By James Peacock

Recently, the Kansas Department of Health & Environment reported that they are investigating an outbreak of E. coli poisoning linked to a local Ciderfest, or a festival involving cider. So far, there have been 7 cases of E. coli poisoning confirmed in the laboratory. Health officials did not say whether or not there are cases of illness awaiting laboratory testing. There have not been any reports of hospitalization. Hemolytic uremic syndrome has not been reported in any ill people. The outbreak has been linked to the Louisburg Mill Ciderfest, an annual event that goes on for several weekends. This year, the Ciderfest took place on September 24 to 25 and October 1 to 2. Kansas health officials have been working with the Food and Drug Administration to investigate the outbreak, and their first assessment of the investigation took place on October 27. On October 31, 2016, samples taken from products served at the Ciderfest turned out to be negative for E. coli bacteria, so the specific source of the outbreak remains unknown. These samples had been taken from the facility’s production area, apple cider, and even the apples themselves. Cider is not the only potentially contaminated item at the Ciderfest, as there are also attractions such as pony rides and a pumpkin patch at the festival. The Ciderfest has pledged to continue to cooperate with the investigation, which is ongoing. As more information is collected, the source of the outbreak may be found or more people may be added to the total number of cases.

Festivals and fairs have always been a common source of foodborne illness outbreaks. In mid 2015, there was an outbreak of E. coli poisoning that came from the Milk Makers Fest in Washington state. More than 45 people were sickened in that outbreak, which had been caused by the petting zoo found at the festival. Several people involved in that outbreak developed hemolytic uremic syndrome, a rare but serious side effect of E. coli poisoning. The petting zoo was also suspected to be a source in an outbreak at the Red River Valley Fair in North Dakota, along with various food vendors. There were five people sickened in North Dakota as a result of the fair. Most of those sickened in that outbreak needed to be hospitalized because of their illnesses. Apple cider itself has also been the source of recent foodborne illness outbreaks. Earlier this year there was an outbreak of Cryptosporidium poisoning that was linked to a festival called the Pike County Color Drive. There were over 70 people sickened in that outbreak, which lasted for several months.

E. coli is a family of bacteria found in most environments. While some strains of E. coli bacteria are likely to cause illness in humans, many strains of the bacteria live inside the human body and are important in maintaining a healthy digestive system. The most common form of pathogenic E. coli is Shiga toxin-producing E. coli, or STEC. Shiga toxin-producing bacteria are the cause of this outbreak. E. coli bacteria most commonly contaminate items such as beef, other meats, raw milk, apple cider, and cheese made with raw milk. E. coli bacteria have also been known to contaminate fruits, vegetables, and water. In the United States, the strain of E. coli that is most often responsible for outbreaks is STEC O157. This strain causes almost 40 percent of the annual infections in the United States.

Cider products, and also raw milk, are often the cause of E. coli outbreaks. This is because the products are sold unpasteurized. Pasteurization is a process developed in the 1800s by Louis Pasteur that heats liquids to the point that bacteria or other pathogens are eliminated. This process greatly reduces the chance of contamination and infection. Products that do not undergo this process are much more likely to be contaminated, and health officials alway recommend caution when it comes to unpasteurized liquids. The contamination of the cider products could have occurred at a variety of points in the production process, from the soil the apples were grown in to the production line itself.

E. coli infections are one of the most common forms of foodborne illness. The CDC estimates that around 265,000 E. coli infections occur annually in the United States. When someone is exposed to pathogenic E. Coli bacteria via contaminated food or water, they can expect to see symptoms within an average of 3 or 4 days. Most of the time, the bacteria could produce symptoms as early as one day or as late as ten days after the initial exposure. Symptoms of E. coli poisoning can vary, but most of the time they include vomiting, fever, stomach cramps, and diarrhea. Doctors may test to confirm the presence of E. coli, but in most cases the best treatment for E. coli is rest and hydration. In a majority of instances an E. coli infection will subside on its own within a week. However, some cases of E. coli infection can be life threatening. While E. coli infections can affect people from any age group and background, young children, the elderly, and those with suppressed immune systems are at an increased risk of developing a serious E. coli infection or even hemolytic uremic syndrome.

In about 5 to 10 percent of E. coli poisoning cases, a complication called hemolytic uremic syndrome (HUS) arises. HUS is a complication that damages red blood cells. These damaged blood cells eventually travel to the kidneys, where they are filtered out of the bloodstream. Filtering these HUS-affected blood cells and removing them from the bloodstream can cause damage to the kidneys, and could even lead to kidney failure. HUS can cause other symptoms, including decreased frequency of urination, loss of color in the eyes and cheeks, and fatigue. Health officials with the Kansas Department of Agriculture have recommended that anyone who experienced diarrhea within ten days of attending the Louisburg Mill Ciderfest should contact them. If you or a loved one begins to show the symptoms of E. coli poisoning or HUS, contact a medical professional.

Sources:

http://www.louisburgcidermill.com/ciderfest/

http://www.kdheks.gov/news/web_archives/2016/11022016.htm

http://www.kshb.com/news/local-news/kansas-department-of-health-investigating-e-coli-outbreak-at-louisburg-cider-mill-ciderfest

http://www.cdc.gov/ecoli/general/index.html