November 2017, the CDC, FDA issued an alert on an outbreak of a particularly robust, acid-resistant, strain of E.coli that is toxic, infectious, and was first identified in 1982.
McDonald’s Restaurant Hamburger 1982
A confirmed outbreak of E. coli O157:H7 was associated with eating ground beef, hamburger, at McDonald’s Restaurant outlets in Oregon and Michigan. Escherichia coli 0157:H7, was isolated from 9 of 12 stools collected and from a beef patty from a suspected lot of meat in Michigan. This was the first time that E. coli O157:H7 was linked to an outbreak; at that time, this serotype was thought of as rare in occurrence. The only known previous isolation of E. coli O157:H7 was from a sporadic case of hemorrhagic colitis in 1975.
INTRODUCTION, BACKGROUND, OVERVIEW
In a research paper (Epidemiologic Reviews by The Johns Hopkins University School of Hygiene and Public Health) called Emerging Foodborne Pathogens: Escherichia coli O157:H7 as a Model of Entry of a New Pathogen into the Food Supply of the Developed World, “A bovine reservoir of E. coli O157:H7 has been suspected ever since the first human outbreak was linked with ground beef consumption in 1982. Prior to that time, neither the US Department of Agriculture (USDA) Animal Laboratories nor the Pennsylvania State University Veterinary Research Laboratory had ever detected this serotype in any of its samples”.
The most recent outbreak onsets were between November 5 and December 12, 2017. Among the 21 ill people for whom CDC has information, nine were hospitalized, including one person in California who died. Two people developed hemolytic uremic syndrome, a type of kidney failure. The outbreak occurred simultaneously in Canada and the United States . The source of contamination was identified as Romaine lettuce … and other “leafy vegetables”. The US Food & Drug Administration (FDA) and CDC was very careful not to implicate any specific point of origin, or source. To this day, they still have not identified a common cause that would link all the confirmed cases of contamination in the US and Canada.
However, a definitive conclusion of (a) where did this strain, E.coli O157:H7 come from, and (b) when, has been and continues to be, a challenge. “(1996) A Research Many of the questions that faced the investigators of the original outbreak in 1982 remain unanswered today. Prominent among these is the question of why this pathogen suddenly emerged as a public health problem. Is E. coli O157:H7 a completely new pathogen which suddenly appeared in the food supply or is this a pathogen which was present but unrecognized prior to 1982? If E. coli O157:H7 infection is truly increasing in incidence, what factors are promoting its emergence and, more importantly, what can be done to stop the spread of this microbe?
Despite the multiple federal, scientific and legal research papers on E.coli O157:H7 and its presence in our food chain – the – and the carrier is under the administration of the USDA. CATTLE. E.coli O157:h7 is naturally occurring in cattle. “Healthy cattle are a reservoir of E. coli O157:H7, and bovine food products and fresh produce contaminated with bovine waste are the most common sources for disease outbreaks in the United States. E. coli O157:H7 also survives well in the environment.
This is a very complex issue – because the strain O157:H7 is almost impossible to eliminate. The cattle that is warehoused right now in the U.S. (count approximately 98.8 million) are destined for slaughter. “E. coli O157:H7 naturally colonizes the gastrointestinal tracts of cattle.”
The FDA can’t figure a primary source or source of origin for the Romaine lettuce contamination with E.coli O157:H7.
This contamination of E.coli O157:H7 is a foodborne pathogen. But how did that get onto the Romaine or leafy vegetables which is what the CDC claimed to be contaminated.
Foodborne illness, like E.coli O157:H7 is a result of cross-contamination …. from sources such as reused IRRIGATION WATER THAT IS CONTAMINATED. Sources like feedlots and manure that is taken from the LARGE CATTLE RANCHES with herds that have E.coli O157:H7… (the primary source of E.coli O157:H7) from processing plants and used for fertilizer.
So how close was any ROMAINE production to potential contamination …
#1. The Yuma area, including the Imperial Valley across the California border, produces about 90 percent of all the leafy vegetables grown in the United States from November to March, when it’s too cold to grow produce in most of the rest of the country. The Imperial Valley is the largest producer of romaine in the United States.
#2. The San Joaquin Valley is second in leafy vegetable production in the U.S.
#3. Kettleman City, CA is right off of Interstate 5 and has enormous feedlots and is located in the San Joaquin Valley.
#4. These feedlots and cattle ranchers share the irrigation water (and reuse of same water) as the agricultural farms growing the leafy green vegetables you eat, such as Romaine.
#5. One of the major aqueducts that irrigates the entire San Joaquin Valley flows down to the Imperial Valley. E.coli can live in soil and channels for up to six months.
#6. Harris Ranch, or the Harris Cattle Ranch, feedlot is California’s largest beef producer and the largest ranch on the West Coast of the United States. Back in 2010 – Harris Ranch processed 150,000,000 MILLION pounds of beef. That is 75,000 TONS which 3/4 the weight of a US Nimitz class aircraft carrier. Harris Ranch does it own rendering and is located alongside Interstate 5 at its intersection with California State Route 198 east of Coalinga. That is in the San Joaquin Valley. That is the same valley that grows the leafy vegetables that you are eating. The slaughterhouses use water to wash down the floors of the slaughterhouses, chutes, etc. That water becomes part of the ground water and aquifers that are part of the irrigation system that is used on our produce. The other water goes into channels and soil.
#7. Water reuse in California is increasingly important, with reclaimed water being used preferably for agricultural irrigation, toilet flushing, and industry.
QUESTION: How would romaine lettuce grown in the Imperial Valley – the largest producer of ROMAINE in the US and the San Joaquin Valley get contaminated.
ANSWER: Irrigation water and manure … to start.
QUESTION: How is it the FDA’s investigative resources don’t seem to know that?
This is to help the FDA (!) identify the “common food or points where the food might have become contaminated” since they seem to be having a hard time. Romaine lettuce does not inherently have E.coli O157:H7. It must be transmitted to the Romaine. So … how would that happen? A few ways.
Starting with this specific strain of E.coli. E.coli O157:H7 – is a pathogen that starts – STARTS – in the gut of certain animals. “E. coli O157:H7 is most commonly found in cows, although chickens, deer, sheep, and pigs have also been known to carry it. Meat becomes contaminated during slaughter, when infected animal intestines or feces come in contact with the carcass.”
“Analysis of 0157:H7 on-farm studies indicates that virtually all types and breeds of cattle should be viewed as potential sources of 0157 contamination.”
Stress is being attributed for an increase of 0157:H7 in cattle in the slaughter pipeline. “It has been suggested that stress may result in increased numbers and/or increased shedding of O157 in cattle. E. coli numbers have also been shown to increase in the gastrointestinal tracts of adult animals and birds following starvation or abrupt dietary changes. Cattle are usually held off feed in the hours prior to slaughter.”
“There is speculation that the use of ionophores, a class of antibiotics which is currently fed to certain types of cattle, may have allowed or enhanced the ability of O157 to become established as part of the intestinal microflora of cattle. The approval and subsequent adoption of ionophores for feedlot diets of cattle in the mid- to late-1970’s roughly coincides with the identification of O157 as a foodborne human pathogen. Ionophore products are currently reported to be used in the diets of more than 90 percent of feedlot and farm-fed cattle and in less than 50 percent of replacement heifers and beef and dairy calves. Ionophores have been shown to inhibit gram-positive organisms in the rumen and, therefore, may allow the increased proliferation of gram-negative organisms such as E. coli. One study has reported that dairy farms feeding ionophores in grain had a higher O157 prevalence in calves than did farms not feeding ionophores. However, a follow-up study found no such association.”
But we’re talking ROMAINE lettuce right? We’re trying to figure out how did the lettuce become infected?
“Root crops and leafy vegetables have the greatest risk of infection from manure application to soil. E. coli O157:H7 is most prevalent in ruminant animals in general and in cattle in particular (both beef and dairy). They shed the bacteria from their guts into their feces. E. coli O157:H7 is more common in larger herds. Pathogens have been shown to be transferred from manure to the surface of crops on contaminated soil particles. Once on the surface of the crop, pathogens can persist for up to 150 days. E. coli O157:H7 can survive for more than six months in the soil. “
“Irrigation water can be a prime source of contamination, with potential sources of contamination.” Think of ground water. Think of aquifers. Think of farms sharing the same ground water/irrigation water – with slaughterhouses. “The probability of contamination of the spinach and lettuce plants appears to be greater when they are exposed to the pathogen just prior to harvest.”
“Reuse of drainage water from infected fields poses a potential source of contamination. The E. coli bacteria can persist in sediment in drainage and irrigation canals as well as in feedlots.”
I am asserting that the manure generated by the more than 98.8 MILLION HEAD OF CATTLE in the United States – under the direction of the USDA, animals being warehoused for slaughter, is being used on farms, and cross-contaminating our crops.
You cannot get E.coli O157:H7 from horse manure. The chemical constituents of horse manure are not toxic to humans. Horse guts do not contain significant levels of the two waterborne pathogens of greatest concern to human health risk, Cryptosporidium or Giardia, neither do they contain significant amounts of the bacteria E. coli 0157:H7 or Salmonella
“The USDA is the primary agency that promotes, regulates and enforces government policy in the American farm and food industries. Its primary mission is to implement policies approved by Congress every five years in what is commonly known to as “the farm bill.” This legislation authorizes federal spending on farm subsidies, food and nutrition programs, rural development initiatives, trade programs, farm credit regulations, conservation plans, market support and more.
USDA, however, is not the only branch of the federal government influencing the agricultural sector. The U.S. Food and Drug Administration (FDA) has jurisdiction over how some foods are handled, prepared and stored. It was created in response to Upton Sinclair’s book “The Jungle” which exposed practices and working conditions in Chicago meatpacking plants at the turn of the 20th century.
The Environmental Protection Agency (EPA) enforces laws relating to air and water quality. Regulation of chemical application on American farmland and the amounts of pollutants allowed in local waterways falls under the purview of the EPA. The agency also is charged with implementing the Renewable Fuel Standard (RFS) which dictates how much biofuels, like corn-based ethanol and biodiesel, must be used in the national fuel supply.
“Escherichia coli 0157:H7 Issues and Ramifications” (1994), “Reducing Risk of E.coli 0157:H7 Contamination (2007)”
FDA Investigates E. coli O157:H7 Outbreak Likely Linked to Leafy Greens
The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local partners, have been investigating an outbreak of E. coli O157:H7 illnesses that were likely linked to leafy greens.
CDC announced on January 25, 2018, that this outbreak appears to be over, because the last case became ill on December 12, 2017. This indicates that the food causing illness is no longer available in the marketplace or consumers’ homes.
Although this outbreak appears to be over, the FDA’s outbreak investigation team is continuing to work with federal, state and local partners to determine what leafy greens made people ill, what people ate, where they bought it, and identify the distribution chain — all with the goal of identifying any common food or points where the food might have become contaminated. To date, no common link has been identified.
Because whole genome sequencing showed that the E. coli O157:H7 strain that resulted in the U.S. illnesses was closely related genetically to the strain that caused illnesses in Canada, the FDA and CDC have been in contact with Canadian food safety authorities throughout this outbreak.
What was the Problem and What is being Done About It?
The FDA and the CDC, along with state and local health officials, have been investigating an outbreak of Shiga toxin-producing E. coli O157:H7 infections likely linked to leafy greens. There were 25 cases in 15 states; California (4), Connecticut (2), Illinois (1), Indiana (2), Maryland (3), Michigan (1), Nebraska (1), New Hampshire (2), New Jersey (1), New York (2), Ohio (1), Pennsylvania (2), Vermont (1), Virginia (1), and Washington (1).
Illness onsets were between November 5 and December 12, 2017. Among the 21 ill people for whom CDC has information, nine were hospitalized, including one person in California who died. Two people developed hemolytic uremic syndrome, a type of kidney failure.
Since the outbreak was identified, the FDA has been working with CDC and state and local partners on the investigation. The FDA’s role in outbreaks of this nature is to utilize food consumption information gained from interviews with people who got sick, trace those foods back through the distribution chain to the original source, and attempt to identify the source and route of contamination.
The Public Health Agency of Canada identified romaine lettuce as the source of the outbreak in Canada. In the United States, the likely source of the outbreak appears to be leafy greens, but the investigation has not identified a specific type of leafy greens that sick people ate in common.
The FDA has been in regular contact with Canadian health authorities to share information about the traceback investigation. The FDA’s investigation team has also reviewed information from previous outbreaks to see if there are any commonalities between those and the current outbreak. To date, no common leafy green grower source has been identified.
What are the Symptoms of E. coli O157:H7 Infection?
The symptoms of Shiga toxin-producing (STEC) E. coli infections vary for each person but often include severe stomach cramps and bloody diarrhea. If there is fever, it is usually not very high (less than 101 degrees F /less than 38.5 degrees Celsius). Most people get better within 5–7 days. Some infections are very mild, but others are severe or even life-threatening.
Around 5–10 percent of those who are diagnosed with STEC infection develop a potentially life-threatening complication, known as hemolytic uremic syndrome (HUS).
Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. Most people with HUS recover within a few weeks, but some suffer permanent damage or die. People who experience these symptoms should seek emergency medical care immediately. Persons with HUS should be hospitalized because their kidneys may stop working (acute renal failure), but they may also develop other serious problems such as hypertension, chronic kidney disease, and neurologic problems.
Although this outbreak appears to be over, it’s important to know that people of any age can become infected with Shiga toxin-producing (STEC) E. coli. Children under the age of 5 years, adults older than 65, and people with weakened immune systems are more likely than others to develop severe illness, including HUS, but even healthy older children and young adults can become seriously ill.
What Do Restaurants and Retailers Need To Do?
Retailers, restaurants, and other food service operators should always take steps to avoid the cross contamination of cutting surfaces and utensils through contact with potentially contaminated products. Retailers, restaurants, and other food service operators should always take steps to adequately control the temperature of cut leafy greens and to avoid cross contamination of cutting surfaces and utensils through contact with potentially contaminated products. To prevent cross contamination, you should follow the steps below:
Wash and sanitize display cases and refrigerators where potentially contaminated products were stored.
Wash and sanitize cutting boards, surfaces, and utensils used to prepare, serve, or store potentially contaminated products.
Wash hands with hot water and soap following the cleaning and sanitation process.
In accordance with the FDA Food Code 2013, cut leafy greens are considered a food requiring time/temperature control for safety and should be refrigerated at 41°F or lower.
Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.
What Do Consumers Need To Do?
Consumers should always practice safe food handling and preparation measures. It is recommended that they wash hands, utensils, and surfaces with hot, soapy water before and after handling food.
For refrigerators and other food preparation surfaces and food cutting utensils that may have come in contact with contaminated foods, it is very important that the consumers thoroughly clean these areas and items.
Consumers should follow these simple steps:
Wash the inside walls and shelves of the refrigerator, cutting boards and countertops; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.
Wash hands with warm water and soap for at least 20 seconds before and after handling food.
Wipe up spills in the refrigerator immediately and clean the refrigerator regularly.
Always wash hands with hot, soapy water following the cleaning and sanitization process.
Persons who think they might have become ill from eating potentially contaminated foods should consult their health care provider.
The FDA encourages consumers with questions about food safety to call 1-888-SAFEFOOD or consult the fda.gov website: http://www.fda.gov
Multistate Outbreak of E. coli O157:H7 Infections
Foodsafety.gov on Food Poisoning – E. coli
Public Health Notice – Outbreak of E. coli infections linked to romaine lettuce
U.S. Food and Drug Administration
10903 New Hampshire Avenue, Silver Spring, MD 20993
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