Food Safety News | Summer 2017

Part One: E. Coli Treatment the Same After Deadly Jack in the Box Outbreak 20+ Years Ago

When it comes to foodborne illness, true progress in fighting it lies in prevention.

Preventing contamination and sickness in the first place is, of course, the gold standard. Beyond that, for unlucky folks who fall ill, prevention of life-threatening health consequences is the goal.

For people who get sick from E. coli—especially those who contract the potentially massively destructive strain of E. coli O157:H7—how quickly and effectively the symptoms are treated can be a life and death situation.

Today, in PART ONE of our series on E. coli treatment, we’re shining a spotlight on how it has evolved since that awful time back in 1993 when over 700 people were sickened with the deadly E. coli O157:H7 bacteria after eating contaminated beef in Jack in the Box hamburgers. That huge outbreak, which killed four children, launched foodborne illness on the center stage as a serious national health threat and served as a catalyst for public and government intervention.

So, 20+ years later, what’s changed?

Read on to find out.

The Progress

The good news is that, indeed, there has been some.

For starters, the U.S. federal government has declared seven strains of E. coli as adulterants in beef. Why is that important? Because beef producers are now legally required to have systems in place to eliminate it and cook, treat, or destroy any product that contains it.

Two other major progress points include improvement in methods to identify an E. coli outbreak and development of quicker lab tests for detecting the bacteria.

There’s also a new vaccine that reduces E. coli shedding in cows, which means less risk of the fatal pathogen ever reaching the beef supply in the first place.

The bottom line is that all of those factors do two important things: They help reduce the number of people affected and get victims the treatment they need faster.


The Lingering Life-Threatening Problem

But, despite the progress, there’s one big problem that still remains: Lack of fast, effective treatment for the severe complication of hemolytic uremic syndrome (HUS) that can result from an E. coli infection.

And the harsh reality is that HUS oftentimes leads to kidney failure and death.

Today, approximately 10-15% of patients who contract a Shiga toxin-producing E. coli (STEC) infection—such as from the O157:H7 strain—develop HUS. Diarrhea-associated HUS, the type that results from a STEC infection, remains the leading cause of kidney failure in children.

HUS unleashes its harmful effects on the body when the Shiga toxins make their way into the bloodstream. The toxins localize in the kidneys because they’ve got the largest concentration of the Shiga toxin’s receptor, globotriaosylceramide. Once here, Shiga toxins damage cells that form the lining of kidney blood vessels. The body then ushers platelets to the damaged area to induce clotting. But these clots then block the flow of red blood cells through the vessels, which wreaks havoc causing kidney injury or failure.

Symptoms of HUS typically include low platelet count, anemia, and compromised kidney function.

Although scientists and researchers have learned a lot about HUS during the past two decades, they haven’t learned how to prevent its onset once a patient comes down with an E. coli infection.

And, unfortunately, doctors don’t have a magic pill to speed recovery for patients either. But supportive care does help reduce the severity and duration of a patient’s illness. These supportive measures include maintaining an appropriate salt/water balance in the body, platelet transfusions to address bleeding, blood transfusions to alleviate anemia, and treating symptoms such as high blood pressure or seizures as they arise.

What Do Victims Say?

Look for PART TWO of this series in the coming months, where we’ll interview E. coli victims who speak out on what their treatment was like, what they learned, and what they feel needs to happen to get patients better treatment.

How About You?

Have you experienced an E. coli infection and want to share your story? Contact Stanley Rutledge, Community Coordinator, at We’re always interested in learning from our supporters, as well as sharing their stories.

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