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E. coli EHEC - USA (22): (CALIFORNIA) RECREATIONAL WATER

E. COLI EHEC - USA (22): (CALIFORNIA) RECREATIONAL WATER

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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>
Date: Thu 3 Aug 2017
Source: The Sacramento (CA) Bee [edited] <http://www.sacbee.com/news/local/health-and-medicine/article165267147.html>


All beaches in the Nevada County community of Lake Wildwood have now been closed after water testing revealed _Escherichia coli_ at 3 locations, according to the Nevada County Public Health Department.

County authorities closed off the gated community's Main Beach, also known as Commodore Park, last [Fri 28 Jul 2017], a day after receiving reports of potential _E. coli_ infection in people who had visited the area. Additional beaches were closed after _E. coli_ bacteria were confirmed present [Tue 1 Aug 2017] in shallow water at 3 of the 5 Lake Wildwood beaches tested: Meadow Park, Hideaway Park, and Commodore Park. All children known by the county to be infected played on the latter, the Nevada County Public Health Department said.

The beaches will remain off-limits until bacteria levels subside, and the county Public Health Department has warned all lake-goers to stay out of the water.

As of [Wed 2 Aug 2017], the county has reported that one adult and 9 children have become ill in connection with the man-made lake. 6 of the children have been hospitalized, 2 of whom were later discharged.
Recovery time for an _E. coli_ infection, which can cause symptoms ranging from cramps to often-bloody diarrhea to nausea, is typically 5 to 10 days, according to WebMD, an online health site.

Three of the children have developed a serious condition called hemolytic-uremic syndrome (HUS) that can result in kidney failure. While most people who contract HUS recover, according the county's public health department, the condition can be fatal. No updates on the children's conditions were available [Thu 3 Aug 2017], said county public health coordinator Patti Carter.

County officials are still trying to determine the cause of the lake's contamination, she said, and will continue to test water for bacteria twice a week at 7 locations along the 5 beaches already checked. Nevada County's Public Works Department found no leaks from nearby sewer lines.

Amy Irani, the county's environmental health director, said the county is examining creeks flowing into the lake, feces from deer, geese, or turkeys, and contamination from humans as possible sources of the bacteria. No reopening date for the beaches has been set. "Unfortunately, this is a natural bathing area, and unlike a swimming pool, chemicals cannot be added to remedy the _E. coli_ bacteria," Irani wrote by email. "Time is what is needed, and thus the closures will remain in effect until further notice."

A public pool at Lake Wildwood remains open as it has not been linked to _E. coli_. In addition to closing beaches, the county's Environmental Health Department and the Lake Wildwood Association have posted signs cautioning about _E. coli_ risk.

[byline: Hannah Knowles]

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

[The state of California can be located on the HealthMap/ProMED-mail interactive map at <http://healthmap.org/promed/p/62262>. Nevada County in eastern California can be seen on the map at <http://geology.com/county-map/california-county-map.gif>. -Sr.Tech.Ed.MJ

This apparently waterborne outbreak of presumed EHEC (enterohemorrhagic _E. coli_; the serotype has not yet been reported) is now up to 10 cases with 3 of these developing hemolytic-uremic syndrome (HUS). HUS generally occurs in 10 per cent or less of EHEC infections so more cases may well have occurred and are not yet reported. Also, since EHEC can have an incubation period up to 12-14 days, more cases may well occur.

Although EHEC is most often associated with undercooked ground beef or other contaminated food, the disease can also be transmitted when people drink, or swim in, tainted water. The primary carriers are cattle but can be deer, sheep, goats, and other livestock, wild animals or humans. In the spring of 2000, in Walkerton, a town of 5000 in southern Ontario, an outbreak of _E. coli_ O157:H7 infection claimed 7 lives -- 6 adults and a child -- and over 200 were seen at local area hospitals.

Swimming-associated transmission is illustrated in the references:
1. Keene WE, McAnulty JM, Hoesly FC, et al. A swimming-associated outbreak of hemorrhagic colitis caused by _Escherichia coli_ O157:H7 and _Shigella sonnei_. N Engl J Med. 1994; 331(9): 579-84; available at <http://www.nejm.org/doi/full/10.1056/NEJM199409013310904>.
2. CDC. Lake-associated outbreak of _E. coli_ O157:H7 - Illinois. MMWR 1996; 45(21): 437-9; available at <https://www.cdc.gov/mmwr/preview/mmwrhtml/00042070.htm>.
3. Ackman D, Marks S, Mack, P et al. Swimming-associated hemorrhagic colitis due to _Escherichia coli_ O157:H7 infection: evidence of prolonged contamination of a fresh water lake. Epidemiol Infect. 1997; 119: 1-8; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808815/>. -Mod.LL]

[See Also:
E. coli EHEC - USA (21): (CA) recreational water
E. coli EHEC - USA (20): (CA) recreational water, RFI
E. coli EHEC - USA (19): (UT, AZ) O157, fatalities, susp. livestock exposure
E. coli EHEC - USA (18): (UT, AZ) O157, fatalities
E. coli EHEC - USA (17): (OH) summer camp, RFI
E. coli EHEC - USA (16) : (MN) fatality
E. coli EHEC - USA (15): (UT) O157, fatalities
E. coli EHEC - USA (14): (UT) O157, fatalities
E. coli EHEC - USA (13): (UT) fatalities, susp EHEC, RFI
E. coli EHEC - USA (12): (TX)
E. coli EHEC - USA (11): O157, deer droppings, water exposure, 2016
E. coli EHEC - USA (10): O157, soynut butter
E. coli EHEC - USA (09): (AR) fatality, unrelated cases
E. coli EHEC - USA (08): (AR) fatality, RFI
E. coli EHEC - USA (07): (MA) O157, restaurant chain, RFI
E. coli EHEC - USA (06): O157, soynut butter
E. coli EHEC - USA (05): O157, soynut butter, CDC update
E. coli EHEC - USA (04): (OR) O157, soynut butter, preschool
E. coli EHEC - USA (03): O157, soynut butter, more cases, recall
E. coli EHEC - USA (02): O157, soynut butter
E. coli EHEC - USA

2016
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E. coli EHEC - USA (35): (KS) 0157, cider festival, RFI
E. coli EHEC - USA (34): O157, ground beef, alert, recall
E. coli EHEC - USA (33): (WA) O157, restaurant, separate strain
E. coli EHEC - USA (32): O157, foodborne
E. coli EHEC - USA (31): (WA) restaurant
E. coli EHEC - USA (30): (MO) school children, RFI
E. coli EHEC - USA (29): (MI) unpasteurized milk
E. coli EHEC - USA (27): (MT) O157, town celebration, RFI
E. coli EHEC - USA (26): (MI) cheese, alert, recall
E. coli EHEC - USA (25): O121, O26, flour, alert, expanded recall
E. coli EHEC - USA (24): (NH)
E. coli EHEC - USA (23): (WA) RFI
E. coli EHEC - USA (22): (IL) restaurant
E. coli EHEC - USA (21): (OH) ex Cote d'Ivoire
E. coli EHEC - USA (20): (OH) ex Cote d'Ivoire
E. coli EHEC - USA (19): (IL) restaurant
E. coli EHEC - USA (18): (CO) O157, restaurant
E. coli EHEC - USA (17): (WA) RFI
E. coli EHEC - USA (16): O121, flour, alert, recall
E. coli EHEC - USA (15): (CA) possible creek water exposure
E. coli EHEC - USA (14) : O121, flour, alert, recall
E. coli EHEC - USA (13): (CT) O157, goat farm exposure, RFI
E. coli EHEC - USA (12): (CT) O157, goat farm exposure
E. coli EHEC - USA (11): O157, goat farm exposure
E. coli EHEC - USA (10): O157, goat farm exposure
E. coli EHEC - USA (09): goat farm exposure
E. coli EHEC - USA (08): O157, dough susp
E. coli EHEC - USA (07): (MN,KS) O157, pizza dough susp
E. coli EHEC - USA (06): (MN,WI) sprouts
E. coli EHEC - USA (05): (CA) O157, unpasteurized milk, alert, recall
E. coli EHEC - USA (04): (CA) O157, unpasteurized milk, alert, recall
E. coli EHEC - USA (03): (CA) O157, unpasteurized milk, alert, recall
E. coli EHEC - USA (02): (TN) O157, ground beef, alert, recall

Published 16-01-2017 in Focus on , last update 17-08-2017

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