Published Date: 2010-05-25 15:00:04
Subject: PRO/AH/EDR> E. coli VTEC non-O157 - USA (05): O145, lettuce
Archive Number: 20100525.1738

E. COLI VTEC NON-O157 - USA (05): O145, LETTUCE
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Date: Fri 21 May 2010
Source: CDC, E. coli Outbreak Investigations [summ. & edited]
<http://www.cdc.gov/ecoli/2010/ecoli_o145/>


[Final update from CDC]
-----------------------
Local and state public health officials in Michigan, New York, Ohio,
Pennsylvania, and Tennessee are investigating human illnesses caused
by _E. coli_ O145. CDC is supporting these investigations and
facilitating regular communication and information sharing between
the states and with the FDA.

As of 20 May 2010, a total of 26 confirmed and 7 probable cases
related to this outbreak have been reported from 5 states since 1 Mar
2010. The number of ill persons identified in each state with this
strain is: MI (11 confirmed and 2 probable), NY (5 confirmed and 2
probable), OH (8 confirmed and 3 probable), PA (1 confirmed), and TN
(1 confirmed). The reported cases in Tennessee and Pennsylvania do
not reflect expansion of the outbreak but retrospective
identification of cases using the PulseNet system -- these cases are
part of the original cluster due to the original implicated lot of
lettuce from March [2010].

Among the 30 patients with available information, 12 (40 percent)
were hospitalized. 3 patients have developed a type of kidney failure
known as hemolytic uremic syndrome, or HUS. No deaths have been
reported.

Multiple lines of evidence have implicated shredded romaine lettuce
from a single processing facility as a source of infection in this
outbreak. This evidence includes the identification of the outbreak
strain of _E. coli_ O145 from an unopened package of shredded romaine
lettuce obtained at an institution that received product from the
processing facility linked to the outbreak. Case-control studies in
Michigan and Ohio found significant associations between illness and
consumption of romaine lettuce processed at the same facility that
processed lettuce consumed by ill persons in New York, Pennsylvania,
and Tennessee.

The lettuce processing company has issued a recall of lettuce
produced at their facility as a result of the evidence obtained to
date. An additional recall was issued by a separate company that
received lettuce from the same farm as the processing company linked
to the outbreak.

Testing of shredded romaine lettuce from the processing company also
identified an _E. coli_ O143 producing Shiga toxin 1, which is
different from the outbreak strain. This strain is not associated
with any human illness, and appears to be an incidental finding.

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See Also

E. coli VTEC non-O157 - USA (04): O145, lettuce 20100517.1618
E. coli VTEC non-O157 - USA (03): O145, lettuce, recall 20100507.1483
E. coli VTEC non-O157 - USA (02): (OH, MI, NY) O145 20100505.1460
E. coli VTEC non-O157 - USA: (MI, OH) 20100427.1358
2008
----
E. coli VTEC non-O157, restaurant - USA (04): (OK), O111 20081201.3779
E. coli VTEC non-O157, restaurant - USA: (OK), O111 20080902.2748
E. coli VTEC non-O157, past. ice cream, 2007 - Belgium: Antwerp 20080218.0655
2007
----
E. coli VTEC non-O157, beef sausage - Denmark 20070602.1784
E. coli VTEC non-O157, 2000-2005 - USA (CT) 20070118.0240
2006
----
E. coli VTEC non-O157, lettuce - USA (UT)(02): background 20060905.2523
E. coli VTEC non-O157, lettuce - USA (UT) 20060904.2521
E. coli VTEC non-O157 - Norway (03) 20060416.1133
E. coli VTEC non-O157 - Norway 20060329.0947
E. coli VTEC non-O157, minced beef - Norway 20060304.0680
2005
----
E. coli O145, fatal - Slovenia 20050916.2739
2003
----
E. coli, VTEC non-O157 - UK (Scotland): correction 20030828.2166
E. coli, VTEC non-O157 - UK (Scotland) 20030825.2144
2001
----
E. coli O26 - South Korea 20010509.0896
1999
----
E. coli O111, diarrhea - USA (Texas) 19990707.1134
1997
----
E. coli, non-0157 - Belgium 19970610.1215
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