E. COLI VTEC NON-O157 - USA (06): O145, LETTUCE

***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Wed 26 May 2010
Source: New York Times [edited]



For nearly 2 decades, public enemy no. 1 for the food industry and
its government regulators has been a virulent strain of _E. coli_
that has killed hundreds of people, sickened thousands and prompted
the recall of millions of pounds of hamburger, spinach, and other
foods. But as everyone focused on controlling that particular
bacterium, known as _E. coli_ O157:H7, the rarer strains of
toxin-producing _E. coli_ were largely ignored.

Collectively, those other strains are now emerging as a serious
threat to food safety. In April 2010, romaine lettuce tainted with
one of them sickened at least 26 people in 5 states, including 3
teenagers who suffered kidney failure.

Although the federal government and the beef and produce industries
have known about the risk posed by these other dangerous bacteria for
years, regulators have taken few concrete steps to directly address
it or even measure the scope of the problem. For 3 years, the United
States Department of Agriculture (USDA) has been considering whether
to make it illegal to sell ground beef tainted with these
lesser-known _E. coli_ strains, which would give them the same outlaw
status as their more famous cousin. The meat industry has resisted
the idea, arguing that it takes other steps to keep _E. coli_ out of
the beef supply and that no outbreak involving the rarer strains has
been definitively tied to beef.

The severity of the April 2010 outbreak is spurring a reassessment.

"This is something that we really have to look at," said Senator
Kirsten Gillibrand, Democrat of New York, who plans to introduce a
bill that would pre-empt the Agriculture Department by declaring a
broad range of disease-causing _E. coli_ to be illegal in ground beef
and requiring the meat industry to begin testing for the microbes.
"How many people do we have to see die or become seriously ill
because of food poisoning?"

The issue will be one of the first faced by President Obama's nominee
to head the department's food safety division, Dr Elisabeth Hagen,
who is scheduled to testify in her Senate confirmation hearing.

Part of the problem is that so little is known about the rarer _E.
coli_ strains, which have been called the "big 6" by public health
experts. (The term refers to the fact that, after the O157 strain,
these 6 strains are the most common of a group of toxin-producing _E.
coli_.) Few food companies test their products for the 6 strains,
many doctors do not look for them and only about 5 percent of medical
labs are equipped to diagnose them in sick patients.

A physiological quirk of _E. coli_ O157 makes it easy to test for in
the lab, and many types of food are screened for it. The other _E.
coli_ strains are harder to identify and testing can be
time-consuming. The USDA has been working to develop tests that could
be used in meat plants to rapidly detect the pathogens.

The lettuce linked to the April 2010 outbreak tested negative for the
more famous form of _E. coli_, but no one checked it for the other
strains, according to the Ohio company that processed it, Freshway
Foods. It turned out that the romaine was infected with _E. coli_
O145, one of the 6 strains.

Earthbound Farm, the nation's largest producer of organic salad
greens, is one of the few companies that does screen for the full
range of toxin-producing _E. coli_, and it has found a worrisome
incidence of the rarer strains. Out of 120 000 microbial tests in
2009, about 1 in 1000 showed the presence of unwanted microbes,
mostly the 6 strains.

"No one is looking for non-O157 to the level we are," said Will
Daniels, Earthbound Farm's senior vice president for food safety. "I
believe it is really going to emerge as one of the areas of concern."
Earthbound Farm was not involved in the April outbreak.

Data from the Centers for Disease Control and Prevention showed at
least 10 food-borne outbreaks from 1990 to 2008 involving the 6
strains, carried in foods like salad or strawberries. Investigators
suspected ground beef as the cause of a 2007 outbreak in North
Dakota, but the link was not confirmed.

The April 2010 outbreak is a signal of a broader problem, said
Michael R Taylor, deputy commissioner for foods at the FDA.

[Byline: William Neuman]

--
Communicated by:
ProMED-mail


[In the laboratory, the non-O157 strains can be detected by testing
for the verotoxin directly. It is high time that these non-O157
strains be looked at the same way that O157 is. - Mod.LL]

[see also:
E. coli VTEC non-O157 - USA (05): O145, lettuce 20100525.1738
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]
...................................ll/mj/lm

*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Donate to ProMED-mail. Details available at:

************************************************************
Visit ProMED-mail's web site at .
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################