Thursday, August 05, 1999

Foodborne illness hunted

E. coli bacteria made 20 people sick in 3 counties

The Cincinnati Enquirer

        A cluster of 20 recent cases of E. coli sickness in Hamilton, Butler and Clermont counties has triggered an investigation by state and federal health officials.

        All 20 victims were infected with E. coli O157:H7, a powerful, sometimes deadly food-borne bacterium that strikes about 65,000 people a year nationwide. E. coli from contaminated beef killed four people and sickened hundreds of others after they ate at Jack-in-the-Box restaurants in Washington state in 1993.

  State and federal health officials are searching for what caused a “cluster” of 20 confirmed cases of e.coli sickness in Greater Cincinnati in June and July. Key test results are expected by week's end. <
  • Hamilton County: 8 confirmed cases including 2 in Loveland, 2 in Indian Hill, 2 in Anderson township, one each in Blue Ash and Symmes Township. <
  • Butler county: 6 confirmed cases, 3 probable cases; includes 4 in Fairfield, 2 in Liberty Township, one each in Union and Madison townships. <
  • Clermont County: 6 confirmed cases, mostly in Union and Miami Townships near the Hamilton County line. <
  Source: Ohio Department of Health and county departments of health.
        No deaths have occurred in the local cluster, but several victims were sick enough to require hospital care.

        Although the investigation is in its early stages, officials do not think all 20 people got sick from a single source of contamination, such as a group picnic or restaurant.

        “It is really very unlikely that it's a single source,” said Janet Rickabaugh, Clermont County health commissioner. “(The investigation) could take several weeks. And we may never find out much more infor mation on the source.”

        Tracking the source of a foodborne illness can be complicated, health officials say. People don't always accurately remember what they eat and finding samples of contaminated food can be elusive.

        The 20 cases include eight in Hamilton County, six in Clermont County and six in Butler

        County. All were diagnosed in June or July.

        That's an unusually high number, even though health officials say summer is the peak season for E. coli infections. Those three counties reported a total of 11 cases in 1998, said Ohio Department of Health spokeswoman Jane Beathard.

        Statewide, 87 cases of E. coli illnesses were reported this year through July 28, compared with 54 cases in the same period a year ago.

        E. coli O157:H7 is one of hundreds of strains of E. coli bacteria, many of which pose no threat to human health. The dangerous strain is commonly passed by eating undercooked beef. However, E. coli outbreaks also have been linked to unpasteurized milk and apple juice, and raw alfalfa sprouts.

        The bug is spread by failing to wash hands after using the restroom or changing diapers, or by drinking or swimming in contaminated water.

        To find the source or sources of the local cluster, county health departments have been interviewing victims about what they ate and where. Bacteria samples collected from the victims have been sent to the state health department for closer analysis.

        Three experts from the Centers for Disease Control and Prevention, brought in at the request of the state health department, arrived Wednesday. They will be working from the Clermont County Health Department.

        Based on interviews with the people who became sick, food samples have been collected from at least two restaurants, but no test results were available Wednesday.

        The state health department expects to have results by week's end from a type of bacteria DNA testing called pulsed field gel electrophoresis.

        Even E. coli O157:H7 can vary in subtle ways. The DNA test can tell much like a fingerprint whether any of the 20 people caught the same variation of the strain.

        The lack of common circumstances among the cases makes it likely that more than one source of contamination was involved.

        In Clermont County, none of the six victims were from the same family. In Butler County, ages of victims ranged from 4 to 82. In Hamilton County, victims lived in five different cities or townships, with ages ranging from 4 to 63.

        “We've been trying to find a common food source, but so far we haven't found one,” said Patricia Burg, director of the Butler County Health Department.

        No new cases have been reported for several days, but it is too soon to tell whether the cluster is likely to grow beyond the 20 cases, Ms. Beathard said. The potential risk to the public depends on the cause or causes of the illness.

        Franklin County has reported four recent E. coli cases near Columbus but state officials do not believe those cases are linked to the Greater Cincinnati cases. Officials also are investigating three cases reported in Kentucky and one in Indiana to see if they might be linked to the local cluster.

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