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Knox County Health Department provides E. coli update


KNOXVILLE – The Knox County Health Department’s (KCHD) investigation of a cluster of Escherichia coli (E. coli) 0157 cases in children is ongoing. While all possible sources are under investigation, the cases are likely associated with two potential sources: consumption of raw milk and contact with farm animals, either direct or indirect. To date, more than 10 cases of E. coli 0157 have been reported to KCHD, all are among children. No new E. coli cases were reported over the weekend. However, the incubation period for E. coli is two to 10 days.

The common link among the majority of those who are ill continues to be consumption of raw milk from a local cow-share dairy, French Broad Farm in Knox County, Tenn. Due to possible contamination with E. coli 0157 and out of an abundance of caution, KCHD continues to advise the public not to consume raw milk or any other unpasteurized products they may have received from this farm prior to it suspending distribution last week. Milk and manure samples were taken from the farm for testing. The timeline for results is unknown. KCHD is working with the farm on restoring operations; however, a date has not yet been determined.

The common link among the other remaining cases remains attendance at a child care facility, Kids Place, Inc. During the investigation, exposure, either direct or indirect, to ruminant farm animals was identified as a potential source of infection for these cases. All of these cases were among an age group that was housed in the Baby House, a separate area of the child care facility. By taking several infection control steps, the imminent health threat has been mitigated. On Friday, June 8, 2018, KCHD lifted its health directive, which was placed only on the Baby House, the portion of the facility with the risk. Environmental samples from the facility and animals have been collected for testing. The timeline for results is unknown. Any further action regarding the operation of the facility will be determined by the Tennessee Department of Human Services, as the facility’s regulatory authority.

While it would be rare, it’s possible that our community is experiencing two unrelated E. coli clusters at the same time. The investigation is ongoing.

Background:
E. coli 0157 can cause disease by making a Shiga toxin; these are referred to as Shiga toxin-producing E. coli or STEC. This can cause severe diarrhea and even life-threatening complications, especially in children, older adults, pregnant women and those with compromised immune systems. Approximately 5 to 10 percent of those diagnosed with a STEC infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). Clues that a person is developing HUS include decreased frequency of urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. Persons with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems.

Raw milk and other unpasteurized products can contain harmful bacteria, including E. coli 0157. While it is possible to get sick from many other foods, raw milk is one of the riskiest. As stated in the American Academy of Pediatrics policy statement on unpasteurized dairy, only an estimated 1 to 3 percent of dairy products consumed in the U.S. are unpasteurized. Yet these products account for 82 percent of the milk- or milk product-associated foodborne outbreaks reported to the Centers for Disease Control and Prevention between 1973 and 2009.

E. coli can also be found in the feces of cattle, goats, sheep and other ruminant animals. Historically, the major source for human illness is cattle, which can carry E. coli 0157 but show no signs of illness. E. coli can be spread person-to-person through the fecal-oral route, which is why adequate handwashing is crucial in preventing the bacteria from spreading to others. More information on preventing E. coli can be found on the CDC’s website.

Symptoms of E. coli infection vary for each person, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some may have a low fever (less than 101˚F). Some infections are mild, but others can be severe. Seek medical attention immediately if you or your child has diarrhea lasting more than two days or contains blood. Tell your provider if you or your child have consumed raw milk or had contact with farm animals.

Published June 12, 2018







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