By: James Peacock

Health officials are continuing to track an outbreak of E. coli poisoning in the small community of Hildale, Utah, located right on the border with Arizona. The Southwest Utah Public Health Department has released a few updates on the situation as the investigation progresses, with the most recent update coming this morning. There are now 11 confirmed cases of E. coli poisoning in the city, and investigators are still looking for a source. This outbreak has nearly doubled in size since it was first announced on July 3. At that time, six people had been sickened, all of which seemed to be located in the same apartment complex. This outbreak has caused many of its victims to seek treatment because of the severity of their illnesses, although details about their condition have not been provided by the Southwest Utah Public Health Department. The outbreak has also claimed the lives of two children- a three-year-old and a six-year-old. The parents of the six-year-old have come forward and talked to local media, saying that they think that dirty diapers that were strewn about the complex were the cause of the outbreak. This has not been confirmed by the local health department, which continues to look for a source of the outbreak.

The investigation into the outbreak originally looked at the drinking water for signs of E. coli contamination. After numerous tests, however, investigators were unable to find any E. coli in the drinking water. They have continued to test the water, however, and the latest tests looking for E. coli should be ready soon. On July 7, when the health department issued its most recent update prior to today, they announced that there had been three new cases added to the outbreak, bringing the total number of people sickened to nine at that point. Health officials also issued a warning later that day regarding raw milk. They recommended that consumers in Hildale and surrounding areas not consume raw milk for the time being. Raw milk, or milk that has not gone through the pasteurization process developed to eliminate potential bacterial contamination, has been at the center of many outbreaks and recalls in recent times. Raw milk is such a common source of pathogen contamination that we have an entire category dedicated to raw milk-related news. E. coli is one of the most common pathogens that contaminate raw milk. With the latest update, though, health officials have also warned consumers that recently purchased ground beef should also be avoided, because it may be contaminated. Ground beef is also a common source of E. coli contamination, so it makes sense that it would be the second item placed on a warning list when an E. coli outbreak is underway. Health investigators will continue to search for a source of the outbreak and will provide updates as more information becomes available.

E. coli

E. coli infections remain one of the most common forms of foodborne illness in the United States. While there are several different types of E. coli that cause illness in humans, the one responsible for this outbreak is E. coli O157H7. This strain of E. coli is one of the varieties that can produce Shiga toxins. E. coli that produce this toxin are commonly referred to as STEC. The CDC estimates that there are around 265,000 cases of E. coli poisoning each year in the United States. Cases of E. coli poisoning can occur even if only a small amount of bacteria is consumed. Because E. coli can be found throughout the natural world, and even in the intestines of animals including humans, it has caused foodborne illness outbreaks via a number of different food and drink items. Outbreaks have been caused by a number of sources, including beef products, raw milk, yogurt, mayonnaise, cheeses, unpasteurized fruit juices, bagged lettuce, alfalfa sprouts, spinach, various water sources, and more. E. coli infections and outbreaks have been steadily on the rise since 2009, reaching an incidence rate of 2.85 cases per 100,000 persons in 2016, which is the highest it has been since 1996. Again, after exposure to even a small amount of bacteria, it is possible for an infection to develop. Symptoms of the infection will usually occur between 3 and 4 days after exposure, but E. coli infections can begin to cause symptoms anywhere between 1 and 9 days after exposure. Symptoms of an E. coli infection will typically include severe cramping, vomiting, nausea, and watery or bloody diarrhea. There is sometimes a low-grade fever associated with the infection as well. These symptoms will, much of the time, go away on their own after about a week but can last longer. Diarrhea can cause dehydration, a potentially serious complication, so it is important that those suffering from an E. coli infection attempt to remain well hydrated.

E. coli is particularly dangerous for two reasons. First, it seems to target children, especially those less than 5 years old, at a much higher rate than other age groups. In fact, according to the CDC, the incidence rate of E. coli poisoning in children under five is more than double the next closest age group, which is children age 5 to 9. Young children under five have an incidence rate of 7.86 cases per 100,000, or almost triple the overall incidence rate. This has led health officials to declare that children, along with the elderly and those with suppressed immune systems, are at an increased risk of catching a serious E. coli infection. The other major issue is that STEC bacteria are able to cause a very serious side effect known as hemolytic uremic syndrome, or HUS for short.

Hemolytic uremic syndrome occurs in about 3 to 7 percent of E. coli cases. HUS damages red blood cells, which are then sent to the kidneys in order to be filtered out. Removing these damaged blood cells can damage the kidneys and clog the mechanisms responsible for removing the blood cells. The damage from the filtration process, coupled with the increased rate of damage inflicted on the kidneys by Shiga toxins, can lead to serious kidney damage and even kidney failure. If a case of E. coli poisoning has progressed to HUS, symptoms such as decreased frequency in urination, fatigue, and loss of color in the eyes and cheeks will be present. HUS is a very serious complication that needs to be treated as quickly as possible. If you or a loved one begins to show the symptoms of E. coli poisoning, contact a medical professional.

Sources:

https://wwwn.cdc.gov/foodnetfast/

https://www.cdc.gov/ecoli/

http://swuhealth.org/ecoli/