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Archive Number 20061207.3448
Published Date 07-DEC-2006
Subject PRO/AH/EDR> E. coli O157, fast food - USA (multistate)(02)

E. COLI O157, FAST FOOD - USA (MULTISTATE)(02)
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[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>

******
[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
----
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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