Genetic testing has shown that an E. coli outbreak thought to be limited to St. Louis, MO, is spread across six other states. Health officials suspect leafy greens are the source of the pathogen.
The outbreak associated with Andre’s Banquets and Catering and Rockwood Summit High School is actually part of a larger outbreak. Whole genome sequencing has linked patients in Missouri and six other states, according to the St. Louis County Department of Health.
As of Dec. 3, the health department had confirmed 115 patients, 13 of whom had to he hospitalized. The outbreak was first reported Nov. 14. Two of the patients remain hospitalized and three developed hemolytic uremic syndrome (HUS), a serious condition that can lead to kidney failure and death.
Public health officials initially identified patients from students, staff and parents who attended off-campus events catered by Andre’s. Additional patients who attended two veterans events and a funeral catered by Andre’s were also identified.
The health department has reported that 25 patients are linked to the caterer, which is the largest subcluster of illnesses in the outbreak. Genetic testing of the E. coli has found patients in Illinois, Indiana, Kansas, North Dakota, Ohio and South Dakota.
Salad served at the St. Louis events was believed to be the source of the illness. The Missouri State Public Health Laboratory tested lettuce samples from the salads, but they turned up negative.
“Our part of the outbreak looks really different from those other states,” Amanda Brzozowski, senior epidemiologist and supervisor for the Communicable Disease Investigation program at the St. Louis County Department of Public Health, said.
Brzozowski said the outbreak in St. Louis County produced more cases than other states experienced. At this point, health officials have yet to determine why that’s the case.
“That gives us an important piece of the puzzle, but it also opens up more questions for us,” she said.
Brzozowski said even though the source of the contamination points toward leafy greens, how the contamination occurred remains unclear.
“Whether that contamination occurred at the farm or on a truck, that part we don’t know,” she said.
On Tuesday, Ed Rhode, a spokesman for the caterer released a statement implying the discovery of similar genetic material in E. coli cases outside of Missouri should clear them of suspicion:
“Two weeks ago, state investigators reported lettuce taken from our facility tested negative for E. coli. Nearly a month after its investigation began, St. Louis County health officials are still working to find the cause of our local outbreak. Today (Dec. 3), they confirmed genetic sequencing of local cases has now connected the outbreak with cases in at least six other states. We have said all along that it was unfair to name André’s before the lettuce was tested and before the investigation was complete. We look forward to St. Louis County finishing its work and finding the source of our local outbreak.”
About E. coli infections
Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.
The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).
About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.
Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.
People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.
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