Table 1 Major E. coli outbreaks in the past
Outbreak date | Location | Population affected | E. coli strain implicated | Food type involved | Outcomes | Interventions and responses |
|---|---|---|---|---|---|---|
1982 [15] | One in Oregon (February–March) and one in Michigan (May–June) | 47 people: 25 from Oregon, 1 from an adjacent county, and 21 from Michigan | E. coli O157:H7 | Hamburgers from the same fast-food restaurant chain containing three ingredients in common (beef patty, rehydrated onions, and pickles) | Several cases of illness marked by bloody diarrhoea, abdominal cramps, and low-grade fever. Few cases of non-bloody diarrhoea and HUS are recorded | Both victims and neighbourhood controls were interviewed to trace the source of infection Specimens from food samples, blood and stool of victims were investigated in laboratories. Cases were managed with fluid resuscitation and antimicrobials |
December 1, 1992–February 28, 1993 [76] | Washington, USA | 501 people: 453 ate at a Washington restaurant chain, 48 had secondary infections | E. coli O157:H7 | Hamburgers | 151 (31%) hospitalizations for bloody diarrheal disease, 45 (9%) cases of HUS, and 3 deaths | More than 250,000 potentially contaminated hamburgers were removed from circulation, averting an estimated 800 cases Surveillance system that mandated the reporting of E. coli O157:H7 infection was established, prompting outbreak recognition and control. Consumers and food service workers were educated about cooking hamburger meat thoroughly |
November 15, 1992–February 28, 1993 (Jack in the Box outbreak) [77] | Multiple states in the US, including Washington, Idaho, California (San Diego), and Nevada (Las Vegas) | 603 total reported cases of bloody diarrhea or HUS across many US cities Washington: 477 cases, of which 372 (88%) reported eating at chain A restaurant Idaho: 14 cases, of which 13 (93%) recently ate at a chain A restaurant California: 34 cases, of which 4 were linked to chain A and 4 to chain B restaurants Nevada: 58 cases | E. coli O157 | In Washington, 312 (92%) ate regular sized hamburger patties | In Washington, 144 were hospitalized for severe illness, 30 developed HUS, and 3 died In Idaho, 4 were hospitalized and 1 developed HUS In California, 14 became hospitalized, 7 were complicated with HUS and 1 died In Nevada, 9 were hospitalized and. 3 developed HUS | Surveillance systems that aided symptoms reporting and disease tracking were set up in those affected states The media and public health advisories encouraged victims to report to health authorities Nevada laboratories distributed sorbitol MacConkey medium to detect E. coli O157:H7 |
May–July 2011 [11] | Germany (mainly northern Germany, including Hamburg) France (Regions near Bordeaux) 16 European countries in total | Total cases in Europe: 4,075 caes Germany: 1,534 cases identified by June 1 France: 10 cases | O104:H4 possessing features of EAEC and STEC | Contaminated fenugreek sprouts | In Europe generally, the major symptom was bloody diarrhea, 908 (22%) of the confirmed cases were complicated by HUS and 50 deaths were reported In Germany, 470 (31%) developed HUS while 7 in France had this. complication | Several cohort studies and traceback investigations were conducted on restaurants in Germany and France, identifying fenugreek sprouts imported from Egypt as the source. EU-wide ban was subsequently placed on fenugreek seeds and similar products from Egypt |
December 2012–January 2013 [78] | 3 provinces in Canada | 31 total confirmed cases New Brunswick—7 Nova Scotia—11 Ontario—13 | E. coli O157:H7 | 24 (83%) ate sandwiches/burgers garnished with lettuce from chain A or B restaurants | 13 (42%) victims were hospitalized, 1 (3%) developed, but no deaths were reported | Measures were carried out to identify potential sources of contamination within food service facilities The Canadian Food Inspection Agency (CFIA) conducted a risk assessment for shredded lettuce served at Chains A and B |
July 12, 2013–September 29, 2013 [79] | 5 Canadian provinces | 29 cases | E. coli O157:H7 | 26 (90%) reported eating Gouda milk cheese from a dairy plant in British Columbia | 5 patients were hospitalized, while 1 died | The CFIA initiated a food recall program for all raw milk cheese cut packaged by the dairy plant from May 27 to September 17, 2013 to identify the source of infection. The British Columbia CDC prohibited the sale and processing of all raw and pasteurized milk cheese pending implementation of preventive measures |
October 7, 2018–December 4, 2018 [18] | 16 states in the US and the District of Columbia | 62 people infected | E. coli O157:H7 | Romaine lettuce harvested from the Central Coastal growing regions of northern and central California | 25 individuals were hospitalized, of which 2 developed HUS. No deaths were reported | Traceback investigations conducted by FDA and CDC on farms and cooling facilities in california identified the outbreak to be from sediment aggregated within an agricultural water reservoir on Adam Bros. Farming Inc. farm in Santa Barbara County |
August 10, 2020–October 31, 2020 [20] | 19 states in the US and the District of Columbia | 40 people infected | E. coli O157:H7 | Fresh leafy greens although investigators were unable to identify the specific type or brand of leafy greens implicated | 20 individuals were hospitalized, of which 4 developed HUS. No deaths were reported | Epidemiological and traceback studies conducted identified the potential sources. Of 23 people interviewed, 16 ate spinach while 15 ate romaine lettuce. FDA subsequently recommended measures on washing preparation of leafy greens |
August 3 to August 16, 2020 [82] | United Kingdom 83% were reported in Midlands region of England and in Wales | 36 cases England: 27 Wales: 9 | E. coli O157:H7 | Fast-food Cucumbers 64% confirmed eating in the same restaurant chain | 13 victims were hospitalized among which 25 reported bloody diarrhea. No case of HUS was reported | Questionnaires were administered to all new cases within 24 h of notification and reported to the National Enhanced Surveillance System for STEC infection (NESSS) Microbiological investigations were carried out on human and food samples to identify the strains of E. coli implicated and suitable antibiotics to administer FSA led food chain investigations with focus on chain A restaurants. A communication system to inform the European Union of the outbreak investigation was set up through the Rapid Alert System for Food and Feed (RASFF) |
September 12, 2024–October 21, 2024 [14] | 14 states in the US | 104 cases | E. coli O157:H7 | 80 (99%) of 81 people interviewed confirmed eating at McDonald's, of which 63 reported a menu garnished with fresh, slivered onions provided by Taylor Farms | 34 patients required hospitalizations, 4 developed HUS, and 1 older adult died | The menu items implicated were temporarily withdrawn from sales Federal and state public health agencies like USDA, FDA, and CDC collaborated on measures and investigations to trace and identify the sources of contamination Supply from the Taylor Farms which distributed the contaminated onions was halted until pending investigation findings and implementation of control strategies |