Tag Archives: E. coli O157:H7

Jack-in-the-Box Hamburgers

February 19, 2015 admin

Outbreak: Jack In The Box Hamburgers
Product: Hamburgers	Investigation Start Date: 01/12/1993
Location: Multi-State Outbreak	Etiology: E. coli O157
Earliest known case onset date: 11/18/1992	Latest case onset date: 02/21/1993
Confirmed / Presumptive Case Counts: 503 / 229	Positive Samples (Food / Environmental / Water): 0 / 0 / 0
Hospitalizations: 151	Deaths: 3

Grill with frozen hamburger patties adjacent.
"Do not use" on box of hamburger patties.
Hamburgers from one of the lots of Jack-in-the-Box burgers implicated in the O157 outbreak.
Under-cooked Jack In The Box hamburger.

OUTBREAK SUMMARY:

This was the largest outbreak of E. coli O157 infections ever documented in the United States, and it injected this pathogen—and threats to food safety in general—into popular consciousness.

acute and communicable disease prevention dr bill keene E. coli O157:H7 FOMES integrated food safety center of excellence international outbreak museum iom jack in the box hamburgers oregon health authority tribute

e-coli-o157

Venison Jerky

July 29, 2014 admin

Outbreak: Venison Jerky

Product: Venison Jerky Investigation Start Date: 11/20/1995

Location: Benton County, Oregon Etiology: E. coli (STEC) O157:H7

Earliest known case onset date: 11/13/1995 Latest case onset date: 11/20/1995

Confirmed / Presumptive Case Counts: 6 / 5 Positive Samples (Food / Environmental / Water): 2 / 2 / 0

Close-up of the food dehydrator used to make contaminated venison jerky.

Food dehydrators used to make venison jerky.

An epidemiologist swabs the band saw used to processed the deer in question; the band saw tested positive.

Dehydrated venison (jerky); this tested positive for E. coli O157.

Dr. Keene retrieving the field dressing from the deer that yielded the contaminated venison jerky; field dressing tested positive.

OUTBREAK SUMMARY:

At a time when ground beef was thought to be the source of all foodborne E. coli O157 infections, this was the first documentation of venison-associated E. coli O157:H7 outbreak. Epidemiologists showed that deer can be colonized by E. coli O157:H7 and ultimately be a source of human infections. … Continue Reading ››

acute and communicable disease prevention dr bill keene E. coli O157:H7 FOMES integrated food safety center of excellence international outbreak museum iom oregon health authority tribute Venison Deer Jerky

e-coli-o157

Foundation Farm Raw Milk

July 29, 2014 admin

Outbreak: Foundation Farm Raw Milk

Product: Foundation Farm Raw Milk Investigation Start Date: 04/10/2012

Location: Clackamas, Multnomah and Washington Counties, Oregon Etiology: E. coli (STEC) O157:H7

Earliest known case onset date: 04/01/2012 Latest case onset date: 04/14/2012

Confirmed / Presumptive Case Counts: 11 / 5 Positive Samples (Food / Environmental): 2 / 13

Hospitalizations: 4 Deaths: 0

The Three Graces: Three Jersey herdshare milkcows await outside the milking station.

Investigators "lean in" to catch the sample slung by Dr. Keene. Note the ankle-deep "river" of mud, excrement, and urine in the milkcow's pasture captured in the photo just behind Dr. Keene. Pasture samples tested positive with matching strains of E. coli.

Dr. Bill Keene leans in for a closer look.

Dr. Keene kneels to swab the milking station which abutted the muddy paddock. Not surprisingly, the sample was positive for E. coli O157 which matched the human cases.

Milking jug hung to air-dry over "clean" milking station.

Swabbing the milking jug.

"Sterilized" containers used to hold raw milk sold to herdshare customers.

Muddy fields with a deluxe chicken “coop” in the background.

Another day in the life of a field epidemiologist.

Pig sty just underneath the milking area.

Resident turkey overseeing the epi investigation.

Milk jars from customer households – one of which tested positive for E. coli O157:H7.

Epidemic curve of the outbreak.

OUTBREAK SUMMARY:

This outbreak highlighted the persistent hazard of raw milk consumption, already well documented in the medical literature. Four of the 11 cases were hospitalized — some critically ill and all with hemolytic-uremic syndrome (HUS), subsequently shown to have been caused by E. coli O157:H7. Although most sales of raw … Continue Reading ››

acute and communicable disease prevention dr bill keene E. coli O157:H7 FOMES Foundation Farm Raw Milk integrated food safety center of excellence international outbreak museum iom oregon health authority tribute

e-coli-o157

Berry Stand Strawberries

July 29, 2014 admin

Outbreak: Berry Stand Strawberries

Product: Strawberries Investigation Start Date: 08/03/2011

Location: Clackamas, Multnomah, Washington, Clatsop, & Yamhill Counties, Oregon Etiology: E. coli (STEC) O157:H7

Earliest known case onset date: 07/01/2011 Latest case onset date: 07/29/2011

Confirmed / Presumptive Case Counts: 14 / 1 Positive Samples (Food / Environmental): 4 / 100

Hospitalizations: 6 Deaths: 2

Traceback: Dr. Tourdjman and team visit a local berry stand.

"Farm A": the initial visit to the strawberry farm suspected as the outbreak source.

Specimen collection: deer feces are observed over wide areas of the strawberry fields. Specimen collection begins.

Deer feces among strawberry plants was common at "farm A".

Deer are observed grazing the strawberry fields.

From farm to fork: Oregon deer have no discretion about where they defecate.

Dr. Keene gets into the weeds.

Some of the crew after a day of collecting feces.

Samples seized from cases.

Preparing to ship a few hundred fecal specimens to the lab.

Months after the outbreak, a household near the implicated farm tested positive for the same O157 strain. The case had not consumed strawberries from farm A, but deer were abundant in the yard of the case. The contents of the household vacuum bag produced the same O157 strain as the outbreak.

Though mounted in the museum, we did not harvest the deer as a result of the investigation: it came from a resale shop in Portland.

The actual museum artifact from the outbreak: a box of strawberries obtained from one of the stands.

Epi curve.

OUTBREAK SUMMARY:

This investigation implicated a novel vehicle—strawberries—as the cause of an outbreak of E. coli O157 infections. An association with locally produced strawberries quickly became apparent as cases were interviewed; but the fact that almost all had purchased them at roadside stands and farmer’s markets led to concern about potential … Continue Reading ››

acute and communicable disease prevention Berry Stand Strawberries dr bill keene E. coli O157:H7 FOMES integrated food safety center of excellence international outbreak museum iom oregon health authority tribute

e-coli-o157

Bagged Spinach

July 29, 2014 admin

Outbreak: Bagged Spinach

Product: Spinach Investigation Start Date: 09/08/2006

Location: Multi-State Etiology: E. coli (STEC) O157:H7

Earliest known case onset date: 08/25/2006 Latest case onset date: 09/13/2006

Confirmed / Presumptive Case Counts: 5 / 0 Positive Samples (Food / Environmental / Water): 0 / 0 / 0

Hospitalizations: 98 Deaths: 3

Oregon, CDC, and Wisconsin share hypotheses via conference call about their locally emerging (but nationally connected) E. coli O157 clusters; Oregon is convinced of bagged spinach.

Contaminated spinach purchased just before the national product recall of these brands was initiated. Packaging with replica spinach are museum exhibits.

Contaminated spinach collected from the home of a case of E. coli O157:H7 infection from Douglas county, Oregon.

Contaminated spinach collected from the home of a case of E. coli O157:H7 infection from Malheur county, Oregon.

Spinach field in Salinas Valley, CA.

Out tending the spinach in the field.

Headlines in the news as the recall story breaks wide open.

A selection of newspaper clippings about the outbreak investigation.

A selection of newspaper clippings about the outbreak investigation.

A selection of newspaper clippings about the outbreak investigation.

A selection of newspaper clippings about the outbreak investigation.

OUTBREAK SUMMARY:

This outbreak highlighted Inter-state health department cooperation. Oregon epidemiologists identified that 4 out of 5 cases in Oregon consumed bagged spinach using their homegrown "Shotgun" hypothesis-generating questionnaire. Contact with WI and NM showed cases already underway with spinach showing signs of being the culprit. Contact with Utah allowed them … Continue Reading ››

acute and communicable disease prevention Bagged Spinach dr bill keene E. coli O157:H7 FOMES integrated food safety center of excellence international outbreak museum iom oregon health authority tribute

e-coli-o157

Cal-Farms Parsley

July 29, 2014 admin

Outbreak: Cal-Farms Parsley

Product: Parsley Investigation Start Date: 10/20/2005

Location: Deschutes County, OR Etiology: E. coli (STEC) O157:H7

Earliest known case onset date: 10/08/2005 Latest case onset date: 10/27/2005

Confirmed / Presumptive Case Counts: 3 / 61 Positive Samples (Environmental / Water) 10 / 2

Nearby livestock

Evidence of heavy deer presence

Parsley epi curve

Parsley-processing machinery

Parsley field at Cascade Pacific

Muddy Parsley field

Deer track.

Muddy boots

Parsley

OUTBREAK SUMMARY:

This 2005 McGrath's Fish House outbreak of E. coli O157:H7 infections was traced back to parsley from Cal-Farms. The journey to finding the source was interesting: 206 people interviewed, 64 ill people, extremely muddy field conditions, cattle near the flooded parsley fields, and even evidence of heavy deer presence.

• … Continue Reading ››

acute and communicable disease prevention Cal-Farms parsley dr bill keene E. coli O157:H7 FOMES integrated food safety center of excellence international outbreak museum iom McGrath's Fishhouse outbreak oregon health authority tribute