An Outbreak of Escherichia coli 0157:H7 Infections Traced to Jerky Made From Deer Meat

Keene, William E.; Sazie, Elizabeth; Kok, J.; Rice, Daniel H.; Hancock, Dale D.; Balan, V.; Zhao, Tong; Doyle, Michael P.

doi:10.1001/jama.1997.03540390059036

Cited by 202 publications

(34 citation statements)

References 16 publications

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“…HUS D+ is more often sporadic, but large outbreaks have been reported. Cattle and sheep are the main reservoirs, and the major transmission route is believed to be food contaminated with animal feces [9][10][11][12][13][14][15][16][17][18] . Contaminated water has also been recognized as a source [19] , and direct human-to-human and animal-to-human transmission have been reported [20] .…”

Section: Epidemiologymentioning

confidence: 99%

Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations

Salvadori

Bertoni²

2013

WJN

116

111

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Hemolytic uremic syndrome (HUS) is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and pathogenetic classifications. New findings in genetics and, in particular, mutations of genes that encode the complement-regulatory proteins have improved our understanding of atypical HUS. Similarly, the complement proteins are clearly involved in all types of thrombotic microangiopathy: typical HUS, atypical HUS and thrombotic thrombocytopenic purpura (TTP). Furthermore, several secondary HUS appear to be related to abnormalities in complement genes in predisposed patients. The authors highlight the therapeutic aspects of this rare disease, examining both "traditional therapy" (including plasma therapy, kidney and kidneyliver transplantation) and "new therapies". The latter include anti-Shiga-toxin antibodies and anti-C5 monoclonal antibody "eculizumab". Eculizumab has been recently launched for the treatment of the atypical HUS, but it appears to be effective in the treatment of typical HUS and in TTP. Future therapies are in phases Ⅰ and Ⅱ. They include anti-C5 antibodies, which are more purified, less immunogenic and absorbed orally and, anti-C3 antibodies, which are more powerful, but potentially less safe. Additionally, infusions of recombinant complement-regulatory proteins are a potential future therapy.

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Section: Epidemiologymentioning

confidence: 99%

Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations

Salvadori

Bertoni²

2013

WJN

116

111

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“…Venison, which may be highly contaminated with fecal bacteria, is usually hung at ambient temperatures, allowing bacteria present to multiply [6]. In contrast, fresh beef is generally chilled rapidly.…”

Section: Resultsmentioning

confidence: 99%

“…Approximately 30% of feedlot cattle shed E. coli O157: H7 [5]. Other animals [6,7]; contaminated water, both for drinking [8] and in swimming pools [9] and lakes [10]; food such as meats [11], mettwurst [12], salad sprouts [13] and lettuce [14]; drinks including unpasteurized apple juice [15] and milk; and direct contact with animals in petting farms [16] may also be sources of STEC.…”

Section: Introductionmentioning

confidence: 99%

Interventions for preventing diarrhea-associated hemolytic uremic syndrome: systematic review

Thomas

Elliott

2013

BMC Public Health

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BackgroundHemolytic Uremic Syndrome (HUS) may follow infection with Shiga-toxin-producing organisms, principally E. coli O157: H7 (STEC), causing high morbidity and mortality. Our aim was to identify interventions to prevent diarrhea-associated HUS.MethodsSystematic search of the literature for relevant systematic reviews (SRs), randomised controlled trials (RCTs) and public health guidelines.ResultsOf 1097 animal and 762 human studies, 18 animal studies (2 SRs, 2 reviews, plus 14 RCTs) and 6 human studies (3 SRs, plus 3 RCTs) met inclusion criteria. E. coli O157: H7 Type III secreted protein vaccination decreased fecal E. coli O157 shedding in cattle (P = 0.002). E. coli O157: H7 siderophore receptor and porin proteins (SRP) vaccines reduced fecal shedding in cows (OR 0.42 (95% CI 0.25 to 0.73) and increased anti-E. coli 0157: H7 SRP antibodies in their calves (P < 0.001). Bacterin vaccines had no effect. Probiotic or sodium chlorate additives in feeds reduced fecal E. coli O157 load as did improved farm hygiene (P < 0.05). Solarization of soil reduced E. coli O157: H7 contamination in the soil (P < 0.05). In an RCT examining the role of antibiotic treatment of E. coli O157: H7 diarrhea, HUS rates were similar in children treated with Trimethoprim-sulfamethoxazole and controls (RR 0.57; 95% CI 0.11 to 2.81). In another RCT, HUS rates were similar in children receiving Synsorb-Pk and placebo (RR 0.93; 95% CI 0.39 to 2.22). In one SR, hand washing reduced diarrhea by 39% in institutions (IRR 0.61; 95% CI 0.40 to 0.92) and 32% in community settings (IRR 0.68; 95% CI 0.52 to 0.90) compared to controls. Guidelines contained recommendations to prevent STEC transmission from animals and environments to humans, including appropriate food preparation, personal hygiene, community education, and control of environmental contamination, food and water quality.ConclusionsAnimal carriage of STEC is decreased by vaccination and improved farm practices. Treatment of STEC diarrhea with antibiotics and toxin-binders did not prevent HUS. Public health interventions are the key to preventing STEC-associated diarrhea and HUS.

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“…In addition to a prolonged shelf life, these ready to eat (RTE) dried meat products are generally considered microbially stable due to the presence of curing salts, organic acids, low pH and a w values 60.77 (Calicioglu, Sofos, & Kendall, 2003;Faith et al, 1998;Lara et al, 2003;Mothershaw et al, 2003;Montet et al, 2009). Although deemed microbially stable, the prevalence of several foodborne pathogens, such as Clostridium botulinum (Midura, Nygaard, Wood, & Bodily, 1972), Staphylococcus aureus (Lara et al, 2003), Escherichia coli 0157:H7 (Faith et al, 1998), Salmonella (Calicioglu et al, 2003) and L. monocytogenes (Calicioglu, Sofos, Samelis, Kendall, & Smith, 2002) have been observed in jerky and were subsequently linked to several outbreaks of foodborne illness (Keene et al, 1997;Nummer et al, 2004). Although there are no documented outbreaks of listeriosis associated with jerky, a 0.52% prevalence of L. monocytogenes at point of sale has been reported for this commodity (Levine, Rose, Green, Ransom, & Hill, 2001).…”

Section: Introductionmentioning

confidence: 99%

“…However, several studies have shown that sub-lethal drying conditions not only promoted pathogen survival and favoured the development of resistance to the drying process (Allen, Cornforth, Whittier, Vasavada, & Nummer, 2007;Buege, Searls, & Ingham, 2006;Calicioglu et al, 2002Calicioglu et al, , 2003Porto-Fett, Call, & Luchansky, 2009;Portocarrero, Newman, & Mikel, 2002), but was also a contributing factor in cases of foodborne illness (Keene et al, 1997;Nummer et al, 2004). Indeed, these studies have highlighted the inadequacy of lower drying temperatures at eradicating pathogenic populations (Nummer et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Survival of Listeria monocytogenes, and enterotoxin-producing Staphylococcus aureus and Staphylococcus pasteuri, during two types of biltong-manufacturing processes

Naidoo

Lindsay

2010

Food Control

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An Outbreak of Escherichia coli 0157:H7 Infections Traced to Jerky Made From Deer Meat

Abstract: Deer can be colonized by E coli O157:H7 and can be a source of human infections. Conditions necessary to ensure the safety of dried meat deserve further review. Game should be handled with the same caution indicated for commercially slaughtered meat.

Cited by 202 publications

References 16 publications

Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations

Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations

Interventions for preventing diarrhea-associated hemolytic uremic syndrome: systematic review

Survival of Listeria monocytogenes, and enterotoxin-producing Staphylococcus aureus and Staphylococcus pasteuri, during two types of biltong-manufacturing processes

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