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| |  Lab Tests Confirm Common Source of E.coli O157/H7 OLYMPIA, Wash.—Nov. 1, 1996 -- Lab tests completed today by the state Department of Health confirm a definite link between the most recent E.coli O157:H7 cases. Pulsed-field gel electrophoresis "fingerprints" the DNA from each persons lab sample. "The tests identify a unique cluster of E.coli O157:H7 associated with the Odwalla outbreak," said Dr. John Kobayashi, communicable disease epidemiologist at state Department of Health. "The pattern of these isolates differs substantially from those of other E.coli O157:H7 cases from the recent past. You can see a clear start in the current epidemic." There now are 17 confirmed cases of E.coli O157:H7 and 4 suspected. Of those confirmed, 15 report that they drank Odwalla apple juice. Twelve of the confirmed cases are in King County, one is in Thurston County, one in Whatcom County, and three are from Snohomish County. When E.coli O157:H7 illness is confirmed by a hospital or physician, the state public health laboratory performs pulsed-field gel electrophoresis. If the DNA fingerprints of E.coli O157:H7 from different patients match, a common source of infection is likely. Additional testing will be conducted over the weekend. Washington was the first state in the nation to begin in 1987 requiring physicians to report E.coli O157:H7 to state health officials. CDC and the Association of State and Territorial Public Health Laboratory Directors last year designated the state public health laboratory as a regional testing center for E.coli O157:H7. The laboratory coordinates studies of E.coli O157:H7 with the CDC, USDA and other regional testing centers. E.coli O157:H7 can cause severe diarrhea and abdominal cramps. Bloody stools are common. Complications are most likely to occur in children up to age nine and in the elderly. Wash hands frequently to avoid spreading the disease to other persons. Beef or venison products, particularly ground beef, can be contaminated during slaughtering or processing. Raw meat juices, dirty hands or unclean surfaces can contaminate foods, such as salads. Raw vegetables and fruit also may be contaminated if they are dropped on the ground and are not washed before they are eaten.
E.coli O157:H7 Fact Sheet What is E.coli? E.coli are bacteria that normally live in the intestines of humans and animals. Although, most strains of this bacteria are harmless, several are known to produce toxins that can cause diarrhea. One particular E.coli strain called O157:H7 can cause severe diarrhea and kidney damage. Who can get E.coli O157:H7 infection? Anyone of any age can become infected with E.coli O157:H7, but the very young and the elderly are more likely to develop serious complications. How does one get infected with E.coli O157:H7? The bacteria can be acquired by eating food containing the bacteria. The bacteria live in the intestines of some healthy cattle and contamination of the meat may occur in the slaughtering process. Deer meat (venison) may also be infected with the organism. Eating meat that is rare or inadequately cooked is the most common way of getting the infection. Fresh vegetables (lettuce), unpasteurized fruit juices (apple cider) and raw milk have also caused outbreaks. Any food product eaten raw can be contaminated by raw meat juices. Person-to-person transmission, especially in child care settings, can occur if infected people do not wash their hands after using the toilet or diapering children. Contaminated drinking water and swimming in contaminated shallow lakes may also cause infection. What are the symptoms of E.coli O157:H7? People infected by E.coli O157:H7 can develop a range of symptoms. Some infected people have mild diarrhea or no symptoms at all. Most identified cases develop severe diarrhea and abdominal cramps. Blood is often seen in the stool. Usually little or no fever is present. Symptoms generally appear 3-4 days after exposure, but can take as long as 9 days to appear. Persons experiencing these symptoms should contact their physician. How is E.coli O157:H7 infection diagnosed? Infection with E.coli O157:H7 can only be diagnosed by a special stool culture that is not performed in all laboratories. Public health authorities advise doctors and laboratories to consider performing a special stool culture test for E.coli O157:H7, particularly in people with bloody or severe diarrhea. What is the treatment for E.coli O157:H7 infection? Diarrhea and other symptoms generally go away without antibiotics or other specific treatment in five to 10 days. Scientific studies have not yet been conducted to determine if antibiotics are useful or harmful in the treatment of E.coli O157:H7 infection. It is recommended that antibiotics and diarrhea medicines not be given. What serious complications can result from E.coli O157:H7 infection? In some people, particularly children under five years of age, the infection can cause a complication called hemolytic uremic syndrome (HUS). This is a serious disease in which red blood cells are destroyed and the kidneys fail. Transfusions of blood or blood clotting factors, as well as kidney dialysis, may be necessary. A prolonged hospital stay is often required. Fortunately, most people with HUS recover completely, but it can be fatal. What can you do to prevent E.coli O157:H7 infection? Do not eat undercooked hamburger or other ground beef products. Cook roasts to at least 130 degrees F and other ground beef to 155 degrees F. Venison should be cooked to 165 degrees F. Make sure cooked ground beef is brown throughout (not pink) and the juices run clear. Drink only pasteurized milk, milk products and fruit juices. Carefully wash all produce, kitchen utensils and countertops. Wash hands carefully with soap after using the toilet or changing a child's diaper to reduce the risk of spreading disease. Wash hands with hot, soapy water, rubbing hands together for 20 seconds. Outbreaks The largest Washington state E.coli O1757:H7 outbreak was in 1993, when 477 people were infected from contaminated, undercooked hamburger. In 1994, 11 people were infected from contaminated ground beef and also in 1994, 15 people were infected from contaminated salami. Additional outbreaks have occurred in the United States from non-beef sources including lettuce and salad bars where foods were contaminated by improperly cleaned utensils, working surfaces and infected food handlers. In addition, outbreaks have occurred in people who have consumed garden vegetables fertilized with animal manure and unpasteurized apple cider. Cases Most infections with E.coli O157:H7 are single cases and not associated with outbreaks. The numbers of reported cases in Washington of E.coli O157:H7 peaked in 1993, and have been dropping since then. Case counts for 1991-1996 are listed below: 1991 -- 164 cases
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