An outbreak of E. coli O157:H7 hemorrhagic colitis associated with unpasteurized Gouda cheese

Capital Health-Public Health Division, Edmonton, Alberta.
Canadian journal of public health. Revue canadienne de santé publique (Impact Factor: 1.02). 05/2005; 96(3):182-4.
Source: PubMed


A cluster of E. coli O157:H7 hemorrhagic colitis was identified in metro Edmonton, Alberta through notifiable disease surveillance in late 2002.
Environmental health officers collected food histories and clinical information from cases in the cluster. The provincial public health laboratory conducted pulsed field gel electrophoresis (PFGE) analysis on E. coli O157:H7 isolates from cluster cases. Public health and food regulatory agencies conducted an investigation when a food source (unpasteurized gouda cheese) was implicated.
PFGE analysis revealed an "outbreak" profile in 13 cases. Onset dates for the outbreak cases ranged between October 2002 and February 2003. Two cases, aged 22 months and 4 years, developed hemolytic uremic syndrome as a result of their infection. Consumption of unpasteurized gouda cheese produced at a local dairy farm was reported by 12 of 13 outbreak cases in the 2 to 8 days prior to illness. E. coli O157:H7 was isolated from 2 of 26 cheese samples manufactured by the implicated producer. The cheese isolates had indistinguishable PFGE profiles as compared with outbreak case isolates. Implicated cheese was found to be contaminated with E. coli O157:H7 104 days after production, despite having met regulated microbiological and aging requirements.
To our knowledge, this is the first confirmed outbreak of E. coli O157:H7 infection in Canada associated with raw milk hard cheese. A review of federal legislation vis-à-vis raw milk hard cheese may be in order.

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Available from: Linda Chui, Sep 30, 2015
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    • "STEC is another important foodborne pathogens responsible for outbreaks which may result in hemorrhagic colitis (HC) and lethal hemolytic uremic syndrome (HUS) [13]. Although most outbreaks of HC and HUS have been attributed to serotype O157:H7, infections are also caused by other serotypes, such as O26:H11, O103:H2, O111:H8, and O145:H28 [8, 10]. Salmonella is another important organism which represents well-recognized foodborne bacterial pathogens. "
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    ABSTRACT: The production and consumption of domestic natural cheese in Japan is increasing year by year. More than ninety percent of domestic natural cheese is produced in Hokkaido region of Japan, while information on its quality and safety related to foodborne pathogens is limited. To assess the microbiological safety of domestic natural cheese, a total of 126 natural cheese samples produced in Hokkaido were collected from December, 2012, to July, 2013. In addition to standard plate count (SPC) and coliform counts, the prevalence study of three pathogens (Listeria monocytogenes, pathogenic Escherichia coli, and Salmonella spp.) was performed on each sample. Real-time PCR and matrix-assisted laser desorption-ionization time-of-flight mass spectrometer methods were employed for identification of presumptive pathogens. Coliform was detected in 25 samples (19.8%) with a minimum of 25 cfu/g and a maximum of more than 3.0 × 10(6) cfu/g. Salmonella spp. and L. monocytogenes were not isolated from any of the samples. Only one sample (0.80%) showed positive PCR amplification for ipaH gene suggesting possible contamination of enteroinvasive E. coli or Shigella in this product. Overall results indicate that natural cheeses produced in Hokkaido region were satisfactory microbiological quality according to existing international standards.
    12/2013; 2013(4):205801. DOI:10.1155/2013/205801
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    • "Since its identification as human pathogen in 1982, Escherichia coli O157:H7 has being a pathogen of major concern due to its ability to cause from relatively mild to fatal illnesses, including bloody diarrhea, hemorrhagic colitis, hemolytic uremic syndrome and thrombotic thrombocytopenic purpura (Ferens and Hovde, 2011). Since the gastrointestinal tract of ruminants, mainly cattle, is the natural reservoir of E. coli O157:H7 (Mainil and Daube, 2005), the consumption of raw milk and dairy products has been associated with several foodborne illnesses caused by this pathogen (CDCP, 2007, 2008; CDSC, 1998, 1999; Guh et al., 2010; Honish et al., 2005; Morgan et al., 1993; Proctor and Davis, 2000; Rangel et al., 2005; Upton and Coia, 1994; Watanabe et al., 1999). "
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    ABSTRACT: A mid-log phase broth culture of Escherichia (E.) coli O157:H7 381 (final concentration 10(4)cfu/mL) was monitored by conventional liquid- and solid-based enumeration techniques combined with PCR while it was subjected to thermal stress in gradually more complex systems (i.e., Tryptone Soya Broth, pasteurized milk and during lab-scale productions of a pasta filata fior di latte cheese obtained from raw or pasteurized milk). Our results highlighted: i) the incapability of the selective medium, ii) the effectiveness of the thin agar layer-PCR method, and iii) the effectiveness of the most probable number (MPN)-PCR method (in comparison with both plating-based methods) in recovering and selectively counting viable and stressed or injured E. coli O157:H7. Moreover, MPN-PCR was superior to both plating-based methods in terms of speed and easiness to get results. The thermal stresses herein applied (heating at 55°C for 5 and 8min) were less effective on the pasteurized milk than on the Tryptone Soya Broth and the pathogen was more protected in the raw milk-based matrices than in the pasteurized ones. Moreover, given the contamination level (10(4)cfu/mL of milk) of the strain, the temperature/time of stretching and the hardening and brining conditions herein used, the complete inactivation of the pathogen is not achievable.
    International journal of food microbiology 07/2012; 159(1):1-8. DOI:10.1016/j.ijfoodmicro.2012.07.013 · 3.08 Impact Factor
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    • "Ruminants seem to constitute a reservoir of E. coli O157 in nature (Rey et al., 2003; Oporto et al., 2008). Contaminated unpasteurized dairy products such as raw milk and raw-milk cheese have been incriminated in recent foodborne STEC outbreaks (Deschenes et al., 1996; Honish et al., 2005; CDC, 2007). Fermented dairy products manufactured using raw milk contaminated with E. coli O157:H7 can pose a threat to human health, as it has been shown that, if present in raw milk, the pathogen can survive during the manufacturing and ripening stages of selected fermented dairy products that do not undergo a sufficient heating step or are contaminated after the heat treatment. "
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    ABSTRACT: Verotoxin-producing of Escherichia coli O157 is an increasingly common cause of severe gastrointestinal illness, enlisted among the most important emerging pathogens. The present study was conducted to investigate the presence of E. coli O157 and E. coli O157: H7 strains and to detect the presence of the stx1, stx2, eae and ehxA insolates derived from 290 samples (120 samples from traditional fresh cheese, 120 samples from traditional ice cream and 50 samples from yoghurt). The samples were purchased from the Isfahan, Chaharmahal, Bakhtyari and Khuzestan provinces in Iran, over a period 6-month from August 2010 to February 2011. Standard cultural method and polymerase chain reaction were applied for these analyses. E. coli O157 was detected in nine of the 290 (3.1%) samples tested (five isolated from traditional cheese and 4 isolated from traditional ice cream samples), whereas E. coli O157: H7 was not detected in any samples. The genes stx1 and stx2 were detected in three E. coli isolated obtained from traditional cheese samples none of the stx1, stx2, eae and ehxA was detected in the E. coli isolates obtained from traditional ice cream samples. Susceptibilities of nine E. coli O157 isolates were determined for ten antimicrobial drugs using the disk diffusion assay. Resistance to ampicillin and gentamycin was the most common finding (44.4%), followed by resistance to erythromycin (33.3%), amoxicillin (11.1%), tetracycline (11.1%) and nalidixic acid (11.1%). All E. coli O157 isolates were susceptible to chloramphenicol, cefuroxime, and streptomycin. Thus, traditional cheese and ice cream manufactured from unpasteurized milk have appositional risk as a result of E.
    African journal of microbiology research 10/2011; 5(22):3706-3710. · 0.54 Impact Factor
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