| Health Advisory -- September 15, 2006
Multiple State E. coli O157:H7 Outbreak
Public health officials in multiple states, with the assistance of the Centers for Disease Control and Prevention (CDC), are investigating a large outbreak of E. coli O157:H7 infections. Thus far, 50 cases with isolates demonstrating a common pulsed-field gel electrophoresis (PFGE) pattern have been reported from CT (1), ID (3), IN (4), MI (3), OR (5), NM (2), UT (11), WI (20). There is one Washington State case, from Cowlitz County, (counted in the Oregon numbers, above).
Eight patients developed hemolytic uremic syndrome (HUS) and one patient in Wisconsin died. Most cases are recent: for those with known illness onset, the range of onset is 08/25/2006 to 09/03/2006. The outbreak is likely ongoing.
Preliminary findings from case interviews indicate that pre-packaged spinach is the most likely source. Additional investigation is necessary to determine the brand or brands of pre-packaged spinach involved. State and CDC investigators are working with FDA to quickly gather information to take action to protect the public. The FDA advises that consumers not eat bagged fresh spinach at this time.
King County healthcare providers are requested to review the following information:
- E. coli O157:H7 infection causes diarrhea that is often bloody and accompanied by abdominal cramps, but fever is absent or mild. The illness typically resolves within a week. However, some people, especially young children and the elderly, develop hemolytic uremic syndrome, or HUS.
- Because of the potential for serious life-threatening illness, people with either bloody diarrhea or diarrhea with severe cramping should be evaluated. A petechial rash in addition to these symptoms is an indication for urgent evaluation.
- Healthcare providers who see a patient with compatible symptoms should order a stool culture requesting specific testing for E. coli O157:H7. If petechiae are present, the laboratory evaluation should include a complete blood count, serum electrolytes, BUN and creatinine, and urinalysis
Suspected and confirmed E. coli O157:H7 cases should be reported immediately to Public Health at (206) 296-4774. For cases in whom spinach is the potential exposure, please ask patients to refrigerate the remaining spinach in its original bag for possible testing.
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E. coli fact sheet
Most strains of
E. coli are harmless. However, one particular strain, E. coli O157:H7, may cause serious illness in people.
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