During the month of July, individuals in 4 states were found to have Shiga toxin-producing E coli O26 connected to contaminated ground beef consumption.
The US Centers for Disease Control and Prevention (CDC) have announced that an investigation of Shiga toxin-producing Escherichia coli O26 (E coli O26) linked to ground beef has been resolved.
During the investigation, the CDC worked alongside the US Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) to determine the source of the outbreak.
As of September 19, 2018, there were 18 reported cases of E coli O26 in 4 states. The onset of illness ranged from July 5 to July 25, 2018. The ill individuals ranged in age from 1 to 75 years with a median age of 16; sixty-six percent of cases were observed in males.
Available information indicates that 6 of the 18 (33%) individuals required hospitalization for their infections. One of the hospitalized individuals developed hemolytic uremic syndrome, a type of kidney failure. One death has been reported in the state of Florida.
Whole genome sequencing (WGS) performed on samples collected from the ill individuals indicated that the strains shared a close genetic makeup, suggesting that these cases are likely from a common source. WGS analysis did not identify antibiotic resistance in any of the 13 strains analyzed. Resistance testing by the CDC’s National Antimicrobial Resistance Monitoring System is currently underway.
As part of the epidemiologic investigation, health officials conducted interviews with 14 of the ill individuals. In answering questions about consumption and exposure in the week prior to the onset of illness, 100% of the individuals reported eating ground beef, purchased at a variety of stores.
Health officials further investigated the stores mentioned in the interviews. In Florida, interviewees reported purchasing the products from different Publix Super Markets across the states.
On August 30, 2018, Publix issued a recall for ground beef products sold in multiple Florida counties. The recall statement identified recalled products as ground chuck items purchased from June 25, 2018, through July 31, 2018.
USDA-FSIS traceback investigation pinpointed Cargill Meat Solutions in Fort Morgan, Colorado, as the source of the contaminated products, including the products sold at the Publix stores. Laboratory testing of leftover ground beef from an ill individual’s home in Florida confirmed the presence of E coli. WGS indicated that the strain in the product was closely related to the outbreak strain.
On September 19, 2018, Cargill issued a recall for 132,606 pounds of ground beef products made from chuck that has been linked to E coli O26. The products were produced and packaged on June 21, 2018.
The CDC and USDA emphasize that the recalled products should not be served or sold due to the harms of consuming products contaminated with Shiga toxin-producing E coli.
Symptoms of Shiga-toxin producing E coli O26 consist of regular and bloody diarrhea and vomiting and typically develop 2 to 8 days after consuming the germ. Antibiotic treatment is generally not recommended due to the fact that the benefit of treatment has not been demonstrated to be effective.
In this investigation, hemolytic uremic syndrome developed in 1 individual. Although these infections can occur at any age, it is most common in young children under 5 years old, older adults, and individuals with weakened immune systems. Symptoms include easy bruising and decreased urine output.
This outbreak appears to be over, according to the CDC.
For the final case counts in the multistate outbreak of Shiga-toxin producing E coli O26 linked with ground beef, check out Contagion®'s Outbreak Monitor.