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
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
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
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
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
- * 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
- * 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.