Friday, August 31, 2018

PRO/AH/EDR> E. coli EHEC - USA (24): (FL) O26, grocery chain ground beef, alert, recall

E. COLI EHEC - USA (24): (FLORIDA) O26, GROCERY CHAIN GROUND BEEF,
ALERT, RECALL
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this posting:
[1] News report
[2] USDA-FSIS news release

******
[1] News report
Date: Thu 30 Aug 2018 06:55 PM EDT
Source: Miami Herald [edited]
<https://www.miamiherald.com/living/food-drink/article217612425.html>


Publix [supermarket chain] is recalling ground beef products sold this
summer [2018] after 18 cases of _E. coli_, mostly in Florida, can be
traced to the beef, according to the USDA. The list of counties that
received the tainted beef did not include Miami-Dade, Broward, Palm
Beach or Monroe counties. But it did include Brevard; Charlotte;
Citrus; Collier; DeSoto; Flagler; Hernando; Highlands; Hillsborough;
Indian River; Lake; Lee; Manatee; Marion; Orange; Osceola; Pasco;
Pinellas; Polk; Sarasota; Seminole; St. Lucie; Sumter; and Volusia.

The list of products, which were sold from 25 Jun 2018 through 31 Jul
2018, includes ground chuck; ground chuck burgers; gourmet burgers
(Jalapeno & Cheddar, Pimento & Cheese, Bacon & Cheddar, Bacon & Fried
Onion, Blue Cheese, and Swiss & Mushroom); seasoned ground chuck
burgers (Badia, Mesquite, Montreal, and Steakhouse); meatballs (Bacon
& Cheddar, Bacon & Fried Onion, Blue Cheese, Jalapeno & Cheddar, Swiss
& Mushroom, and Spanish); Meatloaf (Seasoned and Grillers); sliders
(Bacon & Cheddar, Bacon & Fried Onion, Ground Chuck, Blue Cheese,
Jalapeno & Cheddar, and Swiss & Mushroom); and stuffed peppers.

This is a class 1 recall, defined by the USDA as "a health hazard
situation where there is a reasonable probability that the use of the
product will cause serious, adverse health consequences or death."
Unless frozen, the products should have already been consumed or
tossed. The USDA and Publix worry is about what's in home freezers
across the counties above.

"Food safety is our top priority. We have been working closely with
various federal agencies as we share the common goal of maintaining
food safety and public health. We urge our customers to make sure they
no longer have ground chuck products purchased in the affected Florida
counties from 25 Jun through 31 Jul 2018 in their freezers," said
Maria Brous, Publix media and community relations director in a
company website statement. "Customers should dispose of the product or
bring it in for a full refund."

People can become sick 2 to 8 days after eating the contaminated meat.
Most _E. coli_ [the enterohemorrhagic cases related to Shiga toxin
producing strains - Mod.LL] issues deal with _E. coli_ O157:H7. This
is _E. coli_ O26, a similar strain. "Most people infected with O26
develop diarrhea (often bloody) and vomiting," the USDA said. "Some
illnesses last longer and can be more severe. Infection is usually
diagnosed by testing of a stool sample. Vigorous rehydration and other
supportive care is the usual treatment; antibiotic treatment is
generally not recommended. Most people recover within a week, but
rarely, some develop a more severe infection.

"Hemolytic uremic syndrome (HUS), a type of kidney failure, is
uncommon with the O26 infection."

[Byline: David J Neal]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[2] USDA-FSIS news release
Date: Thu 30 Aug 2018
Source: US Department of Agriculture Food Safety and Inspection
Service (USDA-FSIS) news release [edited]
<https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2018/recall-072-2018-release>


Publix Super Markets Inc. recalls ground chuck products due to
possible _E. coli_ O26 contamination
----------------------------------------------------------------------
Publix Super Markets Inc., a Lakeland, Florida, retail grocery store
chain is voluntarily recalling an undetermined amount of ground beef
products made from chuck that may be contaminated with _Escherichia
coli_ O26, the US Department of Agriculture's Food Safety and
Inspection Service (FSIS) announced today, 30 Aug 2018.

The ground chuck items were purchased by consumers from 25 Jun 2018,
through 31 Jul 2018. The following products are subject to recall:
<https://tinyurl.com/y96wsd2h>

These items were shipped to Publix Super Market retail locations in
the following Florida counties: <https://tinyurl.com/yck46ylb>

On 16 Aug 2018, FSIS was notified of an investigation of _E. coli_ O26
illnesses. FSIS, the Centers for Disease Control and Prevention, and
state public health and agriculture partners determined that raw
ground chuck was the probable source of the reported illnesses. The
epidemiological investigation identified 18 case-patients,
predominantly from Florida, with illness onset dates ranging from 5 to
25 Jul 2018. Traceback information indicated that case-patients
consumed ground chuck products purchased at various Publix Super
Markets that was supplied by a yet-to-be determined source. As this
investigation further develops, FSIS will continue to work with the
supermarket, suppliers and public health partners, and will provide
updated information should it become available.

_E. coli_ O26, like the more common _E. coli_ O157:H7, is a serovar of
Shiga toxin-producing enterohemorrhagic _E. coli_ (EHEC). People can
become ill from EHECs 2-8 days (average of 3-4 days) after exposure to
the organism.

Most people infected with EHEC O26 develop diarrhea (often bloody) and
vomiting. Some illnesses last longer and can be more severe. Infection
is usually diagnosed by testing of a stool sample. Vigorous
rehydration and other supportive care is the usual treatment;
antibiotic treatment is generally not recommended. Most people recover
within a week, but rarely, some develop a more severe infection.
Hemolytic uremic syndrome (HUS), a type of kidney failure, is uncommon
with EHEC O26 infection. HUS can occur in people of any age but is
most common in children under 5 years old, older adults and persons
with weakened immune systems. It is marked by easy bruising, pallor,
and decreased urine output. Persons who experience these symptoms
should seek emergency medical care immediately.

FSIS is concerned that some product may be frozen and in consumers'
freezers. Consumers who have purchased these products are urged not to
consume them. These products should be thrown away or returned to the
place of purchase.

FSIS routinely conducts recall effectiveness checks to verify
recalling firms notify their customers of the recall and that steps
are taken to make certain that the product is no longer available to
consumers. When available, the retail distribution list(s) will be
posted on the FSIS website at <http://www.fsis.usda.gov/recalls>.

FSIS advises all consumers to safely prepare their raw meat products,
including fresh and frozen, and only consume ground beef that has been
cooked to a temperature of 160 F [71 C]. The only way to confirm that
ground beef is cooked to a temperature high enough to kill harmful
bacteria is to use a food thermometer that measures internal
temperature (<http://1.usa.gov/1cDxcDQ>). Consumers should take proper
precautions when handling raw meat products. Proper hand washing after
handling raw meat, poultry and eggs can greatly reduce the risk of
bacterial cross-contamination to other foods and kitchen surfaces. It
is important to prevent cross-contamination by washing counter tops
and sinks with hot, soapy water.

Media with questions can contact Maria Brous, Publix Super Market's
Director of Media and Community Relations, at (863) 680-5339.
Consumers with questions can contact Publix Super Market's customer
care department at 1-800-242-1227 or visit their website at
<http://www.publix.com/contactus> [the site is not fully available
outside the USA].

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[HealthMap/ProMED-mail map of Florida, United States:
<http://healthmap.org/promed/p/212>
Florida county map:
<https://www.mapofus.org/wp-content/uploads/2013/09/FL-county.jpg>

The FSIS report states that not all cases were identified in Florida.

In analyzing the genetic and phenotypic profiles of non-O157 groups,
it has been found that they belong to their own lineages and have
unique profiles of virulence traits different from O157 (1). The
serogroups appearing to be most prominent are O26, O111, O128, and
O103 (2), the former serotype being the implicated strain in this
outbreak.

If a laboratory is using sorbitol-MacConkey (sMAC) plates to identify
EHEC by virtue of O157's inability to ferment sorbitol, the non-O157
strains will be missed. In a 3-year pediatric study from the
University of Washington, USA (3), 1851 stool samples were processed
for sorbitol fermentation as well as toxin production by EIA (enzyme
immunoassay), and 28 strains of O157 were found along with O103 (4
strains), O118 (2 strains), O111 (2 strains), and 3 other strains.

Clinically, the O157 infections had a higher frequency of bloody
stools, fecal leukocytes, and abdominal pain with shorter symptom
duration. Five (18 per cent) of O157 infections developed hemolytic
uremic syndrome (HUS); none of the non-O157 strains did. Since toxin
assay did not identify all O157 strains found on sMAC plates, the
investigators did not advocate performing toxin assay alone. Non-O157
can produce HUS, as demonstrated by a cluster of O121 cases associated
with a lake in Connecticut, USA (4).

Since toxin assays are not uniformly performed in many areas, and most
cases do not produce HUS, it is likely that cases due to non-O157
strains are being missed. How frequent this phenomenon will become
over time is unclear.

References
----------
1. Schmidt H, Geitz C, Tarr PI, et al. Non-O157:H7 pathogenic
Shiga-toxin producing _Escherichia coli_: phenotypic and genetic
profiling of virulence traits and evidence for clonality. J Infect Dis
1999; 179(1): 115-23; available at
<https://academic.oup.com/jid/article/179/1/115/877122>.
2. Bettelheim KA. Role of non-O157 VTEC. Symp Ser Soc Appl Microbiol
2000; (29): 38S-50S; abstract available at
<http://www.ncbi.nlm.nih.gov/pubmed/10880178>.
3. Klein EJ, Stapp JR, Calusen CR, et al. Shiga toxin-producing
_Escherichia coli_ in children with diarrhea: a prospective
point-of-care study. J Pediatr 2002; 141(2): 172-7; available at
<http://www.ncbi.nlm.nih.gov/pubmed/12183710>.
4. McCarthy TA, Barrett NL, Hadler JL, et al: Hemolytic-uremic
syndrome and _Escherichia coli_ O121 at a lake in Connecticut, 1999.
Pediatrics 2001; 108(4): E59; available at
<http://pediatrics.aappublications.org/cgi/content/full/108/4/e59>.
- Mod.LL]

[See Also:
E. coli EHEC - USA (23): (OK) possible recreational water exposure
http://promedmail.org/post/20180801.5941698
E. coli EHEC - USA (22): (WA) restaurants
http://promedmail.org/post/20180708.5893948
E. coli EHEC - USA (21): (TN) O157, 2 clusters, 2 sources
http://promedmail.org/post/20180706.5891482
E. coli EHEC - USA (20): O157, romaine lettuce, water source
http://promedmail.org/post/20180702.5882323
E. coli EHEC - USA (19): (UT, AZ) O157, 2017
http://promedmail.org/post/20180616.5858104
E. coli EHEC - USA (18): (TN) raw milk, more cases
http://promedmail.org/post/20180614.5856110
E. coli EHEC - USA (17): (OR) O111, daycare center
http://promedmail.org/post/20180613.5854733
E. coli EHEC - USA (16): (TN) raw milk
http://promedmail.org/post/20180607.5844304
E. coli EHEC - USA (15): O157, romaine lettuce, more cases, fatal
http://promedmail.org/post/20180604.5837662
E. coli EHEC - USA (14): (WA) sandwich shops
http://promedmail.org/post/20180527.5820803
E. coli EHEC - USA (13): O157, romaine lettuce, increasing cases,
fatality http://promedmail.org/post/20180517.5799620
E. coli EHEC - USA (12): O157, romaine lettuce, increasing cases,
fatality http://promedmail.org/post/20180510.5791677
E. coli EHEC - USA (11): (OK) day care center
http://promedmail.org/post/20180502.5780250
E. coli EHEC - USA (10): O157, romaine lettuce, fatality
http://promedmail.org/post/20180502.5780249
E. coli EHEC - USA (09): O157, romaine lettuce
http://promedmail.org/post/20180427.5771229
E. coli EHEC - USA (08): (CA) military outbreak, undercooked beef,
2017 http://promedmail.org/post/20180425.5769489
E. coli EHEC - USA (07): O157, romaine lettuce
http://promedmail.org/post/20180425.5769488
E. coli EHEC - USA (06): O157, romaine lettuce
http://promedmail.org/post/20180421.5761217
E. coli EHEC - USA (05): O157, romaine lettuce
http://promedmail.org/post/20180418.5756056
E. coli EHEC - USA (04): O157, romaine lettuce
http://promedmail.org/post/20180413.5745944
E. coli EHEC - USA (03): O157, expansion of NJ outbreak
http://promedmail.org/post/20180411.5738813
E. coli EHEC - USA (02): (NJ) poss. restaurant chain link, RFI
http://promedmail.org/post/20180405.5728398
E. coli EHEC - USA: O157, leafy greens
http://promedmail.org/post/20180110.5550773
2017
----
E. coli EHEC - USA (39): relatedness to Canada isolates
http://promedmail.org/post/20171229.5527271
E. coli EHEC - Canada (14): O157, lettuce, fatal
http://promedmail.org/post/20171222.5518867
E. coli EHEC - Canada (13): O157, lettuce, fatal
http://promedmail.org/post/20171215.5506384
E. coli EHEC - Canada (12) : O157, lettuce
http://promedmail.org/post/20171212.5497097
E. coli EHEC - USA (38): (CA)
http://promedmail.org/post/20171212.5498214
E. coli EHEC - USA (37): raw dough, FDA alert
http://promedmail.org/post/20171202.5479176
E. coli EHEC - USA (36): (CA) military outbreak, O157
http://promedmail.org/post/20171111.5436982
E. coli EHEC - USA (35): (CA) military outbreak, O157
http://promedmail.org/post/20171104.5424631
E. coli EHEC - USA (34): (CA) military outbreak, O157
http://promedmail.org/post/20171103.5422415
E. coli EHEC - USA (33): (CA) military outbreak, O157
http://promedmail.org/post/20171102.5421203
E. coli EHEC - USA (32): (CA) military outbreak, revised case numbers
http://promedmail.org/post/20171102.5420166
E. coli EHEC - USA (31): (CA) military outbreak
http://promedmail.org/post/20171101.5417972
E. coli EHEC - USA (30): (CA) military outbreak, RFI
http://promedmail.org/post/20171031.5416569
E. coli EHEC - USA (29): (MI) farm animal exposures, RFI
http://promedmail.org/post/20171030.5410350
E. coli EHEC - USA (28): (VT) O157, ground beef, alert, recall
http://promedmail.org/post/20171014.5381117
E. coli EHEC - USA (27): (WI) O157, RFI
http://promedmail.org/post/20170921.5330484
E. coli EHEC - USA (26): (MI) O157, antimicrobial resistance
http://promedmail.org/post/20170824.5272308
E. coli EHEC - USA (25): (CA) O157, recreational water
http://promedmail.org/post/20170818.5258783
E. coli EHEC - USA (24): (CO) county fair, RFI
http://promedmail.org/post/20170811.5243577
E. coli EHEC - USA (23): (CA) recreational water
http://promedmail.org/post/20170810.5240983
E. coli EHEC - USA (22): (CA) recreational water
http://promedmail.org/post/20170804.5227891
E. coli EHEC - USA (21): (CA) recreational water
http://promedmail.org/post/20170802.5220799
E. coli EHEC - USA (20): (CA) recreational water, RFI
http://promedmail.org/post/20170731.5217061
E. coli EHEC - USA (19): (UT, AZ) O157, fatalities, susp. livestock
exposure http://promedmail.org/post/20170730.5215421
E. coli EHEC - USA (18): (UT, AZ) O157, fatalities
http://promedmail.org/post/20170727.5206988
E. coli EHEC - USA (17): (OH) summer camp, RFI
http://promedmail.org/post/20170724.5198725
E. coli EHEC - USA (16) : (MN) fatality
http://promedmail.org/post/20170721.5195217
E. coli EHEC - USA (15): (UT) O157, fatalities
http://promedmail.org/post/20170711.5167176
E. coli EHEC - USA (14): (UT) O157, fatalities
http://promedmail.org/post/20170705.5152059
E. coli, EHEC - USA (13): (UT) fatalities, susp EHEC, RFI
http://promedmail.org/post/20170703.5147181
E. coli EHEC - USA (12): (TX)
http://promedmail.org/post/20170621.5121066
E. coli EHEC - USA (11): O157, deer droppings, water exposure, 2016
http://promedmail.org/post/20170511.5028649
E. coli EHEC - USA (10): O157, soynut butter
http://promedmail.org/post/20170505.5014128
E. coli EHEC - USA (09): (AR) fatality, unrelated cases
http://promedmail.org/post/20170422.4988037
E. coli EHEC - USA (08): (AR) fatality, RFI
http://promedmail.org/post/20170421.4984124
E. coli EHEC - USA (07): (MA) O157, restaurant chain, RFI
http://promedmail.org/post/20170414.4970974
E. coli EHEC - USA (06): O157, soynut butter
http://promedmail.org/post/20170405.4949992
E. coli EHEC - USA (05): O157, soynut butter, CDC update
http://promedmail.org/post/20170401.4941247
E. coli EHEC - USA (04): (OR) O157, soynut butter, preschool
http://promedmail.org/post/20170315.4902827
E. coli EHEC - USA (03): O157, soynut butter, more cases, recall
http://promedmail.org/post/20170308.4887992
E. coli EHEC - USA (02): O157, soynut butter
http://promedmail.org/post/20170307.4883675
E. coli EHEC - USA http://promedmail.org/post/20170302.4875298
2016
----
E. coli EHEC - USA (25): O121, O26, flour, alert, expanded recall
http://promedmail.org/post/20160726.4371012
E. coli EHEC - USA: O26, restaurant chain, 2nd genotype, RFI
http://promedmail.org/post/20160110.3924096
2015
----
E. coli EHEC - USA (27): O26, restaurant chain
http://promedmail.org/post/20151205.3842020
E. coli EHEC - USA (21): O26, restaurant chain
http://promedmail.org/post/20151122.3809128
E. coli EHEC - USA (20): (WA, OR) O26, restaurant chain
http://promedmail.org/post/20151117.3799040
E. coli EHEC - USA (18): (WA,OR) O26, restaurant chain
http://promedmail.org/post/20151107.3774942]
.................................................ll/mj/dk
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