Preventing E-Coli Outbreaks: Health Officials Working Hard to Stop Food-Borne Illness

Karen Schaefer- Petting a cow at the county fair or eating a hamburger fresh from the grill didn't used to be risky business. But since 1982, when the deadly strain of bacteria known as e-coli 0157:H7 was first identified as a source of human illness, more and more cases of e-coli infection have come to light. Today, e-coli is one of the leading causes of food-borne illness around the world. Dr. Jorn Schlundt with the World Health Organization in Geneva, Switzerland says no one knows quite how e coli came into being.

Jorn Schlundt- This could be for two reasons and one is that we did not look for it in the same way and the other is that it actually just initiated as a human pathogen at that stage and we can't know if one or the other is the actual truth.

KS- Either way, e-coli is now considered an emerging disease, a disease whose incidence appears to be growing. Doctors are still learning how to track e coli to its source or sources - and learning just what those sources might be. Since the first e coli outbreak was traced to a supply of tainted meat - still its primary cause in the U.S. - other infections have been found to be caused by un-pasteurized fruit juice and contaminated water. In May of this year 2,000 people in the rural community of Walkerton, Ontario were stricken with e-coli. Six of them died from the infection. The source has since been traced to farm manure leaking into the town's water supply. Dr. Walter Ewing is a medical officer overseeing the Walkerton cases. He says a number of infections were also passed from one person to another.

Walter Ewing- There were some secondary cases that occurred during the outbreak. Secondary, they would be ones with whom there was person-to-person spread, but they were all only in a household setting, like a family setting.

KS- While the Walkerton outbreak was traced to a single source, finding the exact cause of an e coli infection can be difficult, even impossible. The recent Ohio outbreak seems to have stemmed from visits to the Medina County Fair. But just yesterday, officials at the Ohio Department of Health announced that only sixteen of twenty cases genetically fingerprinted for e-coli were found to be carrying the same strain. Four other cases appear not to be linked to the outbreak at all. Health Department spokesman Randy Hertzer says it's this kind of conundrum that makes tracking the disease an arduous process.

Randy Hertzer- You have to go in prior to that test and re-confirm that in fact the original testing that was done on those individuals and said that they had e-coli is accurate.

KS- While there have been at least a dozen major outbreaks of e-coli in North America in the past two decades, individual cases are still far more the norm. According to the Centers for Disease Control, each year at least 73,000 U.S. residents are infected with the bacteria and at least 61 people die. Outside the U.S. those figures are even higher. Dr. Jorn Schlundt of the World Health Organization says e-coli probably accounts for the death of 2 million children a year in developing nations, where access to good health care is limited. But he cautions that developed countries like the U.S. shouldn't become complacent about their lower number of fatalities.

JS- The CDC and your country actually estimate that one third of your population every year gets some type of food-borne disease. So that's a high number. It's just that the outcome of the disease is not as dramatic as in the developing countries. In fact, it seems that a number of these microorganisms, you might even have a higher probability of getting these in the developed world because of the type of production and the type of food chain we have there in the developed world.

RH- This is a disease that is very, very preventable. I mean, if we follow good hygienic practices as a community, this is not going to spread any further.

KS- Randy Hertzer says Ohio is working with the Centers for Disease Control and other agencies to help educate people about the risks of eating undercooked meat and drinking or swimming in polluted water. But while WHO administrator Jorn Schlundt agrees e-coli is preventable, he says good hygiene is not good enough.

JS- In the last maybe ten, twenty years, we've seen a clear increase in a number of diseases which are related to fecal contamination. This type of thing has not really been covered when you just put in place general hygienic rules. And what we suggest is that we need to look at this from a scientific point of view, looking all the way from the farm to the fork, seeing how the pathogen moves and finally finding out where would be the most efficient place to actually put your money to prevent this.

KS- Dr. Schlundt says the 1996 Farm to Table initiative of the Clinton administration laid groundwork that may help future health officials assess the best strategy for conquering the spread of e-coli. But at the Medina County Health Department, officials says it may be several months before investigators know what caused the latest outbreak. And it may be weeks before new cases stop appearing. Karen Schaefer, 90.3 WCPN, 90.3 FM.

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