Monday, January 7, 2019

Yuma, AZ Farmers Working to Avoid Another E. coli Outbreak Associated with Romaine Lettuce

As farmers in the Yuma AZ region prepare for the upcoming season, they are also working to prevent another E. coli outbreak that dealt a financial blow to their industry as well as sickened 210 people with 96 hospitalizations (27 developing HUS) and 5 deaths.  Although FDA found water samples from an irrigation water canal in eastern Yuma County tested positive for the same genetic type of E. coli that led to E. coli cases, and that there was a cattle feedlot in the area as a potential source of the harmful bacteria, there has been nothing definitive that has turned up regarding the 22 farm fields.  Subsequent testing didn’t find the outbreak pathogen again in the canal.

"Produce growers in Arizona and California have adopted new standards based on the information gleaned from the FDA, including additional water quality testing, increased attention to weather conditions and longer distances from feedlot operations."  Repair work has also been completed on the canal.  "FDA investigators have returned to the Yuma area to test produce at the post-harvest stage at processors and coolers."

Morning Ag Clips / Associated Press
https://www.morningagclips.com/e-coli-outbreak-still-a-concern-for-yuma-area-ag/
E. coli outbreak still a concern for Yuma-area ag
Efforts continue to identify precise vulnerabilities in industry's practices, infrastructure
PUBLISHED ON January 6, 2019
YUMA, Ariz. (AP) — The calendar has turned over to a new year, but the agriculture industry in southwestern Arizona’s Yuma area isn’t forgetting an E. coli outbreak last April that dealt financial setbacks to growers and distributors of romaine lettuce and other leafy greens.

U.S. Food and Drug Administration investigators said water samples from an irrigation water canal in eastern Yuma County tested positive for the same genetic type of E. coli that led to 210 reported illnesses and five deaths. And a cattle feedlot in the area was identified was called a potential source of harmful bacteria.

However, nothing definitive turned up at 22 farm fields, and subsequent testing didn’t find the outbreak pathogen again in the canal.

Now, months later, the Yuma Sun reports that research initiatives are being launched as efforts continue to identify precise vulnerabilities in their industry’s practices and infrastructure.

Produce growers in Arizona and California have adopted new standards based on the information gleaned from the FDA, including additional water quality testing, increased attention to weather conditions and longer distances from feedlot operations.

Elston Grubaugh, general manager of the Wellton-Mohawk Irrigation and Drainage District, said canal repairs after the investigation into the outbreak may have been a step toward one solution. The district hopes to draw down the canal again in early 2019 for additional work, he said.

“There’s still some concrete repair work we can do, so it’ll be good if we can get out of service to do that work,” he said. “And who knows, one of the ideas is that E. coli could have colonized some sediment, and drying out those sediments may be helpful. That’s just one theory of many. But it’s something we can try.”

Gary Pasquinelli of Pasquinelli Produce Co. noted the industry took another blow when another E. coli outbreak tied to romaine was reported just before Thanksgiving, leading the FDA to put out a warning against consumption of all romaine. However, it was unlikely the product that had caused the illnesses came from Arizona.

The November order was lifted a week later, and Pasquinelli said “we’re recovering nicely, and doing everything we can on the food-safety front … to figure this thing out.”

Along with research into other potential causes, he said the vegetable industry will need to improve communication with feedlots and ranches about ways to prevent contamination.

FDA investigators have returned to the Yuma area to test produce at the post-harvest stage at processors and coolers. The FDA’s Center for Food Safety and Applied Nutrition wants to research factors that could increase or decrease the likelihood of E. coli contamination.

Scientists from the center met with Yuma-area industry representatives in December to propose a collaborative research initiative, using the government’s state-of-the-art laboratories to study how the bacteria get into produce and cause illness.

Channah Rock, a University of Arizona Cooperative Extension water quality specialist working with the center on the project, said three committees have been set up to ensure transparency and oversight of the research, addressing concerns voiced by growers at that meeting. More than 20 organizations and individuals are represented on the three new committees, Rock said.

–Associated Press

CDC
https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce (Final Update)

At A Glance
  • Case Count: 210 
  • States: 36 
  • Deaths: 5
  • Hospitalizations: 96
  • Recall: No

Highlights
  • This outbreak appears to be over as of June 28, 2018.
  • CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of E. coli O157:H7 infections. ◦210 people infected with the outbreak strain were reported from 36 states.
    • 96 people were hospitalized, including 27 people who developed a type of kidney failure called hemolytic uremic syndrome.
    • 5 deaths were reported from Arkansas, California, Minnesota (2), and New York.
  • Epidemiologic, laboratory, and traceback evidence indicated that romaine lettuce from the Yuma growing region was the likely source of this outbreak.
  • CDC laboratory testing identified the outbreak strain of E. coli O157:H7 in canal water samples taken from the Yuma growing region. FDA is continuing to investigate the outbreak to learn more about how the E. coli bacteria could have entered the water and ways this water could have contaminated romaine lettuce.
  • According to the FDA, the last shipments of romaine lettuce from the Yuma growing region were harvested on April 16, 2018, and the harvest season has ended. Contaminated lettuce that made people sick in this outbreak should no longer be available.
  • The Public Health Agency of Canada (PHAC) identified ill people in several Canadian provinces infected with the same DNA fingerprint of E. coli O157:H7. On June 22, 2018, PHAC reported that the outbreak in Canada appears to be over.
  • Consumers should follow these steps to help keep fruits and vegetables safer to eat.
  • Read more on general ways to prevent E. coli infection. Important steps to take are to cook meat thoroughly, and wash hands after using the restroom or changing diapers, before and after preparing or eating food, and after contact with animals.
Outbreak Summary

Introduction

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of E. coli O157:H7 infections.

Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on E. coli bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE. WGS performed on bacteria isolated from ill people in this outbreak showed that they were closely related genetically. This means that the ill people were more likely to share a common source of infection.

As of June 27, 2018, 210 people infected with the outbreak strain of E. coli O157:H7 were reported from 36 states. A list of the states and the number of cases in each can be found on the Case Count Map page. Illnesses started on dates ranging from March 13, 2018 to June 6, 2018. Ill people ranged in age from 1 to 88 years, with a median age of 28. Sixty-seven percent of ill people were female. Of 201 people with information available, 96 (48%) were hospitalized, including 27 people who developed hemolytic uremic syndrome, a type of kidney failure. Five deaths were reported from Arkansas, California, Minnesota (2), and New York.

WGS analysis of isolates from 184 ill people identified antibiotic resistance to chloramphenicol, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Standard antibiotic resistance testing of eight clinical isolates by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory confirmed these findings. Isolates from four of those ill people also contained genes for resistance to ampicillin and ceftriaxone. These findings do not affect treatment guidance since antibiotics are not recommended for patients with E. coli O157 infections.


Investigation of the Outbreak


Epidemiologic, laboratory, and traceback evidence indicated that romaine lettuce from the Yuma growing region was the likely source of this outbreak.


In interviews, ill people answered questions about the foods they ate and other exposures they had before they became ill. Of the 166 people interviewed, 145 (87%) reported eating romaine lettuce in the week before their illness started. This percentage was significantly higher than results from a survey[PDF – 787 KB] of healthy people in which 46% reported eating romaine lettuce in the week before they were interviewed. Some people who became sick in this outbreak did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce.


The FDA and state and local regulatory officials traced the romaine lettuce to many farms in the Yuma growing region. The FDA, along with CDC and state partners, started an environmental assessment in the Yuma growing region and collected samples of water, soil, and manure. CDC laboratory testing identified the outbreak strain of E. coli O157:H7 in water samples taken from a canal in the Yuma growing region. WGS showed that the E. coli O157:H7 found in the canal water is closely related genetically to the E. coli O157:H7 from ill people. Laboratory testing for other environmental samples is continuing. FDA is continuing to investigate to learn more about how the E. coli bacteria could have entered the water and ways this water could have contaminated romaine lettuce in the region.


According to the FDA, the last shipments of romaine lettuce from the Yuma growing region were harvested on April 16, 2018, and the harvest season there has ended. Contaminated lettuce that made people sick in this outbreak should no longer be available.


As of June 28, 2018, this outbreak appears to be over.

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