HomeMy WebLinkAbout20140522_E. coli 0121 Associated with Clover Sprouts (PDF)JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street Port Townsend Washington 98368
www.jeffersoncountypublichealth.org
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COMMUNITY HEALTH DEVELOPMENTAL DISABILITIES
MAIN: (360) 385-9400 FAX: (360) 385-9401
ENVIRONMENTAL HEALTH
WATER QUALITY MAIN: (360) 385-9444 FAX: (360) 379-4487
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Health Advisory – Shiga-toxin producing E. coli O121 Infections,
May 22, 2014
To: Jefferson County Health Care Providers
From: Tom Locke, MD, MPH, Jefferson County Health Officer
Action requested:
Be aware of recent Shiga-toxin producing E. coli (STEC) O121 infections associated with clover
sprout consumption.
Consider STEC infection in all persons with bloody diarrhea and persons with bloody or non-
bloody diarrhea and a history of sprout consumption during the exposure period (usually 3-4
days but may be 1-10 days before onset of symptoms).
In patients with symptoms compatible with STEC infection, collect a stool specimen and
request E. coli testing by culture and Shiga toxin test.
o If bloody diarrhea is present, laboratory evaluation should include a complete blood count,
serum electrolytes, BUN, and creatinine
o Shiga toxin immunoassays should be obtained in addition to cultures, but should not replace
culture on a sorbitol MacConkey agar plate
Report confirmed or suspected STEC cases immediately to Public Health at 385-9400, fax 385-9401.
Obtain the following history during the exposure period (1 to 10 days before symptom onset):
Dietary history, including: meats, raw produce, unpasteurized juices or dairy products, and sprouts
Group and restaurant meals, including meal dates, restaurant names, and restaurant addresses
Travel history with travel dates and destinations
Animal exposures (pets, farms, etc.)
Background
Ten recent cases of Shiga-toxin producing E. coli O121 infections have been reported from Washington State
(including King and Spokane County) and Idaho. Nine of the cases reported consuming raw clover sprouts
during their exposure period. The WA Department of Health issued a press release on 5/21/14 reporting
results from initial investigations indicate a strong link to eating raw clover sprouts produced by Evergreen
Fresh Sprouts, LLC of Idaho.
Aldrich’s Market and the Food Coop of Port Townsend are on the list of retailers supplied with this product.
JCPH contacted them on 5/21/2014 recommending that they pull the product from the shelves and notify
customers not to consume the product raw until further notice.
Since 1996, at least 30 nationally reported outbreaks of foodborne illness associated with different types of raw
and lightly cooked sprouts have occurred. Most of these outbreaks were caused by E. coli and Salmonella. In
most sprout outbreaks, the restaurant is not the source of the contamination, which usually happens when the
seeds are grown or harvested and is often impossible to wash off.
Resources:
CDC STEC and E. coli FAQ: www.cdc.gov/ecoli/general/index.html