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August 18, 2010

Region issues E. coli alert

Public urged to take precautions in handling food

The Winnipeg Health Region is alerting the public to a recent outbreak of a virulent strain of E. coli that occurred in the first two weeks of August.

Fifteen suspected and one confirmed case have presented to Emergency Departments between Aug. 1 and 16, says Dr. Pierre Plourde, Medical Officer of Health for the Winnipeg Health Region. So far, four people have been admitted to hospital for treatment. Three have been released and one remains in hospital. Previous to the outbreak, there had been only nine cases in Winnipeg since January.

Further Reading
Facts about E. coli infection

The majority of the cases are associated with food eaten at the Russian Pavilion during the first week of August, according to Region health officials.

Although the pavilion is now closed, the Region is cautioning the public about the risk of secondary spread. In order to reduce this risk, the Region is reminding members of the public to always wash their hands carefully with soap after going to the bathroom, after changing soiled diapers and before preparing any meals. As well, anyone suffering from diarrhea should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

Also, people should not go to work until diarrhea resolves, especially those who work with young children, handle food or provide health or personal services to others. Children with diarrhea should not attend daycare or camps.

The Region is continuing to look into the circumstances surrounding the outbreak in order to determine the exact source of the problem.

"Ongoing monitoring will continue for the next couple of weeks to identify any ongoing spread that may require additional control measures," says Plourde.

Russian Pavilion organizers are working with the Region to ensure that no further transmission occurs.

The most common sources of E. coli infection are raw meat products, especially ground beef. Plourde said it is important the public remember to ensure proper handling of raw meat products, especially ground beef both in home and public kitchens, including:

  • Washing hands after handling raw meat products, especially before handling other food items such as lettuce, hamburger buns, etc., which could become contaminated by unwashed hands.

  • Ensuring any surfaces (plates, platters, countertops, utensils) that have come into contact with raw meat products do not come into contact with cooked meat unless thoroughly washed.

  • Thoroughly cleaning dish cloths after handling raw meat products or wiping counters.

  • Cooking all ground beef to an internal temperature of 71 degrees Celsius.

In addition, Plourde recommends that when eating in public venues, consumers may want to observe hygiene practices in kitchen workers, especially availability and frequency of hand washing.

Facts about E. coli infection

What is hamburger disease or E. coli infection?

E. coli are bacteria that normally live in the intestines of humans and animals. Although most strains of this bacteria are harmless, several are known to produce toxins that can cause diarrhea. Some E. coli strains (i.e. E. coli O157:H7) can cause severe diarrhea and kidney damage. This disease is more commonly known as Hamburger Disease, because it is frequently associated with eating inadequately cooked ground beef.

Who gets E. coli infection?

Anyone of any age can become infected with E. coli, but children are more likely to develop serious complications.

How does one get infected with E. coli?

The bacteria is acquired by eating food containing the bacteria. The bacteria live in the intestines of some healthy cattle, and contamination of the meat may occur in the slaughtering process. Eating meat that is rare or inadequately cooked is the most common way of getting the infection. Person to person transmission can occur if infected people do not wash their hands after using the toilet. Contamination of the environment (i.e., counter tops and dish cloths) may also be a source of infection, especially in young children.

What are the symptoms of E. coli infection?

People infected by E. coli can develop a range of symptoms. Some infected people may have mild diarrhea or no symptoms at all. Most identified cases develop severe diarrhea and abdominal cramps. Blood is often seen in the stool. Usually little or no fever is present.

How soon after the exposure do symptoms appear?

The symptoms usually appear about five days after exposure, with a range of two to ten days.

How is infection with E. coli diagnosed?

Infection with E. coli can only be diagnosed by a special stool test performed in laboratories.

What is the treatment for infection with E. coli?

Most people recover without antibiotics or other specific treatment in five to ten days. Scientific studies have not yet determined whether antibiotics are useful or harmful in the treatment of E. coli infection. Therefore, antibiotics are not usually recommended.

What complications can result from infection with E. coli?

In some people, particularly children under five years of age, the infection can cause a complication called hemolytic uremic syndrome (HUS). This is a serious disease in which red blood cells are destroyed and the kidneys fail. Transfusions of blood or blood clotting factors as well as kidney dialysis may be necessary. A prolonged hospital stay is often required. Fortunately, most people with HUS recover completely, but it can be fatal.

How can infection with E. coli be prevented?

Make sure infected people, especially children, wash their hands carefully with soap after using the toilet to reduce the risk of spreading the disease. It is also important that caregivers wash their hands after changing diapers. Do not eat undercooked hamburger or other ground beef products. Cook all ground beef and hamburger thoroughly. Make sure the cooked meat is brown throughout (not pink), and the juices run clear. Drink only pasteurized milk and milk products. Make sure counter tops and dish cloths are properly cleaned after handling of raw ground beef products; and hands should be washed after handling of raw ground beef products.

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