7 have been reported from 10 states. The number of ill
people identified in each state is as follows: Arizona (1), Arkansas
(2), Georgia (1), Illinois (9), Indiana (2), Kansas (3), Kentucky (1),
Minnesota (3), Missouri (37), and Nebraska (1). Among those for whom
information is available, illnesses began from 10 Oct 2011 to 4 Nov
2011. Patients ranged in age from 1 to 94 years (median 29 years). 63
per cent were female. Among the 45 patients with available
information, 30 (67 per cent) were hospitalized, and 2 developed
hemolytic uremic syndrome (HUS). No deaths have been reported.
Investigation of the outbreak
-----------------------------
Collaborative investigative efforts of state, local, and federal
public health agencies indicate that romaine lettuce sold primarily at
several locations of a single grocery store chain (Chain A) was the
likely source of illnesses in this outbreak. Contamination likely
occurred before the product reached grocery store Chain A locations.
During 10 Oct to 4 Nov 2011, public health officials in several states
and CDC conducted an epidemiologic study by comparing foods eaten by
22 ill and 82 well people, including 45 well people who shopped at
grocery store Chain A during the week of 17 Oct 2011. Analysis of this
study indicates that eating romaine lettuce was associated with
illness. Ill people (85 per cent) were significantly more likely than
well people (46 per cent) to report eating romaine lettuce in the week
before illness. Ill people (86 per cent) were also significantly more
likely than well people (55 per cent) to report shopping at grocery
store Chain A. Among ill and well people who shopped at grocery store
Chain A, ill people (89 per cent) were significantly more likely than
well people (9 per cent) to report eating a salad from the salad bar
at grocery store Chain A. Several different types of lettuce were
offered on the salad bar at grocery store Chain A. Of 18 ill people
who reported the type of lettuce eaten, 94 per cent reported eating
romaine lettuce. No other type of lettuce or other item offered on the
salad bar was reported to be eaten by more than 55 per cent of ill
people.
Ill people reported purchasing salads from salad bars at grocery store
Chain A between 5 Oct and 24 Oct 2011. A total of 9 locations of
grocery store Chain A were identified where more than one ill person
reported purchasing a salad from the salad bar in the week before
becoming ill. This included 2 separate locations where 4 ill people
reported purchasing a salad at each location. For locations where more
than one ill person reported purchasing a salad from the salad bar and
the date of purchase was known, dates of purchase were all within 4
days of other ill people purchasing a salad at that same location.
Chain A fully cooperated with the investigation and voluntarily
removed suspected food items from the salad bar on 26 Oct 2011, out of
an abundance of caution. Romaine lettuce served on salad bars at all
locations of grocery store Chain A had come from a single lettuce
processing facility via a single distributor. This indicates that
contamination of romaine lettuce likely occurred before the product
reached grocery store Chain A locations.
The FDA and several state agencies conducted traceback investigations
for romaine lettuce to try to identify the source of contamination.
Traceback investigations focused on ill people who had eaten at salad
bars at several locations of grocery store Chain A and ill people at
university campuses in Minnesota (1 ill person) and Missouri (2 ill
people). Traceback analysis determined that a single common lot of
romaine lettuce harvested from Farm A was used to supply the grocery
store Chain A locations as well as the university campus in Minnesota
during the time of the illnesses. This lot was also provided to a
distributor that supplied lettuce to the university campus in
Missouri, but records were not sufficient to determine if this lot was
sent to this university campus. Preliminary findings of investigation
at Farm A did not identify the source of the contamination. Farm A was
no longer in production during the time of the investigation.
--
communicated by:
ProMED-mail rapporteur Brent Barrett
<
promed@promedmail.org>
[The epidemiological analysis certainly suggests romaine lettuce as
the source.
No "smoking" romaine lettuce was found -- that is, the outbreak strain
was not isolated from the implicated vehicle but finding a smoking
vehicle is not always the case. Traceback analysis pointed to a
particular farm but no source of contamination was identified. -
Mod.LL
The state of Missouri can be located on the HealthMap/ProMED-mail
interactive map at <
http://healthmap.org/r/1oUI>. - Mod.SH]
[see also:
E. coli VTEC - USA (12): (MO), O157 20111111.3344
E. coli VTEC - USA (11): (NC) O157, livestock building 20111110.3334
E. coli VTEC - USA (10): (NC) fair link, more cases 20111103.3281
E. coli VTEC - USA (09): (MO), O157, poss. produce link 20111103.3276
E. coli VTEC - USA (08): (MO), O157, poss. produce link 20111101.3246
E. coli VTEC - USA (07): (NC), fair link 20111101.3244
E. coli VTEC - USA (06): (MO), O157, poss. produce link 20111029.3224
E. coli VTEC - USA (05): (NC) more cases 20111029.3222
E. coli VTEC - USA (04): (NC) more cases 20111027.3201
E. coli VTEC - USA (03): (MO) RFI 20111027.3195
E. coli VTEC - USA (02):(NC), possible fair link 20111027.3193
E. coli VTEC - USA: (NC) RFI 20111026.3184
E. coli O157 - USA (08): (WI) more cases 20111016.3101
E. coli O157 - USA (07): (WI) 20110915.2819
E. coli O157 - USA (06): (OR) strawberry, deer dropping source
20110819.2520
E. coli O157 - USA (05): (PA) lake swimming 20110817.2493
E. coli O157 - USA (04): (PA) lake swimming 20110810.2428
E. coli O157 - USA (03): (OR) strawberry 20110809.2413
E. coli O157 - USA (02): (AL) water park 20110629.1981
E. coli O157 - USA: Lebanon bologna, alert, recall 20110325.0946
E. coli O157 - North America: hazelnut, alert, recall 20110310.0777
2010
---
E. coli O157 - USA (07): cheese 20101105.4007
E. coli VTEC non-O157 - USA (07): O26, ground beef, alert, recall
20100831.3097
E. coli O157 - USA (06): ground beef, alert, recall 20100809.2715
E. coli O157 - USA (05): (CO, NY), bison meat, alert, recall
20100709.2286
E. coli O157 - USA (04): (MN) unpasteurized milk 20100607.1900
E. coli O157 - USA (03): (MN) unpasteurized milk 20100528.1776
E. coli O157 - USA (02): (WA), day care 20100413.1200
E. coli VTEC non-O157 - USA (02): (OH, MI, NY) O145 20100505.1460
E. coli VTEC non-O157 - USA: (MI, OH) 20100427.1358
E. coli O157 - USA: 2009, tenderized non-intact steak 20100108.0092]
.................................................ll/sh
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Sometimes it seems as though one has to cross the line just to figger out where it is