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A Multistate Outbreak of E. coli O157:H7 Infections Linked to Soy Nut Butter
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10 2019
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Source: Pediatrics. 144(4)
[PDF-732.17 KB]
Details:
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Alternative Title:Pediatrics
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Description:Background:
In 2017, we conducted a multistate investigation to determine the source of an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections, which occurred primarily in children.
Methods:
We defined a case as infection with an outbreak strain of STEC O157:H7 with illness onset between January 1 and April 30, 2017. Case-patients were interviewed to identify common exposures. Traceback and facility investigations were conducted; food samples were tested for STEC.
Results:
We identified 32 cases from 12 states. Twenty-six (81%) cases occurred in children <18 years-old; eight children developed hemolytic uremic syndrome. Twenty-five (78%) case-patients ate the same brand of soy nut butter or attended facilities that served it. We identified three illness sub-clusters, including a childcare center where person-to-person transmission may have occurred. Testing isolated an outbreak strain from 11 soy nut butter samples. Investigations identified violations of good manufacturing practices at the soy nut butter manufacturing facility with opportunities for product contamination, although the specific route of product contamination was undetermined.
Conclusions:
This investigation identified soy nut butter as the source of a multistate outbreak of STEC infections affecting mainly children. The ensuing recall of all soy nut butter products the facility manufactured, totaling over 1.2 million pounds, likely prevented additional illnesses. Prompt diagnosis of STEC infections and appropriate specimen collection aids in outbreak detection. Childcare providers should follow appropriate hygiene practices to prevent secondary spread of enteric illness in childcare settings. Firms should manufacture ready-to-eat foods in a manner that minimizes the risk of bacterial contamination.
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Pubmed ID:31519792
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Pubmed Central ID:PMC6774848
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