CDC Statement on E. coli O145 Outbreak Investigation

CDC has provided eFoodAlert with the following statement about the multi-state outbreak of E. coli O145 illnesses.

State Reported Outbreak Information

 As of June 8, 2012, there are 14 cases of Shiga toxin-producing Escherichia coli (STEC) O145 infection with indistinguishable DNA patterns that have been identified in lab samples from persons in 6 states: Alabama (2), California(1), Florida (1), Georgia (5), Louisiana (4), Tennessee (1). The dates when those persons became ill range from April 15 to May 12, 2012. Three ill persons have been hospitalized. One death has been reported in Louisiana. The most recent report of illness was on June 4, 2012.

The time from the beginning of a patient’s illness to the confirmation that he or she was part of an outbreak is typically about 2-3 weeks. Case counts during an outbreak investigation are therefore preliminary and must be interpreted within this context.

This ongoing multi-state investigation has not yet identified a source of these infections. The investigation is looking at both food-and non-food exposures are part of the ongoing investigation. State public health officials are interviewing ill persons to obtain information regarding foods they might have eaten and other exposures in the week before illness. There is no evidence to suggest the recent death of a child in Louisiana, who had this O145 strain, and a child in Massachusetts, who had the O157 strain, are related to one another. The patients had two different kinds of STEC infection.

Advice to Consumers

We do not have specific consumer advice at this time, but in general E. coli can be prevented using these tips:

  • WASH YOUR HANDS thoroughly after using the bathroom or changing diapers and before preparing or eating food. WASH YOUR HANDS after contact with animals or their environments (at farms, petting zoos, fairs, even your own backyard).
  • COOK meats thoroughly. Ground beef and meat that has been needle-tenderized should be cooked to a temperature of at least 160°F/70˚C. It’s best to use a thermometer, as color is not a very reliable indicator of “doneness.”
  • AVOID raw milk, unpasteurized dairy products, and unpasteurized juices (like fresh apple cider).
  • AVOID swallowing water when swimming or playing in lakes, ponds, streams, swimming pools, and backyard “kiddie” pools.
  • PREVENT cross contamination in food preparation areas by thoroughly washing hands, counters, cutting boards, and utensils after they touch raw meat.

If a specific food source is identified for this outbreak, public health officials will advise the public and take steps to prevent additional illnesses.

People at higher-risk for foodborne illness are pregnant women and newborns, children, older adults and those with weak immune systems.

Clinical Features/Signs and Symptoms

People usually get sick from STEC 2 – 8 days (average of 3 – 4 days) after swallowing the organism. Most people infected with STEC O145 develop diarrhea (usually watery and often bloody) and abdominal cramps. Most illnesses resolve on their own within 7 days. Some illnesses last longer and can be more severe.∙ Infection is usually diagnosed by testing of a stool sample.

Many clinical laboratories do not test for non-O157 STEC, such as STEC O145. Compared with STEC O157 infections, identification of non-O157 STEC infections is more involved. First, clinical laboratories must test stool samples for the presence of Shiga toxins. Then, the positive samples must be sent to public health laboratories to look for non-O157 STEC.∙ Most people recover within a week but, rarely, some develop a more severe infection. Hemolytic uremic syndrome (HUS), a type of kidney failure, can begin as the diarrhea is improving. HUS can occur in people of any age but is most common in children under 5 years old and the elderly.

Further information about STEC can be found at and

Our thanks to Lola Russell of the US Centers for Disease Control and Prevention for sharing this information.

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