CDC FOOD POISONING QUESTIONS AND ANSWERS --WITH COMMENTS -- IT'S NOT JUST ABOUT FOOD

CDC's Public Relation Page on E.coli 0157:H7
with/comments added -- What CDC had rather forget

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/escherichiacoli_g.htm#What%20are%20the%20long-term%
20consequences%20of%20infection

Escherichia coli O157:H7

(Updated December 6, 2006)


Dec 2006: Update on the current East Coast outbreak
Disease Listing | General Information | Technical Information | Additional Information

Frequently Asked Questions

What is Escherichia coli O157:H7?
How is E. coli O157:H7 spread?
What illness does E.coli O157:H7 cause?
How is E. coli O157:H7 infection diagnosed?
How is the illness treated?
What are the long term consequences of infection?
What can be done to prevent the infection?
What can you do to prevent E. coli O157:H7 infection?

The study:
http://www.cdc.gov/ncidod/eid/vol5no5/mead.htm
CDC (Mead, 1999): We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000
hospitalizations, and 5,000 deaths in the United States each year

Comments:
EPA (Gerba 1986) estimated 1 - 2 million illnesses cause by foodborne diseases each year,
before EPA, USDA, FDA and CDC approved the 1989 disease contaminated sewage sludge dumping policy
(503 rule) for food crops.

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CDC:
Escherichia coli O157:H7 is a leading cause of foodborne illness.
Based on a 1999 estimate, 73,000 cases of infection
and 61 deaths
occur in the United States each year. In the ten CDC Foodborne Diseases Active Surveillance Network
(FoodNet) sites (which represent 15% of the US population), there was a 29% decline in E. coli O157:H7 infection
since
1996-98
(see FoodNet Reports).

Comment:
Viruses are the leading cause of foodborne illnesses. The fatality rate for Salmonella, nontyphoidal  
(1,412,498 illnesses) were about the same as E. coli 0157.  The fatality rate for Campylobacter spp    
(2,453,926 illnesses were slightly less than E.coli.   
Clostridium perfringens   (248,520 illnesses),
Staphylococcus foodborne (185,060 illnesses), Streptococcus, foodborne  (50,920 illnesses) may be the
most dangerous. These are the three primary pathogens associated with necrosis, bacteremia,
emphysematous cholecystitis, and
gas gangrene commonly referred to as  the flesh eating bacteria or
necrotizing fasciitis --a rare disease in 1990.

[CDC, like other government agencies is using 1999 guesstimates in order to mislead the public and public
officials. CDC talks about a 29% decline that may or may not have happened between 1996 and 1998 -- that's
ten years ago.  Between 1982 and 1990 there were only 15 reported deaths from E. coli 0157. Based on the
current deaths (2 per 100), deaths should have been about 1,480 rath than the guesstimated 61.  The actual
numbers of E. coli infections for 1999  in the ten CDC Foodborne Diseases Active Surveillance Network
(FoodNet) sites (which represent 15% of the US population, Escherichia coli O157:H7  
(73,480 people), E.
coli, non-O157 STEC
(36,740 people), E. coli, enterotoxigenic (79,420 people), E. coli, other diarrheogenic
(
79,420 people), for a total of 269,060 people.]

FoodNet conducts active surveillance for seven bacterial and two parasitic foodborne diseases within a
defined population of 20.5 million Americans

Before the EPA, USDA, FDA and CDC sewage effluent (reclaimed water) and sludge (biosolids) use policy
was created:
ICampylobacter jejuni (2,453,926), Escherichia coli O157:H7 (73,000), Listeria monocytogenes (2,518),
Cyclospora cayetanensis (16,264) were not recognized as causes of foodborne illness just 20 years ago.
(1979)

CDC, The study:
Infection with E. coli often leads to bloody diarrhea, and occasionally to kidney failure. People can become infected with
E.coli O157:H7 in a variety of ways. Though most illness has been associated with eating undercooked, contaminated
ground beef, people have also become ill from eating contaminated bean sprouts or fresh leafy vegetables such as
lettuce and spinach. Person-to-person contact in families and child care centers is also a known mode of transmission.
In addition, infection can occur after drinking raw milk and after swimming in or drinking sewage-contaminated water.

Comment:
The latest figures from CDC: Among 71 ill persons
in a recent Taco Bell outbreak, 53 (75%) were hospitalized
and 8 (11%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS). That is a little more
than occasionally.  Since E. coli 0157 contaminated sewage effluent (reclaimed water) is used on parks, golf
course, school grounds, etc., and unlabelled sewage sludge soil amendments or composted sewage
sludge called biosolids may be on lawns, gardens, parks, school grounds, etc, person-to-person contact
may carry to much blame.

While CDC found one strain of E. coli 157.H7 in yellow onions at a Taco Bell, CDC said this was not the strain
that caused the outbreak -- and -- any illness not cause by the strain of E. coli it was looking for was
dropped from the outbreak figures.



CDC:
Consumers can prevent E. coli O157:H7 infection by thoroughly cooking ground beef, avoiding unpasteurized milk, and
by washing hands carefully before preparing or eating food. Fruits and vegetables should be washed well, but washing
may not remove all contamination. Public service announcements on television, radio, or in the newspapers will advise
you which foods to avoid in the event of an outbreak.

Because the organism lives in the intestines of healthy cattle, preventive measures on cattle farms, during meat
processing, and during the growth, harvest and processing of produce are being investigated.

Comment:
The fox is inside the Hen House on this one. With a guesstimated 6.3 million foodborne illnesses per month
public service announcements will only be issued for a few minor outbreaks connected to produce. The
agencies who are responsible for investigations, EPA, USDA, FDA, and CDC, actually promoted the
spreading of disease organisms on food crops and grazing land in the form of sewage effluent and sewage
sludge -- they playfully call this disease contaminated hazardous waste biosolids. EPA rules promote the
grazing of animals after 30 days, but don't object to grazing in less than 30 days.


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What is Escherichia coli O157:H7?
CDC:
E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless, this
strain produces a powerful toxin that can cause severe illness. E. coli O157:H7 has been found in the intestines of
healthy cattle, deer, goats, and sheep.

Comments:
E. coli 0157:H7 is either a mutated or genetic engineered strain that now includes the Shigella toxin
producing gene. While genetic transfer of genes has been documented during the  sewage treatment
process, the Board of Trustees of the Leland Stanford Jr. University in Stanford, Ca., was assigned
 US
PATENT: 4237224 SERIES CODE: 6 in 1980 to genetically engineer bacteria which could not normally exist in
nature and were drug resistant.

It is interesting that CDC doesn't mention E. coli 0157:H7 can destroy the stomach lining, kidneys and cause
death. Survivors may also suffer lifetime health problems. It is even more interesting that E. coli as well as
other disease causing organisms were rarely found in cattle, deer, goats and sheep before the sludge
dumping policy was created for food crops in  the early 80s.

CDC:
E. coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of severe bloody diarrhea; the
outbreak was traced to contaminated hamburgers. Since then, more infections in the United States have been caused
by eating undercooked ground beef than by any other food.

Comments:
It was in Omaha, NE, that CDC first figured out that giving antibotics to combat an E. coli infection would kill
the bacteria which caused a release of toxins that could bring on kidney failure and/or death quickly.

CDC:
The combination of letters and numbers in the name of the bacterium refers to the specific markers found on its surface
and distinguishes it from other types of E. coli.

Comment:
In the Taco Bell outbreak CDC found that there were two strains of E.coli 0157:H7 associated with the
outbreak but apparently only followed one strain.

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How is E. coli O157:H7 spread?
CDC
The organism can be found on most cattle farms, and it is commonly found in petting zoos and can live in the intestines
of healthy cattle, deer, goats, and sheep. Meat can become contaminated during slaughter, and organisms can be
accidentally mixed into meat when it is ground. Bacteria present on the cow's udders or on equipment may get into raw
milk. In a petting zoo, E.coli O157:H7 can contaminate the ground, railings, feed bins, and fur of the animals.

Comment:
E. coli can be found in sewage sludge, biosolids ,compost used to fertilizer farm and garden food crops and
runoff from sludge use and disposal sites.  In Kansas City, Mo., runoff from a city owned sewage sludge
farm caused both Salmonella and E. coli bacteria levels on a neighboring farm to reach over 800,000 per 100
grams of soil. E. coli has been documented to reproduce  in sewage effluent released to water.
Reproduction starts within 10 hours of leaving the treatment plant and there was a 50 fold within after 74
hours. It has also been documented by EPA to survive in salt water for three years.

CDC:
Eating meat, especially ground beef, that has not been cooked sufficiently to kill E. coli O157:H7 can cause infection.
Contaminated meat looks and smells normal. The number of organisms required to cause disease is very small.

Comment:
It has been estimated that 10 E. coli bacteria can cause disease. Cooking does not destroy all disease
causing organisms and their toxins. There is no current approved treatment method that destroys all
disease causing organisms and their toxins including
irradiation.

CDC:
Among other known sources of infection are consumption of sprouts, lettuce, spinach, salami, unpasteurized milk and
juice, and by swimming in or drinking sewage-contaminated water.

Comments:
CDC  forgot onions, strawberries, almonds and others fertilized with sewage effluent (reclaimed water) or
sewage sludge (biosolids) compost.

CDC
Bacteria in loose stool of infected persons can be passed from one person to another if hygiene or hand washing habits
are inadequate. This is particularly likely among toddlers who are not toilet trained. Family members and playmates of
these children are at high risk of becoming infected.

Comments:
Knowing these facts, why would CDC and FDA approve the policy of using E. coli contaminated sewage
effluent and sewage sludge on food crops, parks, home lawns and forests?

CDC:
Young children typically shed the organism in their feces for a week or two after their illness resolves. Older children and
adults rarely carry the organism without symptoms.

Comments:
Young children and the elderly are also more likely to experience kidney failure and/or death than older
children and adults.

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What illness does E. coli O157:H7 cause?
CDC
People generally become ill from E. coli O157:H7 two to eight days (average of 3-4) after being exposed to the bacteria.
Escherichia coli O157:H7 infection often causes severe bloody diarrhea and abdominal cramps. Sometimes the infection
causes non-bloody diarrhea or no symptoms. Usually little or no fever is present, and the illness resolves in 5 to 10 days.

Comments:
It is interesting that this first paragraph is a PR statement implying that there is little to worry about from an
infection.

CDC:
In some persons, particularly children under 5 years of age and the elderly, the infection can also cause a complication
called hemolytic uremic syndrome (HUS), in which the red blood cells are destroyed and the kidneys fail. About 8% of
persons whose diarrheal illness is severe enough that they seek medical care develop this complication. In the United
States, HUS is the principal cause of acute kidney failure in children, and most cases of HUS are caused by E. coli O157:
H7.

Comment:
CDC doesn't want to panic people so they don't discuss the suffering which puts 75 percent of the infected
people in the hospital and may cause lifelong problems or the long term suffering of those children and
elderly people who recover from kidney failure or the deaths associated with E. coli infections.

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How is E. coli O157:H7 infection diagnosed?
CDC:
Infection with E. coli O157:H7 is diagnosed by detecting the bacterium in the stool. About one-third of laboratories that
culture stool still do not test for E. coli O157:H7, so it is important to request that the stool specimen be tested on
sorbitol-MacConkey (SMAC) agar for this organism. All persons who suddenly have diarrhea with blood should get their
stool tested for E. coli O157:H7.

Comment:
According to European researchers, non-O157 Shiga toxin—producing Escherichia coli (STEC) is often
overlooked in clinical microbiology laboratories because the toxigenic phenotype is not exploited to
identify such pathogens, because most laboratories use sorbitol MacConkey agar and serotyping (which
cannot detect most non-O157 STEC).

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How is the illness treated?
CDC:
Most people recover without antibiotics or other specific treatment within 5 to 10 days. Antibiotics should not be used to
treat this infection. There is no evidence that antibiotics improve the course of disease, and it is thought that treatment
with some antibiotics could lead to kidney complications. Antidiarrheal agents, such as loperamide (Imodium®), should
also be avoided.

Comments:
CDC has a strong statement that antibiotics should not be used for this infection -- then a rather mild
statement that there is no evidence that antibiotics helps and in fact may lead to kidney complications. I
would guess that kidney failure and death is a scientific complication.

CDC
In some people, E. coli O157:H7 infection can cause a complication called hemolytic uremic syndrome (HUS), a life-
threatening condition that is usually treated in an intensive care unit. Blood transfusions and kidney dialysis are often
required. With intensive care, the death rate for hemolytic uremic syndrome is 3%-5%.
 

Comment:
By gosh CDC does finally talk about treating kidney failure as a life threating condition that is treated in an
intensive care unit including  blood transfusions and kidney dialysis with a 3 -5% death rate.

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What are the long-term consequences of infection?

Persons who only have diarrhea usually recover completely.
CDC:
A small proportion of persons with hemolytic uremic syndrome (HUS) have immediate complications with lifelong
implications, such as blindness, paralysis, persistent kidney failure, and the effects of having part of their bowel
removed. Many persons with hemolytic uremic syndrome have mild abnormalities in kidney function many years later.

Comments:
Now, we can see that an E. coli 0157:H7 infection is no longer a short term minor inconvenience. From a
suffering point of view the dead may be the lucky ones. And to think, EPA, USDA, FDA and CDC approves
spreading E. coli contaminated sewage effluent (reclaimed water) and sewage sludge (biosolids) on food
crops, lawns, playgrounds and parks.

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What can be done to prevent the infection?
CDC:
Cattle are the principal source of E. coli O157 infection; they carry E. coli O157 in their intestines. Changes in the
preparation of animals for slaughter and in slaughter and processing methods could decrease the contamination of
carcasses with E. coli O157 and the subsequent contamination of meat. Testing ground beef for E. coli O157 and
withholding it from the market until the test is negative, as many meat producers began doing in 2002, is probably partly
responsible for the subsequent decrease in illnesses.

Comment:
The studies indicate the principal source of E. coli 0157H7 is the sewage treatment plants which releases it
in effluent to water courses, parks, golf course, industrial facilities for irrigation and building cooling
systems. The treatment plants promote the residue of sewage treatment -- sewage sludge -- as a soil
amendment and fertilizer for grazing land where cattle may become infected, and for parks, playgrounds
and home lawns where children may become infected.

CDC
Cattle manure is an important source of E. coli O157. Manure can contaminate the environment, including streams that
flow through produce fields and are used for irrigation, pesticide application, or washing. Collaborative efforts are
needed to decrease environmental contamination and improve the safety of produce.

Comment:
After grazing on pastures where E. coli contaminated sewage sludge has been disposed, sewage sludge
and contaminated manure will contaminate the environment including the ocean, streams that are used for
drinking water or that flow through produce fields and used for pesticide application, or washing. Many of
the so called sludge use sites are in flood plains or along water ways. In Kansas City, Mo., the 1500 acre
sludge disposal site is on the banks of the Missouri River.

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What can you do to prevent E. coli O157:H7 infection?
CDC:
Cook all ground beef and hamburger thoroughly. Because ground beef can turn brown before disease-causing bacteria
are killed, use a digital instant-read meat thermometer to ensure thorough cooking. Ground beef should be cooked until
a thermometer inserted into several parts of the patty, including the thickest part, reads at least 160º F. Persons who
cook ground beef without using a thermometer can decrease their risk of illness by not eating ground beef patties that
are still pink in the middle.

Comment:
After supporting the contamination of the beef supply, CDC says we can not have our rare hamburger
anymore. It's the cook's fault if we get sick or our fault for not checking to be sure the hamburger was burnt.

CDC:
If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further
cooking. You may want to ask for a new bun and a clean plate, too.

Comment:
Yep, E. coli 0157:H7 infection is your fault if you don't break the hamburger patty apart to see if it is pink
inside. You have got to disassemble that sucker for inspection -- while you are at it you have to run a lab
test on the lettuce, tomato and onion.

CDC:
Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands,
counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef
on the unwashed plate that held raw patties. Wash meat thermometers in between tests of patties that require further
cooking.

Comment:
Yep, its your fault if your family gets an E.coli 0157:H7 infection, or any one of the other 1,400 foodborne
diseases. Forget the fact, that you may have purchase unlabelled E. coli 0157.H7 soil amendments for your
lawn or garden or the potted plants you are so proud of. It is your responsibility not to buy contaminated
meat, produce or soil amendments and the blame falls on the cook.

CDC:
Drink only pasteurized milk, juice, or cider. Commercial juice with an extended shelf-life that is sold at room temperature
(e.g. juice in cardboard boxes, vacuum sealed juice in glass containers) has been pasteurized, although this is generally
not indicated on the label. Juice concentrates are also heated sufficiently to kill pathogens.

Comment:
Pasteurization, like irradiation does not kill all pathogens. As FDA so wisely states, "Bacteria produce
spores as a means to survive adverse environmental conditions, while some fungi use them as a form of
reproduction. Spores show great resistance to high temperature, freezing, dryness, antibacterial agents,
radiation, and toxic chemicals. Under favorable conditions, spores can germinate into actively growing
bacteria and fungi. Many of these spore-forming microorganisms are pathogenic to humans and have been
implicated in causing morbidity and mortality."

CDC:
Wash fruits and vegetables under running water, especially those that will not be cooked. Be aware that bacteria are
sticky,
so even thorough washing may not remove all contamination. Remove the outer leaves of leafy vegetables.
Children under 5 years of age, immunocompromised persons, and the elderly should avoid eating alfalfa sprouts until
their safety can be assured. Persons at high risk of complications from foodborne illness may choose to consume
cooked vegetables and peeled fruits.

Comments:
CDC admits that even thorough washing may not remove all of the disease organisms and it only takes
exposure to about 10 bacteria to kill you. CDC has to be aware that disease organism may be taken up
inside the growing produce. Therefore, people at high risks should not eat uncooked produce.

CDC:
Drink municipal water that has been treated with chlorine or another effective disinfectant.

Comment:
Chlorine and other disinfectants causes injury to bacteria which may become viable again.
1979   1986

CDC
Avoid swallowing lake or pool water while swimming. (For more information, see the CDC Healthy Swimming website.)

Comment:
Since we now know E. coli  in effluent may increase 50 fold in the receiving water within  74 hours after
leaving the sewage treatment plant swimming in lakes may be dangerous indeed. The same is true for
swimming in pools filled with treated drinking water contaminated with bacteria that has chlorine injuries.

CDC
Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements
to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers. Anyone with a
diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

Comment:
Amen

CDC
For more information about reducing your risk of foodborne illness, visit the U.S. Department of Agriculture’s Food
Safety and Inspection Service website or the Partnership for Food Safety Education at: For more advice on cooking
ground beef, visit the U.S. Department of Agriculture website.

Comment:
USDA is starting to admit there is a problem in the study, "Resuscitation of Acid-Injured Salmonella in
Enrichment Broth, in Apple Juice and on the Surfaces of Fresh-Cut Cucumber and Apple"

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Date: September 24, 2006
Content source: Coordinating Center for Infectious Diseases / Division of Bacterial and Mycotic Diseases