FDA Investigates Outbreak of E. coli O157 Illnesses Possibly Linked to Pre-packaged Salad Products

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The Food and Drug Administration (FDA) along with the U.S. Department of Agriculture’s Food Safety and Inspection Service, the Centers for Disease Control and Prevention (CDC) and state and local officials are investigating a multi-state outbreak of E. coli O157:H7 infections. The FDA provides the following Q&A: 

What is the Problem and What is Being Done About It?

The FDA, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), the Centers for Disease Control and Prevention (CDC), and state and local officials are investigating a multi-state outbreak of E. coli O157:H7 illnesses possibly linked to prepackaged salad meals. At the present time there have been 26 cases of illness reported in three states: Arizona, California and Washington.   

On Nov. 10, 2013, the FSIS announced that Glass Onion Catering, a Richmond, Calif. establishment, is recalling approximately 181,620 pounds of ready-to-eat salads and sandwich wrap products with fully-cooked chicken and ham because some of these products have been linked to the illnesses through epidemiological and traceback investigation.

In a related recall announcement, Atherstone Foods, Inc. of Richmond, Calif. recalled ready to eat salads and wraps with “Best Buy” dates 9-23-13 through 11-14-13 because they may be contaminated with E. coli O157:H7 bacteria. 

Investigation into this outbreak continues, in order to determine the source of the outbreak.

What are the Symptoms of E coli?

The symptoms of Shiga toxin-producing E. coli (STEC) infections vary for each person but often include severe stomach cramps, diarrhea (often bloody), and vomiting. If there is fever, it usually is not very high (less than 101˚F/less than 38.5˚C). Most people get better within five to seven days. Some infections are very mild, but others are severe or even life-threatening. Around 5 percent to 10 percent of those who are diagnosed with 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. Most persons with HUS recover within a few weeks, but some suffer permanent damage or die.

How soon do symptoms appear after exposure?

The time between ingesting the STEC bacteria and feeling sick is called the “incubation period.” The incubation period is usually three to four days after the exposure, but may be as short as 1 day or as long as 10 days. The symptoms often begin slowly with mild belly pain or non-bloody diarrhea that worsens over several days. HUS, if it occurs, develops an average seven days after the first symptoms, when the diarrhea is improving.

What are the complications of STEC infections?

Around 5 percent to 10 percent of those who are diagnosed with 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. Most persons with HUS recover within a few weeks, but some suffer permanent damage or die.

Who is at Risk? 

People of any age can become infected. Very young children, older Americans, and people with weakened immune systems are more at risk of developing severe illness and HUS, but even healthy older children and young adults can become seriously ill.

What Specific Products are Being Recalled? 

On Nov. 10, 2013, the FSIS announced2 that Glass Onion Catering, a Richmond, Calif. establishment, is recalling approximately 181,620 pounds of ready-to-eat salads and sandwich wrap products with fully-cooked chicken and ham because some of these products have been linked to the illnesses through epidemiological and traceback investigation. The products were produced between Sept. 23 and Nov. 6, 2013 and shipped to distributions centers intended for retail sale in Arizona, California, Nevada, New Mexico, Oregon, Texas, Utah and Washington. When available, the retail distribution list(s) will be posted on the FSIS website at www.fsis.usda.gov/recalls3

12 oz. packages of  “delish pan pacific chop salad”
13.4 oz. packages of  “delish California style grilled chicken salad”
9.9 oz. packages of  “delish uncured applewood smoked ham & cheese wrap”
10.5 oz. packages of “delish grilled chicken caesar wrap”
10.9 oz. packages of  “delish southwestern chicken wrap”
11.5 oz. packages of  “delish greek brand low-calorie grilled chicken wrap”
9.9 oz. packages of  “delish white chicken club wrap”
11.2 oz. packages of  “delish asian style chicken wrap”
13.4 oz. packages of  “atherstone Fine Foods Southwestern Style White Chicken Wrap with Chimichurri Sauce”
10.5 oz. packages of  “atherstone Fine Foods Asian Style White Chicken Wrap with Mango Vinaigrette”
9.9 oz. packages of  “atherstone Fine Foods Grilled White Chicken Caesar Wrap with Caesar Dressing”
10.7 oz. packages of  “super fresh Foods California Grilled Chicken Salad, Low Fat Mendocino Mustard Dressing”
10.7 oz. packages of  “Lunch Spot Southwestern Style Chicken Wrap, Chile & Lime  Dressing”
9.2 oz. packages of  “super fresh Foods Pan Pacific Chopped Chicken Salad, Ginger Soy Dressing”
10.7 oz. plastic containers of “TRADER JOE’S Field Fresh Chopped Salad with Grilled Chicken.”
11 oz. plastic containers of “TRADER JOE’S MEXICALI SALAD with Chili Lime Chicken.”
 
In a related recall announcement, Atherstone Foods, Inc. of Richmond, Calif. recalled ready to eat salads and wraps with “Best Buy” dates 9-23-13 through 11-14-13 because they may be contaminated with E. coli O157:H7 bacteria. The following products are affected by the recall announced by Atherstone Foods, Inc.: 

Delish Greek Style Orzo Salad (6.oz) Clam Shell/ UPC#49022 74630/ Distributed to Northern Calif. Walgreens
Delish Asian Style Noodle Salad (6. oz)  Clam Shell/ UPC# 49022 74628/ Distributed to Northern Calif. Walgreens
Delish Vegetarian Wrap (11.3oz) Cellophane/ UPC# 49022 55349/ Distributed to Northern Calif. Walgreens
Classic Greek Salad (9. oz) Clam Shell/ UPC# 0083 5794/ Distributed to Northern Calif. and Northern Nevada Trader Joe’s
Southwestern  Salad Kit (20 Lbs box)/ No UPC#/ Distributed to Northern Calif. Whole Foods
Wheat Berry Salad Kit (20 Lbs box)/ No UPC#/ Distributed to Northern Calif. Whole Foods 

What Do Consumers Need To Do? 

If consumers have the recalled products, they should dispose of them or return them to the place of purchase for a full refund.  Consumers should always practice safe food handling and preparation measures. At home, wash hands, utensils, and surfaces with hot, soapy water before and after handling food; keep raw meat, poultry, and seafood separate from fresh produce and other ready-to-eat foods; cook foods to the proper temperature; and refrigerate perishable foods promptly.   

What is the best treatment for STEC infection?

Non-specific supportive therapy, including hydration, is important. Antibiotics should not be used to treat this infection. There is no evidence that treatment with antibiotics is helpful, and taking antibiotics may increase the risk of HUS. Antidiarrheal agents like Imodium® may also increase that risk.

Who Should be Contacted? 

Consumers with questions may contact Atherstone Foods at (510) 236-8905 Mon-Fri 9 a.m. to 5 p.m. PST.

Contact your healthcare provider if you have diarrhea that lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

The FDA encourages consumers with questions about food safety to call 1-888-SAFEFOOD Monday through Friday between 10 a.m. and 4 p.m. Eastern time, or to consult the fda.gov website: www.fda.gov.
 
Source: FDA

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