PRO/AH/EDR> E. coli EHEC - USA (01): O157, CDC, insalata in busta

E. COLI EHEC - USA (01): O157, CDC, PACKAGED SALAD
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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 30 Dec 2021
Source: Centers for Disease Control and Prevention (CDC) [edited]
https://www.cdc.gov/ecoli/2021/o157h7-12-21/details.html

_E. coli_ outbreak linked to packaged salads
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CDC, public health and regulatory officials in several states, and the US Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of _Escherichia coli_ O157:H7 infections. Epidemiologic data show that Simple Truth Organic brand and Nature's Basket brand Organic Power Greens may be contaminated with _E. coli_ and may be making people sick.

Epidemiologic data
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As of 29 Dec 2021, 13 people infected with the outbreak strain of _E. coli_ O157:H7 have been reported from 6 states (see map https://www.cdc.gov/ecoli/2021/o157h7-12-21/map.html). Illnesses started on dates ranging from 27 Nov 2021 to 9 Dec 2021 (see timeline https://www.cdc.gov/ecoli/2021/o157h7-12-21/epi.html).

State of residence / Number of sick people
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Alaska / 2
California / 1
Mississippi / 1
Ohio / 1
Oregon / 1
Washington / 7

Sick people range in age from 4 to 79 years (median 54), and 92% are female. Of 12 people with information available, 4 have been hospitalized and one person developed a type of kidney failure called hemolytic uremic syndrome (HUS). No deaths have been reported.

The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for _E. coli_. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of 12 people interviewed, all reported eating packaged salads. Of 10 people who provided brand information, 6 ate or bought Simple Truth Organic Power Greens and one ate Nature's Basket Organic Power Greens. Both Organic Power Greens salads have the same mix of leafy greens: organic spinach, mizuna, kale, and chard. Several sick people reported using these salads in smoothies.

Laboratory data
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Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people's samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

Public health actions
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CDC is advising not to eat Simple Truth Organic Power Greens and Nature's Basket Organic Power Greens with "best if used by" dates through 20 Dec 2021. Investigators are working to determine if additional products may be contaminated.

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communicated by: ProMED

[This outbreak is likely to be the one we reported yesterday (ProMED. E. coli EHEC - USA (22): O157, FDA, unknown source 20211230.8700592) for which no suspected vehicle for transmission had been identified. - Mod.LL

ProMED map: United States: https://promedmail.org/promed-post?place=8700612,106]