CDC E. coli O145 and HUS Outbreak Investigation

CDC is investigating a multistate outbreak of Shiga toxin-producing Escherichia coli serogroup O145 infections.  To date, a total of 14 persons infected with the outbreak strain of STEC O145 infection have been identified in 6 states: Alabama (2), California (1), Florida (1), Georgia (5), Louisiana (4), and Tennessee (1).  Three people were hospitalized; tragically, one young child died in New Orleans from hemolytic uremic syndrome (HUS), a severe complication of an E. coli infection.

According to the CDC, onset of E. coli symptoms were from April 15, 2012 to May 12, 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, so there may be additional confirmed cases this week. E. coli poisoning victims range from 1 year to 79 years old, with a median age of 33 years old; 79% are female.

E. coli O145 is a Shiga toxin-producing E. coli or STEC.  STEC bacteria are grouped by serogroups (e.g., O157 or O145). This serogroup of E. coli frequently causes E. coli-HUS, as it did in this outbreak.  Currently, there are limited public health surveillance data on the occurrence of E. coli O145 infections, so many of them may go undiagnosed or unreported. Identification of E. coli O145 infections is complex.  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 O145 STEC. Clinical laboratories typically cannot identify O145 STEC.  The STEC O145 PFGE pattern in this outbreak has not been seen in PulseNet before.

E. coli O145 Investigation Information

The CDC initiated an investigation into this cluster of E. coli O145 illnesses on May 14, 2012.  At that time, there were 6 ill people from 2 states. As noted above, there are now 14 confirmed cases, and the CDC continues to work with state public health officials to identify additional cases and the source of these STEC O145 infections.

State public health officials (epidemiologists, public health nurses and others) have been interviewing ill persons to obtain information regarding foods they might have eaten and other exposures in the week before illness.  Based on interviews of 10 ill persons to date, a source for these infections has not been identified. Additional work needs to be done to determine if any suspected food products are the cause of this outbreak that resulted in personal injury and wrongful death.

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Category: Food Poisoning
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