By: Heather Williams

An E. coli outbreak has the Marine Corps Recruit Depot in San Diego on high alert as more than 200 recruits have been sickened with diarrheal illness as a result of an E. coli outbreak.  As of last week, there were 214 recruits currently undergoing treatment.  Earlier in the week the number was closer to 300, with some patients already recovering from the illness.  With more than 5,500 recruits at the location, staff are on edge.  No drill instructors or other base staff members have been reported as being infected. This staff is responsible for training 17,000 male recruits each year.

This outbreak has affected both the Marine Corps Recruit Depot and the command field’s training areas located at Edson Range at Camp Pendleton.  The source of the outbreak is still being investigated.

This past Friday more than 500 new Marines have graduated from the Marine Corps Recruiting Depot’s Hotel Company, 2nd Recruit Training Battalion, though individuals who presented symptoms of the illness will remain at the depot for continued observation.

Family members will be contacted if a recruit’s graduation date changes or if the recruit is hospitalized.

Attempts at Limiting Spread of Outbreak

The bases are doing all that they can to limit the spread of the outbreak, but with so many people in a small area, the battle is a long and tough one.  The biggest effort is focused toward preventing the spread and determining the source so that it can be mitigated.

“The command’s full effort is focused on caring for those recruits who are affected, ensuring we limit any spread of the illness, and identifying the source of the infection,” Brig. Gen. William Jurney, commanding general of Marine Corps Recruit Depot San Diego and the Western Recruiting Region said in a statement.  He indicated that the immediate focus is on identifying, isolating, and treating recruits who present symptoms.  “We are working to identify the cause of the sickness, making sure our affected recruits can return to training as soon as possible and continuing training for recruits not influenced,” explains Brig. Gen. Jurney.

At this time the base is testing samples and specimens to identify the cause of the illness and inspecting the facilities for issues that may have contributed to the outbreak.  Things like cleanliness of the facility, food storage, and handling procedures are being investigated.  The food menus for those who have been affected have been modified to help them recover more easily.

Meanwhile, preventative measures have been instituted to respond to the outbreak.  Samples are being forwarded to the U.S. Army Public Health Command at Fort Sam Houston in San Antonio, Texas to determine the cause of the outbreak.  All meal preparation and service facilities at the affected facilities are undergoing continued inspection for cleanliness, safe handling procedures, as well as proper food storage.  Cleaning procedures are being enhanced to ensure proper hygiene in all areas of the facility and increased hygiene requirements that focus strongly on hand washing are being enforced.  Barracks, common areas, and cafeterias are being inspected more regularly by the Naval Medical Center San Diego Preventative Medicine Unit.  Additional measures to reduce the spread of the outbreak include disseminating guidance on how to identify symptoms of the illness, which would allow for a more proactive and more prompt treatment of someone who is potentially infected in addition to implementing isolation protocols to separate recruits who have symptoms and limit the interaction with those who are not ill.

Dangers of E. coli

Escherichia coli is the full name of the bacteria commonly known as E. coli.  The bacteria are commonly found in the intestines of both animals and humans.  While there are hundreds of different strains of the bacteria, both toxigenic and non-toxigenic, E. coli O157:H7 is most dangerous to people because it can produce a powerful toxin responsible for severe illness.

The illness associated with E. coli was first called the “hamburger disease” due to a 1982 outbreak where severe, bloody diarrhea was traced back to contaminated hamburgers.  Now we know so much more about the bacteria and characteristics of different strains in our environment and can distinguish those that make us sick.  The Center for Disease Control and Prevention (CDC) estimates that E. coli bacteria is responsible for sickening 265,000 American each year, resulting in 3,600 illnesses requiring hospitalization and about 30 deaths each year in the United States.

Symptoms of infection often include stomach cramps, diarrhea that may be bloody, vomiting, and mild fever.  Most otherwise healthy individuals recover within a week, though some may experience more serious complications that might be life-threatening.   Between five and seven percent of patients develop Hemolytic Uremic Syndrome or HUS, which escalates to a form of kidney failure.  Patients that develop HUS symptoms must be hospitalized or their kidneys can fail.  Most recover from HUS within a few weeks, though some may suffer permanent damage or death.

E. coli O157:H7 and E. coli O104:H4 as well as other deadly strains that are believed to be the result of E. coli bacteria and Shigella swapping genes that created these forms that secrete the dangerous Shiga toxin. Tentative evaluations lead to investigators believing that the affected recruits are suffering from Shiga toxin-producing E. coli infection.

Possible Sources

At this time, investigators have not announced the source of the infection that has spread across the depot, though the common culprits are being investigated.  Common sources include ground beef, in that E. coli present in the intestines of the animal at slaughter may contaminated the beef during the butchering process and passed into the meat during the grinding process.

This contamination risk is not limited to meat.  The bacteria is also known to be found in unpasteurized milk, cider, and juices as well as on raw vegetables, cheese, and contaminated water.  Beef is not the only meat of interest.  Chicken, turkey, ham, roast beef, and sandwich meats may also be contaminated with E. coli.  Sprouts such as bean and alfalfa may also be contaminated.

Children, the very old, and those with a compromised immune system are encouraged to drink juice that has been pasteurized or treat the product by boiling it prior to consumption due to the potential presence of E. coli along with Salmonella and Cryptosporidium.

Beyond consuming food that is contaminated, infection may be passed from person to person by hand-to-mouth contact.  E. coli contamination from person-to-person is often transmitted fecal-oral, so handwashing procedures must be carefully followed to avoid spreading the illness.

UnsafeFoods will continue to monitor this outbreak and update as more information becomes available.