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E. COLI O157, FAST FOOD - USA (MULTISTATE)(02)
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A ProMED-mail post
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International Society for Infectious Diseases
<http://www.isid.org>
[1]
Date: Thu, 7 Dec 2006
From: ProMED-mail <promed@promedmail.org>
Source: New York Times [edited]
<http://www.nytimes.com/2006/12/07/nyregion/07coli.html?ref=health>
After Taco Bell traced a growing _E. coli_ outbreak to green onions
at its restaurants yesterday morning, 6 Dec 2006, government
investigators began an intensive search to identify the source of the
contamination. The total number of cases in 3 Northeastern states
swelled to 99, implicating several additional restaurants and a 2nd
food distributor, who said the onions came from a California farm.
Taco Bell officials said early yesterday, 6 Dec 2006, that their
preliminary tests had traced the _E. coli_ to 3 samples of green
onions, which the restaurant chain sprinkles on many of its menu
items. In what the company president, Greg Creed, called "an
abundance of caution," Taco Bell removed green onions from its 5800
outlets across the USA.
A Suffolk County (NY) laboratory later confirmed _E. coli_ in 3 of 4
green onions taken from a previously unopened package at one of the
restaurants, "suggesting that it was already contaminated before it
arrived," said Suffolk's acting health commissioner, Dr. David G.
Graham. County officials retrieved the green onions from a Taco Bell
in Deer Park after the franchise identified them as the probable
cause of the outbreak.
New cases were reported yesterday in New York, New Jersey and
Pennsylvania. In New York, the number of sick people on Long Island
nearly doubled to 41, while the outbreak spread to far-flung counties
upstate, where several new cases were reported. The Taco Bell
franchises in upstate New York get their food from a distribution
center in Albany, not the huge warehouse in Burlington, NJ, that
serves the Taco Bell outlets first tied to the outbreak.
Three new cases were reported in New Jersey, for a total of 43 under
investigation. The new cases included that of a 43-year-old North
Plainfield man who ate at a Taco Bell on 2 Dec 2006, far later than
most of the other victims, who reported getting sick after eating at
the restaurants about the 3rd week of Nov 2006. In Pennsylvania,
officials reported 3 new cases for a total of 7.
While some of the victims told investigators that they had not eaten
green onions, "with green vegetables there is a possibility of
cross-contamination from onions to other food substances in the
production line," said Harry Duran, public health epidemiologist for
Camden County, NJ.
As the inquiry widened, federal and state officials were
investigating 2 New Jersey suppliers to Taco Bell: McLane
Foodservice of Burlington and Ready Pac Produce in Florence. McLane
is the sole distributor of ingredients including cheese, meat and
produce for Taco Bell stores in New Jersey, Pennsylvania and Delaware
and on Long Island. Ready Pac, which is based in California,
processes produce like lettuce, tomato and onions.
Bart McKay, associate general counsel for McLane, a Texas-based
company, said inspectors from the New Jersey Department of Health and
the FDA looked at shipping dates and other documents at the 192 000
square foot Burlington facility, but did not inspect any of the food areas.
Shane Falls, general manager of the warehouse, which provides food
for 1100 restaurants, including KFC, Pizza Hut and Long John Silver's
as well as Taco Bell, said, "We?re cooperating in any way we can."
Ready Pac, which Taco Bell praised with an award in 2001 for
'outstanding performance' in food safety, was one of dozens of
companies that recalled prepackaged spinach during an _E. coli_
outbreak in September that killed 3 people and sickened more than 200
in 26 states.
"We have taken every prudent precaution and immediately stopped
production and shipments of all green onions," said Steve Dickstein,
the vice president for marketing at Ready Pac. He said the onions
were produced in only one section of the plant, and only for Taco Bell.
Mr. Dickstein said Ready Pac bought the onions from a California
producer, Boskovich Farms. At the Florence plant, green onions are
cut, washed and sanitized 3 times, he said, then bagged, boxed and
sent to McLane for distribution. A spokeswoman for Boskovich said it
was working closely with Taco Bell in the investigation.
In recent years, the number of outbreaks from contaminated produce
has far surpassed those from beef and poultry and has drawn nearly
even with those linked to seafood, according to the Center for
Science in the Public Interest, a nutrition advocacy group. While
there are more food-borne outbreaks related to seafood, far more
people get sick from produce outbreaks, the group found.
"I think we are really at a tipping point for consumer confidence
with fresh fruits and vegetables," said Caroline Smith DeWaal, the
group's director of food safety. She noted that the FDA's guidelines
for safe farming practices were voluntary and that the number of
inspectors had been pared by budget cuts. The FDA regulates the
produce and seafood industries, while the Department of Agriculture
oversees poultry and meat production.
"We are doing a number of things to address food-borne outbreaks and
recognize that the system is not perfect," said an FDA spokeswoman,
Julie Zawisza. "But fresh produce does carry risks, and we are
committed to finding effective ways to prevent and reduce incidents
and have made good progress using available resources in a more
targeted and strategic way."
The current outbreak is not the first time that people have gotten
sick from eating green onions, also called scallions, at Taco Bell.
In 2000, 23 people in Florida contracted hepatitis A after eating
green onions at a Taco Bell, and similar outbreaks in Nevada and
Kentucky were tied to green onions from Taco Bell, said Andrew
Weisbecker, a Seattle lawyer who represented people who sued in the
Florida case.
The number of people who have fallen ill in recent weeks is minuscule
given the number of people who eat at Taco Bell, which the company
estimates at 5000 to 7000 a week at a given store. Doctors said
possible explanations were that the bacteria were limited to a small
quantity of produce or that resistance to _E. coli_ varied among customers.
While state authorities have identified 99 probable cases, the CDC
cited 43 confirmed cases. Besides on Long Island, the new cases
reported in New York were in the Middletown area of Orange County,
the Cooperstown area of Otsego County, the Utica-Rome region in
Oneida County, and Clinton County near the Canadian border.
[Byline: Andrew Martin and Bruce Lambert]
--
ProMED-mail
<promed@@promedmail.org>
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[2] Pennsylvania
Date: Thu, 7 Dec 2006
From: ProMED-mail <promed@promedmail.org>
Source: Delaware County (PA) Times [edited]
<http://www.zwire.com/site/news.cfm?newsid=17560524&BRD=1675&PAG=461&dept_id=18177&rfi=15>
At least 7 people in Pennsylvania have been reported with a strain of
_E. coli_ linked to Taco Bell restaurants as of Wed, 6 Dec 2006,
including a case in Delaware County. As fallout from the outbreak
continues, Taco Bell ordered all 5800 of its restaurants nationwide
to remove green onions after preliminary tests by an independent lab
found the onions positive for the bacteria.
Of the 7 cases reported in Pennsylvania, 5 were from Montgomery
County, one from Delaware County and one from Berks County, according
to Troy Thompson, spokesman for the Pennsylvania Department of Health.
All 9 Taco Bell restaurants in Montgomery County have been
temporarily closed, but the 6 in Delaware County were open Wednesday.
It is unknown which restaurant was linked to the case in Delaware County.
Thompson said officials had yet to determine whether the incidents in
Pennsylvania were related to the illnesses reported in New Jersey and New York.
[Byline: Solomon Leach]
--
ProMED-mail
<promed@promedmail.org>
******
[3] FDA
Date: Wed, 6 Dec 2006
From: ProMED-mail <promed@promedmail.org>
Source: FDA.gov [edited]
<http://www.fda.gov/bbs/topics/NEWS/2006/NEW01517.html>
The FDA is assisting in the investigation of an outbreak of _E. coli_
O157 infection in consumers associated with eating food from several
Taco Bell restaurants in Northeastern states. FDA is actively working
with state and local health officials, the CDC, the firm, suppliers
and distributors to determine the cause of the sicknesses and prevent
additional infections.
States reporting probable cases associated with the outbreak are: New
Jersey (20); New York (15); Pennsylvania (7); and Delaware (1).
Additional cases are suspected in these states and in Connecticut. 35
individuals have been hospitalized, 3 with hemolytic uremic syndrome
(HUS). No deaths have been reported to date. CDC reports that the 1st
reported onset of illness connected with this outbreak occurred on 20
Nov 2006; the latest on 2 Dec 2006.
This morning, 6 Dec 2006, Taco Bell Corp. announced it was
voluntarily removing green onions from its restaurants nationwide
after preliminary tests by the firm indicated the possible presence
of _E. coli_ O157:H7 in samples of the product. To date the
confirmatory test has not been reported by Taco Bell. In view of this
FDA is continuing to explore the possibility of other food
commodities being the source of the _E. coli_.
FDA is obtaining samples of all non-meat items served in the
restaurants that could carry the pathogen. These include cilantro,
cheddar cheese, blended cheese, green onions, yellow onions, tomatoes
and lettuce. The samples will be tested at FDA laboratories. The
states involved are testing as well. At this time the agency does not
have data implicating or ruling out any of these items.
FDA also is working with Taco Bell Corp. and its suppliers and
distributors to obtain information on sources and distribution of
products, to aid in tracing back any products identified as
contaminated with the pathogen. The agency continues to cooperate
with CDC and state and local health officials to determine the
specific cause of the outbreak and prevent further illnesses.
Infection with _E. coli_ O157 causes diarrhea, often bloody. Although
most healthy adults can recover completely within a week, some people
can develop hemolytic uremic syndrome, a form of kidney failure. HUS
is most likely to occur in young children and the elderly. The
condition can lead to serious kidney damage and even death.
Consumers who are concerned that they may have contracted E. coli
O157 infection should notify your local health department, contact
their physician or health care provider or seek medical attention, as
needed. FDA will provide regular updates on this investigation as
more information becomes available.
--
ProMED-mail
<promed@promedmail.org>
[Not surprisingly, the number of reported cases and affected states
continue to grow. Of note, at least one case had an onset of illness
only 5 days ago. It is not stated when the contact with the alleged
vehicle was. - Mod.LL]
[see also:
E. coli O157, fast food - USA (multistate): green onions 20061206.3441
E. coli O157 - USA (NJ, NY) 20061205.3425
E. coli O157 - USA (NJ) 20061203.3415
E. coli O157, spinach - USA (multistate)(20) 20061027.3067
E. coli O157, spinach - USA (multistate): alert 20060915.2608
E. coli O157, day care - USA (TN) 20060701.1823
E. coli O157 - USA (multistate): unknown source 20060410.1068
E. coli O157, unpasteurized milk - USA (OR,WA)(04) 20060121.0199
2005
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E. coli O157, unpasteurized milk - USA (OR,WA) 20051216.3622
E. coli O157 - USA (HI): alert 20050830.2564
E. coli O157, lake swimming - USA (MN) 20050712.1983
E. coli O157, ground beef - USA (multistate): recall 20050610.1612
E. coli O157, religious camp - USA (OR)(02) 20050602.1540
E. coli O157, religious camp - USA (OR) 20050531.1504]
...........................ll/pg/mpp
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