E. coli 0157:H7

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E. coli 0157H7
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• Presented by
• Kendra McQueen
• Jennifer Rasmussen
• Edward Guevara

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E. coli 0157H7
In February 2004, the Okinawa Prefectural Chabu
Health Center and the Okinawa Prefectural
Institute of Health and Environment reported
multiple cases of E. coli 0157H7 in a single
family possibly after eating contaminated meat
bought at a U.S. military commissary in Okinawa.
Positive ID of E. coli 0157H7 was made on
02/17/2004, after OCHC gathered samples of the
frozen meat and analyzed it by means of pulse
field gel electrophoresis (PFGE), a process in
which gel medium can differentiate between DNA
fragments, simply by changing the electrical
potential within the gel. The samples were sent
to PulseNet USA for comparison to U.S. isolates,
and matched E. coli 0757H7. To exclude the
possibility of contamination after opening of the
meat packages, the U.S. Naval Hospital, Okinawa,
Jp. Obtained unopened packages, leftovers, and
the samples of human isolates, and compared all
the samples. Per the report by the CDC, the
isolates had indistinguishable PFGE patterns.
Over 90000 Lbs of frozen meat from the U.S. and
Far East bases were pulled by Richwood Meat Co.,
Inc., of Merced, California.
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I thought E. Coli was Good?
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E. coli 0157H7

• E. coli is a normal inhabitant of the intestines
  of all animals, including humans. Normally E.
  coli serves a useful function in the body, by
  suppressing the growth of harmful bacterial
  species, and by synthesizing appreciable amounts
  of Vitamins. E. coli 0157H7 on the other hand
  produces toxins that cause severe damage to the
  lining of the intestine, and produce illness in
  humans. Some of the S/S are diarrhea, fever,
  cramps, Abd. pain, vomiting and in severe cases
  hemorrhagic diarrhea that can cause death in the
  very young and the very old.
• An estimated 73,000 cases occur annually in the
  United States. That number is probably many times
  multiplied due to poor reporting in less
  industrialized countries.

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Where does it come from?
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Come and get it, mmm
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E. coli 0157H7

• Undercooked or raw hamburger (ground beef) has
  been implicated in many of the documented
  outbreaks, however E. coli O157H7 outbreaks have
  implicated alfalfa sprouts, unpasteurized fruit
  juices, dry-cured salami, lettuce, game meat, and
  cheese curds. Raw milk was the vehicle in a
  school outbreak in Canada.

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Treatment
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E. coli 0157H7

• Most persons recover without antibiotics or other
  specific treatment in 5-10 days. Treatment of E.
  coli infection generally consists of managing
  dehydration caused by diarrhea. Usually, the
  infection goes away on its own. If you develop a
  severe blood problem, such as anemia, you will
  receive fluids and, if necessary, have a blood
  transfusion. If you develop kidney problems, you
  may have wastes removed from your blood
  (dialysis). Hemolytic uremic syndrome is a
  life-threatening condition usually treated in an
  intensive care unit. Blood transfusions and
  kidney dialysis are often required. With
  intensive care, the death rate for hemolytic
  uremic syndrome is 3-5.

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How do we control this type of epidemic outbreak ?
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E. coli 0157H7

• There are many ways to control this type of
  epidemic outbreak. Most important is to cook all
  ground beef and hamburger thoroughly. That means
  not only cooking until completely browned but
  also keeping a digital meat thermometer to check
  internal temperature. Also equally important is
  to avoid spreading the bacteria in the kitchen
  this is done a few different ways, always keep
  raw meat separate from ready-to-eat foods, always
  wash hands, counters and utensils with hot soapy
  water after they touch raw meat, never place
  cooked hamburgers or ground beef on the same
  plate that held the raw meat, and wash meat
  thermometers and utensils between tests of
  patties that require further cooking. Never
  hesitate to send a hamburger or ground beef back
  that looks undercooked. Another way to stop the
  spread of contamination is to assist toddlers to
  the bathroom and help them wash their hands
  thoroughly. Definitely be sure to wash hands
  after changing soiled diapers. Always have wipes
  and disinfectant spray handy in the bathroom,
  kitchen, and other places of need. Anyone with
  diarrhea should avoid swimming in public pools or
  lakes, sharing baths with others, and preparing
  food for others.

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How was this allowed to spread?
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E. coli 0157H7

• There were many conditions present that allowed
  bacterial growth and spread. First, since the
  organism is found in the intestines of healthy
  cattle, it is noted that meat can become
  contaminated during slaughter, and organisms can
  be thoroughly mixed into beef when it is ground.
  Also, meat is not being cooked sufficiently
  enough to kill the bacteria E. coli 0157H7. The
  bacteria in stool of infected persons can be
  passed from one person to another if hygiene and
  hand washing habits are inadequate. Toddlers and
  children contribute to the infecting others
  category greatly. This leads to children and
  toddlers spreading the bacteria to family members
  and playmates. Finally the 6 month lag between
  the production in the U.S. and the actual sale in
  Japan, demonstrates the long life of products
  such as frozen ground meat and the prolonged
  survival of food borne pathogens in frozen food.

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Can this be prevented?
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E. coli 0157H7

• The CDC explains that this organism lives in the
  intestines of healthy cattle, so preventative
  measures need to be taken at the very beginning.
  They go on to explain that research is being done
  to find measures that will prevent meat from
  being contaminated during the slaughter process.
  The consumer would take the next step of
  prevention, the CDC says that safe food handling
  in preparation of foods can correct the problem
  of contamination. Meat has to be cooked to the
  proper temperature. The CDC explains that a
  digital instant read thermometer should be used
  and the temperature should read 160 degrees F to
  be safe. The USDA explains that it is not enough
  to go by the color of the meat, depending on
  whether the meat is fresh or frozen can make a
  difference in the color of the meat at the safe
  temperature. They go on to explain how research
  shows that one quarter of the burgers tested were
  brown before the safe temperature was met. The
  CDC agrees and adds that beef can turn brown
  before the pathogenic bacteria are killed. CDC
  states that proper hand washing, as well as
  cleaning and disinfecting areas used in cooking
  can prevent and correct an outbreak.

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How do we educate the public?
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E. coli 0157H7

• Being educated about foods that hold a certain
  risk to consumers is very important in preventing
  outbreaks of E.coli as well as other food borne
  pathogens. The CDC says to cook beef thoroughly,
  avoid raw milk or fruit juice and wash hands.
• Get off to a CLEAN start
• One of the best ways to prevent the spreading of
  and illness is handwashing. This needs to be
  done before and after food handling as well as
  when switching between different foods.
• CHILL food and stop bacteria cold
• The danger zone for bacterial growth is between
  40-140 degrees F. Chilling foods does not kill
  the bacteria it only stops growth. Cooking
  kills.
• SEPARATE dont cross contaminate
• Raw meat should be placed on the bottom shelf in
  the fridge so it cannot drip onto other foods.
  When shopping, storing or preparing food, raw
  meat should be placed away from ready to eat
  foods.
• COOK safely
• Cooking meat to the safe temperature, 160
  degrees F, kills E.coli. Hamburger can turn
  brown before it is at this safe temperature. The
  look, color, or feel of the meat is not a test
  for doneness, only trust the thermometer.

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Sources

• CDC website
• http//www.cdc.gov
• Food Safety and Inspection Service
• http//www.fsis.usda.gov
• U.S. Food Drug Administration
• http//www.fda.gov
• http//www.cfsan.fda.gov
• Yahoo Health
• http//health.yahoo.com/ency/healthwise/hw133795
• USDA
• www.fsis.usda.gov/oa/news/1998/colorpr.htm
• Canadian Food Inspection Agency
  www.inspection.gc.ca/english/corpaffr/foodfacts/ec
  olie.shtml