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Back To Vidyya Possible E. Coli Outbreak Investigated In Mississippi

Possible Outbreak Of E. Coli 0157:H7 On The Popular Gulf Coast

State Department of Health disease investigators are looking into a possible outbreak of E. coli 0157:H7 on the Gulf Coast. One confirmed case and two suspected cases discovered through the Department's routine surveillance of reportable diseases jump-started the investigation.

Officials stressed that no outbreak has been confirmed at this time. They are focusing efforts to determine whether the illness in the two suspect cases was caused by E. coli 0157:H7 and whether any additional case has occurred.

Escherichia coli 0157:H7 is an emerging cause of foodborne illness in the United States. An estimated 73,000 cases of infection and 61 deaths occur each year. E. coli 0157:H7 infection commonly produces bloody diarrhea and occasionally leads to kidney failure and a blood disorder known as hemolysis.

Mississippi Department of Health officials confirmed E. coli in an adult male Gulf Coast resident. Two other unrelated individuals with disease symptoms "consistent with," but not specific for, E. coli are being investigated as possible cases. Initial tests for E. coli were negative in both, but additional laboratory testing is being done before E. coli can be ruled out.

Public health officials have not yet identified a source for the confirmed case. The public health team is working with private medical doctors and facilities to look for other possible cases and to find any "common thread" among the case and suspects.

Like most states, Mississippi began aggressively counting E. coli cases in 1994. Only one case was reported that year, with three reported in 1995, 13 in 1996, seven cases each in 1997 and 1998, and eight in 1999. To date in 2000, case reports total 18.

"We are investigating the latest case as a possible outbreak because of the closeness in time and geography with two additional suspect cases," State Health Officer Dr. Thompson said. "This is a red flag, and we are treating it very seriously. If an outbreak is occurring, our goal is to find its source and try to prevent additional cases."

E. coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of severe bloody diarrhea; the outbreak was traced to contaminated hamburgers. Since then, most infections have come from eating undercooked ground beef.

Most illness has been associated with eating undercooked, contaminated ground beef, but E. coli O157:H7 has also been transmitted by produce, salami, and apple cider. Person-to-person contact in families and child care centers is also an important mode of transmission. Infection can result from drinking unpasteurized milk and after swimming in or drinking sewage-contaminated water.

Consumers can prevent E. coli O157:H7 infection by thoroughly cooking ground beef, avoiding unpasteurized milk, and washing hands carefully. The Centers for Disease Control and Prevention offers these tips:

  • * Cook all ground beef and hamburger thoroughly. Because ground beef can turn brown before disease-causing bacteria are killed, use a digital instant-read meat thermometer to ensure thorough cooking to at least 160o F. Persons who cook ground beef without using a thermometer can decrease their risk of illness by not eating ground beef patties that are still pink in the middle.
  • * If served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking. Ask for a new bun and a clean plate, too.
  • * Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties. Wash meat thermometers in between tests of patties that require further cooking.
  • * Drink only pasteurized milk, juice, or cider. Commercial juice with an extended shelf-life that is sold at room temperature (e.g. juice in cardboard boxes, vacuum sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Juice concentrates are also heated sufficiently to kill pathogens.
  • * Wash fruits and vegetables thoroughly, especially those that will not be cooked. Children under five years of age, immuno-compromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated.
  • * Drink municipal water that has been treated with chlorine or other effective disinfectants.
  • * Avoid swallowing lake or pool water while swimming.

E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless and live in the intestines of healthy humans and animals, this strain produces a powerful toxin and can cause severe illness. The combination of letters and numbers in the name of the bacterium refers to the specific markers found on its surface and distinguishes it from other types of E. coli.

Most persons recover without antibiotics or other specific treatment in five to 10 days. No evidence indicates that antibiotics improve the course of disease, and treatment with some antibiotics might precipitate kidney complications. Persons who have only diarrhea usually recover completely.

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Editor: Susan K. Boyer, RN
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