The Kentucky Department for Public Health (DPH)  late Friday said  20 Kentuckians have tested positive with a strain of  E. coli O103.   Kentucky public health officials did not comment on reports of at least three other cases in  Ohio, Indiana and Tennessee.

Nor has the federal Centers for Disease Control and Prevention (CDC) disclosed any new multi-state outbreaks.

Kentucky public health investigators have not yet identified the source of the outbreak, but have noted that some sort of food distribution is a likely mechanism for this outbreak among many of the individuals afflicted by the sometimes life-threatening bacteria.

 The reported cases involve a number of children as well as adults, many of whom reside in Central Kentucky. No deaths linked to the outbreak have been reported but six people have been hospitalized.  The cases in Kentucky were apparently reported between March 5 and 25.

Healthcare providers across the state have been notified of the outbreak and are advised to be alert for patients experiencing acute diarrheal illness, which could be associated with E. coli. Appropriate testing and investigative work will need to be completed to determine which cases are outbreak-associated. This is a particular strain of E. coli that produces a type of toxin (Shiga toxin) that can be dangerous for those infected.

 “Exposure to E. coli bacteria can be debilitating and potentially life-threatening, especially for small children and individuals with weakened immune systems. With this in mind, the Department for Public Health has taken swift action to identify patients, ensure appropriate testing, and follow up care as we work to determine the source of the outbreak,” said DPH Commissioner Dr. Jeff Howard. “Healthcare providers across Kentucky have been alerted to this potential threat and are working with us to make sure patients are identified and are receiving appropriate care. Meanwhile, we encourage all Kentuckians to be aware of the signs and symptoms of E. coli illness and to seek care if they are ill.”

 Symptoms of E. coli O103 illness typically include stomach cramps and diarrhea, including bloody diarrhea, and people generally become ill two to five days after consuming contaminated food. E. coli O103 disease sometimes leads to hemolytic-uremic syndrome (HUS), a serious complication that can cause kidney failure and can occur a week or more after the onset of diarrhea. Those most at risk of developing complications from E. coli infection include the very young, the elderly, and people with weakened immune systems State health officials are working with staff at local health departments in the counties with suspected or confirmed cases to determine the source of the infections.

.The department said the public can help prevent E. coli infections by;

  •  Washing hands frequently for at least 20 seconds with soap and warm water, especially before eating,after going to the bathroom,handling raw meat and eggs, and after handling or petting animals;
  • Thoroughly washing produce before eating;
  • Thoroughly cooking meat;
  • Cleaning and sanitizing food preparation areas;
  •  Avoiding swallowing lake or pool water;
  • Drinking only pasteurized milk;
  • ·Frequently cleaning and sanitizing restrooms, including door knobs and faucets; and
  •  Reporting diarrheal illnesses to your physician.

 Anyone who experiences symptoms of illness that could be associated with this E. coli outbreak, should see their  health care provider or  local health department.

 

Outbreaks of E. coli O103 are rare.  From the CDC NORS dataset:

https://wwwn.cdc.gov/norsdashboard/

Year State Transmission Serotype Setting Illnesses
2000 Washington Food O103 Caterer (food prepared off-site from where served); Other 18
2010 Minnesota Food O103:H2; O145:NM School/college/university 29
2011 Wisconsin Animal Contact O103; O157:H7 6
2013 Minnesota Person-to-person O103 Child day care 3
2013 Pennsylvania Indeterminate O103:H2 Private home/residence 2
2014 Ohio Indeterminate O103 Child day care 3
2014 Multistate Food O103:H2 Restaurant – other or unknown type 12
2014 Ohio Indeterminate O103; O157:H7; O146:H21 Private home/residence 4
2015 Multistate Food O103 Restaurant – other or unknown type 4
2015 Ohio Person-to-person O103 School/college/university 6
2015 Multistate Food O103 Restaurant – other or unknown type 6
2015 Kansas Person-to-person O103 Child day care 12
2015 North Carolina Person-to-person O103 Child day care 20
2015 Virginia Person-to-person O103:H2 Prison/jail 4
2015 Ohio Indeterminate O103; Child day care 5
2016 Ohio Indeterminate O103 Other, specify 7
2017 Ohio Person-to-person O103 Child day care 4
2017 Oregon Food O103 Other 13

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