Published Date: 2011-11-03 20:59:34
Subject: PRO/AH/EDR> E. coli VTEC - USA (09): (MO), O157, poss. produce link
Archive Number: 20111103.3276
E. COLI VTEC - USA (09): (MISSOURI), O157, POSSIBLE PRODUCE LINK
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
In this posting:
 St. Louis area
 Central Missouri
 St. Louis area
Date: Thu 3 Nov 2011
Source: KMOX [edited]
The Missouri Department of Health and Senior Services (DHSS) reports
the number of suspected _E. coli_ cases in the St. Louis area has now
reached 51 with 26 confirmed cases. The health department is leading a
team of local, federal, and state public health experts in
investigating the cause of the outbreak. The investigation involves
laboratory analysis, environmental sampling, and interviews of
reported cases. This information is then combined to determine the
possible cause(s) of the outbreak.
The Missouri State Public Health Laboratory has received an additional
38 food samples collected from 5 Schnuck's stores as a result of
patient interviews. Testing of those samples is currently underway.
The 38 food samples on which testing began include: Bistro Salad
Dressing, broccoli florets, deviled eggs, diced hard boiled eggs,
honey Dijon dressing, Italian dressing, pineapple chunks, red wine
vinaigrette, shredded carrots, shredded radishes, shredded zucchini,
sliced red onions, and the following packaged salads that included
salad bar ingredients: Bistro Chopped Salad, Fresco House Salad, Fried
Chicken Salad, Garden Salad, Italian Salad, and Turkey Cobb Salad.
Additional food samples are being collected and tested as the
To date, the State Lab is testing or has tested 51 samples from
individuals suspected to have the illness. So far, DHSS can report
that 26 individuals have laboratory-confirmed _E. coli_ illness. The
completion of testing on remaining samples continues.
DHSS continues to work closely with a team from the Centers for
Disease Control and Prevention (CDC). In addition to the assistance
that CDC scientists in St. Louis have been providing, the CDC this
evening will stand up a call center based out of Atlanta, Georgia to
assist with the case control study. The case control study will
compare what the people who became ill ate with what was consumed by
individuals that did not become ill. This will enhance efforts to
identify food(s) which may be the source of the _E. coli_. The call
center will contact residents in neighborhoods where patients have
been identified using random digit dialing.
DHSS has been working in consultation with the FDA and enlisted
additional assistance when it became known that products were obtained
from distributors and/or producers located outside of Missouri.
Inspectors from the FDA arrived in St. Louis to assist in the
inspection of facilities that may have been part of the distribution
As the investigation progresses, the investigators are also providing
updates to hospitals and health care professionals in the region.
These updates include diagnosis and treatment recommendations.
[ProMED-mail awaits more information regarding the vehicle of this
growing outbreak of enterohemorrhagic _E. coli_. - Mod.LL]
 Central Missouri
Date: Wed 2 Nov 2011
Source: Columbia Daily Tribune [edited]
Three people in Boone County have confirmed cases of _E. coli_
infection, but public health officials said there is no connection to
a St. Louis outbreak that has sickened 35 people since 25 Oct 2011.
Meanwhile, lab tests are pending for 2 other patients to confirm
whether they also have been infected.
"We are doing thorough foodborne investigations as we always do," said
Geni Alexander, spokeswoman for the Columbia/Boone County Department
of Public Health and Human Services. She said there was no evidence
that a particular location or food was linked to the confirmed and
"suspect" cases. "We found no commonality between those 5 people" who
reported suspected cases of _E. coli_ since 26 Oct 2011, Alexander
said. The 5th case was reported yesterday, 1 Nov 2011.
The Boone County _E. coli_ cases range in age from 11 to 63. "All 5
sought medical care," Alexander said. "2 of the 5 cases required
Boone County had no confirmed cases of _E. coli_ in 2008, 3 cases in
2009, and 1 case in 2010. The local health department has reported 8
confirmed or suspected cases so far in 2011.
[Byline: Jodie Jackson Jr]
[The serotype of these cases is not stated but is likely to be
O157:H7. Although the Boone County cases do not appear to be related
to the growing outbreak in St. Louis, which is about 70 miles [113 km]
to the east, only the genetic analysis of the isolates can show that
they are not related. - Mod.LL]
[The state of Missouri can be located on the HealthMap/ProMED-mail
interactive map at http://healthmap.org/r/1oUI. Boone County in
central Missouri can be seen on the map at