E. coli 0157:H7 : what you need to know if there is an outbreak in your community : background information, prevention guidelines, protecting your children, USDA-E. coli control efforts

14 Pages·1995·1.1 MB·English

Historic, Archive Document
Do not assume content reflects current
scientific knowledge, policies, or practices.

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•E82E3
1995
E.coli
0157sH7
What you need to know
if there is an outbreak
in your community
• Background information
• Prevention guidelines
• Protecting your children
• USDA--E. coli control efforts
Document Delivery Sen/ices Branch
U.S. DEPARTMENT OF Aft»lC» n V irf
USDA, National Agricultural Library
NATIONAL AGRICULTURAL I
Nal Bldg. ~ 1
10301 Baltimore Blvd.
Beitsville, MD 20705-2351
199/
\ CATALOGING PREP.
United States Department of Agriculture
Food Safety and Inspection Service
JULY 1995
USDA forms Epidemiology and Emergency
Response Program to study the occurrence of
foodbornc illness and provide quick assistance in
outbreaks
USDA's Food Safety and Inspection Service has FEET Officers in the Field
established the Epidemiology and Emergency
Response Program (EERP) as part of a commit¬
ment to safer meat and poultry products and im¬ Indiana Arkansas Oklahoma
Dlinois Dr. Ronald D. Powell
proved public health. Directly focused on ill¬
Dr. Ruth Spargur [phone]
ness related to meat, egg and poultry products, [phone]
EERP will handle product recalls and act as the
Ohio Kansas Nebraska
liaison with state and local health departments Dr. William M. Hockman Dr. Mohammad Abdullah
to assist in rapid response to foodbome disease [phone] [phone]
outbreaks. Alabama Mississippi Louisiana
Dr. James L. Burt Dr. Harry E. Moore
[phone] [phone]
Currently there is a Washington, D.C. headquar¬
ters staff and a liaison office at CDC in Atlanta. Georgia Missouri New Mexico
South Carolina Dr. Wayne E. Weber
A rapid response staff or Field Epidemiology
Dr. Franklin A. Norwood [phone]
Emergency Team (FEET) has also been estab¬ [phone]
Connecticut Rhode Island
lished and consists of 22 officers stationed across
Kentucky West Virginia Maine Massachusetts
the country. These field personnel are FSIS meat Dr. Michaelle R. Fisher New Jersey New Hampshire
and poultry production staff experts trained in [phone] Dr. Florante R. Rellosa
[phone]
the investigation of foodbome disease outbreaks. North Carolina Tennessee
Dr. Theora I. Jamison Texas
[phone] Dr. Steven G. Stoops
The EERP staff enables us to provide greatly en¬
[phone]
hanced assistance to the public health commu¬ Florida Puerto Rico
Dr. Rafael Florit-Lebro Pennsylvania
nity. Whenever a local health organization needs
[phone] Dr. Armia A. Tawadrous
help with an outbreak investigation associated [phone]
Alaska Washington
with consumption of meat, eggs or poultry prod¬
Idaho Montana Iowa Minnesota
ucts, this staff and the field personnel can assist Dr. Mark R Elliot Dr. Michael E. Fisher
in determining the source and distribution of con¬ [phone] [phone]
taminated product, investigating the production New York Vermont Delaware Maryland Virginia
of the product or removing contaminated prod¬ Dr. Mohammed S. Ibraheim Dr. Richard C. Hackenbracht
[phone] [phone]
uct from sale.
Wyoming Arizona Wisconsin Michigan
Colorado North Dakota Dr. Stephen V. Guryca
For more information on the EERP staff and their
South Dakota [phone]
functions, call Dr. Steven Wolpert
[phone], Ext. 591 California Hawaii
Dr. Adel A. Malak
Jacque Knight
Oregon Nevada Utah [phone]
News Bureau Dr. Alan Knox
[phone]
[phone].
July 1995 United States Department of Agriculture
Food Safety and Inspection Service
*This material can be copied
E. coli 0157-.H7
At a Glance
T
he bacteria E. colt Ol 57:H7,
also known just as 0157, is
a dangerous type of E. coli.
Healthy cattle carry the
bacteria. It can be transferred from
animal to animal, animal to man,
from animal to man on food and
from person to person through close
contact or food. NOTE: 0157 can
survive refrigeration and freezer
storage. Thorough cooking to 160° F,
which kills 0157 bacteria, is recom¬
mended as a safeguard against
infection. Careful kitchen sanitation
is also vital.
Food sources. Undercooked ham¬
burger and roast beef, raw milk,
improperly processed cider, con¬
taminated water and mayonnaise
and vegetables grown in cow
Patients may suffer severe abdomi¬ Carefully wash all fruits and
manure have caused outbreaks.
nal cramps, diarrhea and sometimes vegetables before eating. Scrub
Recently, contaminated cantaloupe
bloody diarrhea. melons with a vegetable brush
and hard, dry sausages (salami)
under running water before
have made people sick. Increasingly,
Complications. Young children, the cutting into them.
cross-contamination at food service
elderly and infirm may develop
outlets—delis, grocery carryouts
complications. They can develop Avoid raw milk, untreated water
and salad bars is causing outbreaks.
HUS (hemolytic uremic syndrome) and unpasteurized cider. Heat
which can cause kidney failure, raw cider to 160° F before using.
Person-to-person transmission of
brain damage, strokes and seizures.
the illness, particularly among
When eating out — Check burgers
children in daycare, is another
Protect yourself and your family for doneness—no pink in the
problem.
center or in juices. Return any
• Cook meat 160° F or until all pink
undercooked food for thorough
Outbreaks. Since the large Western is gone from the interior and any
cooking.
States outbreak in January 1993, juices.
there have been nearly 50 smaller
Parents should make sure their
outbreaks in the United States. The • In your kitchen - Refrigerate or
daycare manager is aware of local
national Centers for Disease Control freeze all meat products as soon
health department procedures on
and Prevention (CDC) estimate as you return from shopping.
infection control. Daycare work¬
there may be 20,000 illnesses a year. Wash hands after toileting or
ers should also be following
changing diapers and before food
guidelines to screen for symptoms
The illness. 0157 is dangerous. It preparation in HOT, soapy water.
of 0157:H7 illness. This helps sick
appears that just a few of these Carefully wash your hands,
youngsters get prompt treatment
bacteria can make you sick. After an utensils and work surfaces after
and prevents them from infecting
incubation period of 3-8 days, the contact with raw meats and their
others. ■
disease normally lasts 4-10 days. juices.
July 1995
U.S. DEPARTMENT OF AGRICULTURE • FOOD SAFETY AND INSPECTION SERVICE
An Outbreak of E. coli 0157:H7
How could it happen?
O On the farm
A few animals in a cattle herd are carrying the
0157:H7 bacteria in their intestinal tracts. These Plant
bacteria don’t make cattle sick, so the farmer or
rancher has no way of knowing which animals to
remove or isolate from the herd.
Grocery
0 At the meat plant Store
During processing, the OI57:H7 bacteria from an infected animal’s
gut spreads to the meat surface. Later in the plant or at a grocery,
this contaminated meat is mixed with other meat and ground for
hamburger.
0 Someone eats contaminated food
Food can be contaminated by OI57:H7 bacteria in two ways:
1) Bacteria in contaminated food are not thoroughly cooked;
or 2) The bacteria spreads in the kitchen from contaminated
items to food like salad or a mayonnaise dressing that is
eaten without cooking.
In our example, contaminated meat was used to make
meatballs. A few meatballs were not cooked thoroughly
enough to kill the OI57:H7 bacteria. The toddler
contracts OI57:H7 from eating the undercooked meat.
Q The toddler passes the illness to
another child at daycare
The OI57:H7 bacteria can be passed from one person
to another. In daycare centers, where many children are in
diapers or not fully toilet-trained, this bacteria can spread
quickly from the stool of an infected child through contact
with daycare workers and other children.
0 Symptoms of the disease
E. coli 0157:H7 invades the human intestine. Most people are
sick from 4 to 10 days with severe abdominal cramps, diarrhea
and sometimes bloody diarrhea. But roughly 6 percent of
victims, usually children, develop complications which can lead
to kidney failure, seizures and other serious conditions.
Complications may lead to strokes in the elderly.
OI57:H7 can spread in a number of ways
Illness from the 0157:1-17 bacteria has been caused by foods Wash hands, utensils and kitchen surfaces with hot, soapy
including undercooked ground beef, roast beef, raw milk, water after contact with raw meats and raw meat juices.
improperly processed cider, contaminated water, mayonnaise, Carefully wash all fruits and vegetables before eating. Scrub
cantaloupes, vegetables grown in cow manure and salami (a dry melons with a vegetable brush under running water before
sausage). Outbreaks have also started in cross-contamination cutting into them.
at food service outlets—delicatessens, grocery carryouts and
Avoid raw milk, untreated water and unpasteurized cider. Heat
salad bars.
raw cider to 160° F before using.
Person-to-person transmission in families and daycare
is on the rise. When eating out, check burgers for doneness (no pink in the
center or in juices). Return undercooked food to complete
Protect yourself and your family cooking.
Parents should make sure their daycare manager is following
• To kill the OI57:H7 bacteria, cook meat to 160° F or until all pink
local health department procedures on infection control.
is gone from the interior and any juices.
Daycare workers should also be following guidelines to screen
• Refrigerate or freeze all meat products immediately when you for symptoms of OI57:H7 illness. This helps sick youngsters
return from shopping. get prompt treatment and prevents them from infecting others.
• Wash hands with hot, soapy water after using the toilet,
changing diapers and before preparing food.
For further information on safe food handling, call USDA’s Meat and Poultry Hotline [phone],10 to 4 weekdays, ET.
Source: U.S. Department of Agriculture, July 1995.
Protecting Your Children
What you should know about E. coli 0157: H7
by Mary Ann Parmley, U.S. Department of Agriculture
W
hat do you as a parent need If Your Child Is Sick
to know about E. coli
Bloody diarrhea, the chief sign of
0157-.H7? First, this food-
E. coli 0157:H7, is not normal for any
borne bacteria is not an isolated
young child. So if your youngster has
phenomena. Children and adults are
blood in the stool or diarrhea with
getting sick from eating fast food
severe abdominal pain, get medical
hamburgers, some have contracted
help immediately.
the illness from raw milk, and some
Dr. Phillip Tarr, a pediatrician at
children have gotten sick from ground
Seattle Children's Hospital and
meat cooked at home.
Medical Center active in 0157
Second, 0157 has caused some real
research, advises parents to get a
tragedies since the early 1980's.
child with severe diarrheal illness to
Children have died from complica¬
the pediatrician, family doctor or
tions like HUS (hemolytic uremic
clinic promptly.
syndrome) which can cause kidney Cut into or break open meat to check for doneness.
Make sure the practitioner has a
failure and other grave problems. Teach older children to check their own burgers.
stool sample tested. Quick diagnosis
Other youngsters survived but with
of 0157 is critical since remedies for
serious health problems. What's
going on? oughly to a bubbling, steamy state. other kinds of diarrhea may make
Why an E. coli epidemic? Poultry and fish should always be diagnosis and treatment of this illness
more difficult.
Epidemiologists who study the thoroughly cooked too.
spread of disease say some aspects of Microwave carefully - Cover, rotate Most people recover from 0157 in
modern food production make these foods and let them stand after you about a week, but some 10 percent of
kinds of outbreaks more likely. take them out of the oven to ensure patients, often children, develop com¬
Food is mass produced and as a result thorough cooking. Food, especially plications like kidney problems and
anemia which can be life-threatening.
bacteria can easily spread through meats, cooked in the microwave
large volumes of product. People eat should be hot and steaming. Complications from 0157 are also a
grave danger to the elderly.
out more at high-volume restaurants At the Grill - Meat patties can look
Dr. Patricia Griffin, M.D., with the
which exposes hundreds to any done on the outside but still have
Centers for Disease Control, says you
mistake in food preparation. some pink inside. Slice to the center to
should remember that 0157 can be
While we are still learning about E. make sure no pink remains. Serve
transmitted from one infected person
coli 0157:H7 and improving the meat cooked food with clean plates and
to another. Generally, you need to be
inspection system, there are several utensils.
careful to wash your hands after
basic safe cooking and handling Wash your hands with hot, soapy
changing a sick child's diapers or
instructions that can help protect your water before preparing food or eating,
cleaning up bed or bathroom acci¬
family. particularly after using the bathroom
dents. Your health practitioner can
or diapering a child. Also...wash your
provide detailed infection-control
hands, utensils and work areas before
Parents, Please
instructions.
and after contact with raw, meat,
Inspect hamburgers - At home or eat¬ poultry or fish.
ing out, make sure burgers are done. Milk - Raw milk can contain disease
That means brown or gray in the mid¬ organisms including E. coli 0157:H7. :
For more information
dle. The E. coli bacteria is killed by Use only pasteurized milk.
higher cooking temperatures (160° F). Water - Use only safe, treated water. on food safety, call the
Cooking meat at home - Tomato or Wild animals can carry E. coli in their USDA Meat and Poultry
barbecue sauce turns a meat mixture systems and infect streams and ponds. Hotline, tollfree, at
red, making it harder to see if the Fruits and vegetables - Wash all 1-800-535-4555.
meat is done. Cook these dishes thor- fruits and vegetables before eating.
Day Care And Food Safety
FACTS FROM THE U.S. DEPARTMENT OF AGRICULTURE
Care-Givers & Children Should Wash Hands:
• Whenever they come in contact with
body fluids
After toileting or changing diapers
(M)'
(Also wash the hands of the diapered
child)
After assisting a child with toileting
• Before handling food and after handling
raw meat, poultry or fish
• Before and after eating meals
and snacks
• After handling pets or other animals
To help prevent problems caused by foodborne bacteria like
E. coli 0157:H7 and other harmful strains, child care staff and
children should wash their hands frequently during the day.
(NAPS) — Every morning, nearly • Are diaper-changing areas sepa¬
half of the children under five years rate from eating areas? Keeping these
old in this country are taken to a child areas separate helps prevent the
care center or a family day care home. spread of disease.
As a parent, how do you know the • Does your child care provider
food that’s served is safe? handle food safely? Child care pro¬
According to Dr. J. Glenn Morris, viders should keep perishable foods
such as meat, poultry and fish refrig¬
Jr. of the U.S. Department of
erated or frozen, then thaw in the re¬
Agriculture’s Food Safety and In¬
frigerator or microwave; keep raw
spection Service, “Parents can get a
foods separate from other foods to
pretty good idea of their child’s risk
prevent the spread of bacteria; thor¬
of getting sick from food by seeing
oughly wash anything that touches
how well their child care provider
raw foods and make sure raw foods
pays attention to the basic rules of are thoroughly cooked. Hamburger,
cleanliness and safe food handling. ” for instance, should be cooked until
As a parent, you can check out your there is no pink in the center. Hot
child care provider by observing: foods should be kept hot and leftovers
• How often do care-givers and refrigerated promptly in small, shal¬
children wash their hands? Staff and low containers to speed cooling.
children should wash hands when¬ "Parents and providers can get re¬
ever they come in contact with body minders on safe food handling by
fluids; after toileting or changing dia¬ checking out the new ‘Safe Handling
pers; before handling, preparing or Label’ now included on packages of
touching food; before and after touch¬ raw meat and poultry’ sold in grocery
ing raw meat, poultry or fish; before stores, ” says Dr. Morris.
People interested in more informa¬
and after eating meals and snacks; af¬
tion on safe food handling can call
ter handling pets.
the USDA Meat and Poultry Hotline
• Does your child care provider
at 1-800-535-4555, weekdays from
clean and disinfect areas where chil¬
10-4 p.m., E.T.
dren play and eat?
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