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Angus Beef Patties E. coli

February 27, 2018 admin

Outbreak: Angus Beef Patties E. coli
Product: Beef Patties	Investigation Start Date: 09/17/2007
Location: Multi-State	Etiology: E. coli (STEC) O157:H7
Earliest known case onset date: 08/01/2007	Latest case onset date: 10/08/2007
Confirmed Case Count: 47	Positive Food Samples : 17

Implicated lots of American Chef's Angus Beef Patties.
Outbreak cases by state.
Epi curve.
Two implicated lots, only 1 minute apart.
Minnesota Department of Health outbreak press release.
Associated Press outbreak coverage.
Chicago Sun-Times outbreak coverage.
Case-Patient Characteristics

OUTBREAK SUMMARY:

Minnesota Department of Health (MDH) staff quickly identified the outbreak vehicle when the first four detected outbreak cases all reported consuming the same brand of premade beef patties. Investigators tracked down detailed product information from two cases, and two leftover boxes of beef patties obtained from case households were found … Continue Reading ››

ecoli

Raw Flour E. coli

February 20, 2018 admin

Outbreak: Raw Flour E. Coli
Product: Raw Flour	Investigation Start Date: 6/1/2016
Location: Multistate	Etiology: E. coli O121
Earliest known case onset date: 12/21/2015	Latest case onset date: 9/5/2016
Confirmed Case Count: 63	Positive Environmental Samples: 39
Hospitalizations: 17	Deaths: 0

An example of a Gold Medal flour bag implicated in this outbreak.
The 63 ill were spread across 24 states.
Epi Curve.
General Mills expanded their recall to include many products.

OUTBREAK SUMMARY:

CDC worked with public health and regulatory officials in many states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Shiga toxin-producing Escherichia coli (STEC) infections.
Public health investigators used the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet, coordinated by CDC, … Continue Reading ››

listeria

Listeria Soft Cheese

November 14, 2017 admin

Outbreak: Listeria Soft Cheese
Product: Soft Cheese	Investigation Start Date: 06/27/2013
Location: Multi-State	Etiology: Listeria monocytogenes
Earliest known case onset date: 5/14/2013	Latest case onset date: 6/16/2013
Confirmed / Presumptive Case Count: 5 / 0	Positive Samples (Food / Environmental): 18 / 1

Product Distribution Chain
Recreation of grocery store receipt for Les Freres purchase
PFGE Testing Results
Cases by Week of Illness Onset
Outbreak Case Distribution

OUTBREAK SUMMARY:

Five outbreak cases of listeriosis were identified in Minnesota, Indiana, Illinois, and Ohio. The use of the CDC Listeria Initiative questionnaire to identify a soft cheese signal, along with re-interviewing cases (or their proxies) and calling restaurants to get specific details on cheese brand and cheese type were critical … Continue Reading ››

norovirus

Protected: Faerieworlds Festival – unlikely to be published (lack of content)

November 14, 2017 admin

Outbreak: Faerieworlds Festival
Product: Food vendor stalls	Investigation Start Date: 8/2/2006
Location: Veneta, OR	Etiology: Norovirus
Earliest known case onset date: 7/29/2006	Latest case onset date: 8/2/2006
Confirmed / Presumptive Case Count: 4 / 0	Positive Environmental Samples: 0

Dr. Bill Keene with the implicated grocery bag.
Local and national media cover the reusable shopping bag norovirus outbreak.
The chips and cookies were the first clues leading to the discovery of the reusable shopping bag as the source of this norovirus outbreak.
Epi curve from the outbreak.
Using a follow-up questionnaire focused on food exposures helped epidemiologists to narrow down the source of the outbreak. Here is a snapshot of Sunday’s meals, which led to identifying the source.
Cases were defined as group members who developed vomiting or diarrhea (≥3 loose stools in <24h) during October 9–13, 2010. This is a snapshot of symptom frequency among cases.

OUTBREAK SUMMARY:

On August 2, the Lane County Public Health received eight separate reports of gastrointestinal illness from attendees of an arts and music festival held in Veneta, Oregon July 29-30. Initial inquiries by environmental health staff suggested several potential problems that could have posed a risk of transmission. The likely culprit was … Continue Reading ››

shigella

Hubbard Splash Fountain

August 25, 2016 admin

Outbreak: Hubbard Splash Fountain
Product: Splash Fountain in Hubbard, OR	Investigation Start Date: 07/25/03
Location: Marion County, OR	Etiology: Shigella sonnei
Earliest known case onset date: 07/16/03	Latest case onset date: 08/17/03
Confirmed / Presumptive Case Count: 19 / 37	Positive Samples: 0

Dr. William E. Keene at the splash fountain implicated in the 2003 shigellosis outbreak in Marion County.
The splash fountain in Hubbard, Oregon was re-engineered and an automated chlorinator was installed after the 2003 shigellosis outbreak.
The shigellosis outbreak at the splash fountain in Hubbard, Oregon underscores the necessity for standards and regulations for the design and maintenance of such fountains.

OUTBREAK SUMMARY:

Investigation of an outbreak of gastrointestinal illness erupted among children in a small community in Marion County, Oregon. Investigation by epidemiologists found that the illnesses were due to the fecal bacterium Shigella sonnei, and traced to an unusual common source: a splash fountain. This outbreak underscores the risk of large … Continue Reading ››

e-coli-o157

Protected: 2002 Lane County Fair

August 15, 2016 admin

Outbreak: 2002 Lane County Fair
Product: Animal Petting Exhibit	Investigation Start Date: 08/21/02
Location: Eugene, OR	Etiology: E. coli O157
Earliest known case onset date: 08/02	Latest case onset date: 08/02
Confirmed / Presumptive Case Count: 56 / 14	Positive Environmental Samples: 1

The largest outbreak of E. coli O157 in Oregon’s history was linked to ill persons who visited the animal exhibits at the Lane County Fair.
Immediately after visiting the animals exhibits, washing your hands and those of your children with warm soapy water for at least 20 seconds can help prevent illness.
The Oregon Dept. of Human Services PSA (Click to play this video in a new window).

OUTBREAK SUMMARY:

The 2002 Lane County Fair was the site of the largest outbreak of E. coli O157 in state history with 56 confirmed cases, 14 presumptive cases and 11 cases with hemolytic uremic syndrome (HUS). Oregon epidemiologists discovered that an animal exhibit, not food vendors, was the source of the outbreak. … Continue Reading ››

norovirus

Diaper Changing Station Norovirus

August 1, 2016 admin

Outbreak: Diaper Changing Station Norovirus
Product: Diaper changing Station	Investigation Start Date: 05/16/2012
Location: Washington County, OR	Etiology: Norovirus
Earliest known case onset date: 05/15/2012	Latest case onset date: 05/15/2012
Confirmed / Presumptive Case Count: 12 / 4	Positive Environmental Samples: 1
Hospitalizations: 0	Deaths: 0

Underside of implicated diaper changing station in this outbreak; fecal material is visible.
Collection kit for environmental samples that were taken to the Oregon State Public Health Laboratory for norovirus testing.
Underside of another diaper-changing station in Washington County that was tested for norovirus. Debris was visible on the underside of most diaper-changing stations viewed in this investigation.
Epidemic Curve.
Outbreak report created by Oregon epidemiologists during the investigation of a norovirus outbreak at an auto dealership.

OUTBREAK SUMMARY:

This outbreak initially appeared to be a standard foodborne point-source outbreak from a restaurant with known previous critical violations. However, upon extensive interviewing, it transpired that a toddler with explosive diarrhea and the associated contaminated surfaces were the source of the outbreak.

Documents

• Outbreak Questionnaire (PDF) | Continue Reading ››

e-coli-o157

Protected: Odwalla Juice

July 29, 2016 admin

Outbreak: Odwalla Juice

Product: Odwalla Juice Investigation Start Date: Oct. 20, 1996

Location: Multi-state WA, CA, CO, BC Etiology: E. coli O157

Earliest known case onset date: 10/13/1996 Latest case onset date: 11/08/1996

Confirmed Case Count: 67 (12 with HUS, 1 death) Positive Food Samples: 1

A young Dr. William Keene with Odwalla juice products. Odwalla unpasteurized apple juice was implicated in the 1996 O157 E. coli outbreak.

Odwalla Juice Company issued a voluntary nationwide recall of all its products containing apple juice during the 1996 outbreak.

A chart of consumption dates associated with confirmed cases in the 1996 E. coli O157 Odwalla outbreak. Below the chart are handwritten notes of Dr. William Keene.

A chart of the incubation period for confirmed cases in the 1996 E. coli O157 Odwalla outbreak. Note that some cases reported a 10 day incubation period. The incubation period for E. coli O157:H7 is usually 3 to 4 days.

A chart of illness onset by date for the 1996 E. coli O157 Odwalla outbreak.

Distribution data and lot numbers for products epidemiologists were analyzing as possible sources of the outbreak. Handwritten notes highlight product lots associated with the “bad apple” shipment.

OUTBREAK SUMMARY:
The health conscious juice company Odwalla became the epicenter of a 1996 outbreak of E. coli O157. Health officials in the Pacific Northwest identified Odwalla’s unpasteurized apple juice as the source of the outbreak. This outbreak lead to industry wide changes in the use of flash pasteurization, a high temperature, … Continue Reading ››

norovirus

Shopping Bag Norovirus

July 24, 2016 admin

Outbreak: Reusable plastic shopping bag

Product: Reusable Shopping Bag Investigation Start Date: 10/13/2010

Location: Single County Etiology: Norovirus

Earliest known case onset date: 10/10/2010 Latest case onset date: 10/12/2010

Confirmed / Presumptive Case Count: 7 / 5 Positive Environmental Samples: 1

Dr. Bill Keene with the implicated grocery bag.

Local and national media cover the reusable shopping bag norovirus outbreak.

The chips and cookies were the first clues leading to the discovery of the reusable shopping bag as the source of this norovirus outbreak.

Epi curve from the outbreak.

Using a follow-up questionnaire focused on food exposures helped epidemiologists to narrow down the source of the outbreak. Here is a snapshot of Sunday’s meals, which led to identifying the source.

Cases were defined as group members who developed vomiting or diarrhea (≥3 loose stools in <24h) during October 9–13, 2010. This is a snapshot of symptom frequency among cases.

OUTBREAK SUMMARY:
Health officials made a rare discovery with this outbreak by identifying a reusable shopping bag as the vehicle for norovirus investigation. The reusable shopping bag was stored in a bathroom used by the index case during her illness onset. The bag contained cookies, chips and other food items that were … Continue Reading ››

Campylobacter

Pennsylvania Raw Milk

May 31, 2016 admin

Outbreak: Pennsylvania Raw Milk Campylobacter

Product: Raw Milk Investigation Start Date: 01/24/2012

Location: Maryland, New Jersey, West Virginia Etiology: Campylobacter jejuni

Earliest known case onset date: 01/14/2012 Latest case onset date: 02/01/2012

Confirmed / Presumptive Case Count: 81 / 67 Positive Samples: 2

Hospitalizations: 10 Deaths: 0

Outbreak artifact that currently resides in the International Outbreak Museum.

The outbreak epi curve.

A portion of the outbreak news coverage.

OUTBREAK SUMMARY:
While it is legal to sell unpasteurized raw milk in Pennsylvania and illegal to sell in neighboring Maryland, New Jersey and West Virginia, this outbreak included cases in residents from all of these states. While additional regulations by state officials could be considered, such as monthly pathogen testing, … Continue Reading ››

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