Health Advisories
5.11.10 - Health Alert: E. coli O145 Outbreak
Health Alert: E. coli O145 OutbreakLocal and state public health officials in Michigan, New York, and Ohio are investigating human illnesses caused by shiga toxin 2 producing E. coli O145. To date approximately 30 illnesses have been linked to the outbreak. Epidemiologic evidence pointed to shredded lettuce from a same supplier. E. coli O145 has been isolated from an unopened bag of shredded lettuce. Because of this evidence, Freshway Foods in Ohio announced a recall on May 6th. The product is not sold as pre-bagged lettuce in grocery stores. The product is not distributed in Nebraska and no cases have been linked to this outbreak from Nebraska.
This outbreak highlights the difficulty in identifying the causative agent in toxigenic E coli infections caused by non-O157:H7 strains. Stool specimens assessed by culture alone are likely to miss this strain of E. coli. If assessed by shiga toxin assay alone, the isolate cannot be serotyped or tested by PFGE for the ‘DNA fingerprint’. Nebraska regulations require laboratories to forward all isolates of toxigenic E. coli (e.g., E coli O157:H7) to the Nebraska Public Health Laboratory (NPHL). Laboratories that utilize the shiga toxin assay are required to forward to NPHL stool sample from any specimen that tests positive on shiga toxin assay. NPHL will conduct further diagnostic tests to facilitate epidemiologic follow-up and assessment of relatedness to other toxigenic E. coli isolates from the nation’s public health laboratory surveillance program.
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