CDC: E. coli outbreak appears over with 5 deaths, 96 hospitalized

The Centers for Disease Control and Prevention announced July 12 that the recent multi-state outbreak of E. coli infections linked to romaine lettuce grown in Arizona appears to be over as of June 28.(Anne-Gerard Flynn photo)

The Centers for Disease Control and Prevention announced July 12 that the recent multi-state outbreak of E. coli infections that resulted in the deaths of five people and the hospitalizations of 96, including 27 people who developed kidney failure, appears to be over as of June 28.

According to the CDC website, "epidemiologic, laboratory, and traceback evidence" indicate that romaine lettuce from the winter growing region around Yuma, Arizona was the "likely source of the outbreak."

Some 210 people from 36 states, including four in Massachusetts, infected with Shiga toxin-producing Escherichia coli or STEC were reported to have become ill between March 13 and June 6.

E. coli are common bacteria that play an important role in the gastrointestinal tract of both human and animals but some strains can produce Shiga toxins with the potential to cause systemic disease in humans.

Two deaths during the recent outbreak were reported in Minnesota and one each in Arkansas, California, and New York from E. coli O157:H7, the most commonly identified STEC in the United States.

The Yuma region of Arizona is said to supply romaine lettuce to the U.S. from November through March each year.

The Food and Drug Administration has been investigating environmental sources in the area including water, soil and cow manure and has said it found presence of E. coli with the same genetic "finger print" as the outbreak strain in canal water.

It says it is continuing to investigate how the water became contaminated and in turn how it could have contaminated the romaine lettuce.

Contaminated fecal matter can end up contaminating water, fruits and vegetables and even meat.

The FDA has said the suspected predominately chopped lettuce that made people ill was "supplied to restaurants and retailers through multiple processors, grower/shipper companies, and farms" and that the information it collected "indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor."

There are about 100 different groups of Shiga toxin-producing E. coli that are associated with human disease.

The FDA, which identified the Yuma growing area as the likely source of the recent contamination on April 13 through interviews with ill people, is quoted as saying that the lettuce linked to the outbreak "should no longer be available."

It said the final harvest in the area was April 16 and that it received confirmation May 2 that romaine lettuce from the Yuma growing area was no longer being produced and distributed.

Shelf life of the product is 21 days.

Eight cases of E. coli O157 were also reported in Canada "with a similar genetic finger print to illnesses reported in the U.S. investigation."

According to the CDC, people ingesting Shiga toxin-producing E. coli get sick between two and eight days later.

The most common symptoms are said to be diarrhea that can be bloody, severe stomach cramps, and vomiting.

While most people recover within a week, some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome.

Those most at risk are said to be children younger than 5 years, adults aged 65 years and older, and people with weakened immune systems.

During the recent outbreak, according to the CDC, those infected in the U.S. ranged in age from 1 to 88, with a median age of 28. Sixty-seven percent of them were female.

Transmission of STEC infection is said to occur chiefly through contaminated food or water and contact with animals. Person-to-person transmission is also possible as the result of poor hygiene.

Common ways to avoid transmission, according to the CDC, are to cook meat thoroughly, scrub all fruits and vegetables under running water, wash hands after using the restroom or changing diapers, before and after preparing or eating food, and after contact with animals.

The CDC has issued a number of advisories of late related to food-borne illnesses.

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