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E. coli Outbreak: Persistent Strain Identified

E. Coli Outbreaks: A Persistent Threat to Food Safety

Recent Outbreaks and Their Impact

food safety remains a critical concern, highlighted by recent E coli O157 outbreaks linked to seemingly common food sources. Last year, romaine lettuce and McDonald’s onions were identified as culprits in separate outbreaks, causing widespread illness and raising questions about the resilience of our food supply chains.

  • Romaine Lettuce Outbreak: This outbreak sickened 89 people across 15 states. Of the 74 cases with available outcome information, 36 individuals required hospitalization, and seven experienced kidney failure. tragically, one death was attributed to this outbreak.
  • McDonald’s Onions Outbreak: This outbreak resulted in 104 illnesses and 34 hospitalizations, with one fatality.

Did you know?

E coli O157:H7 is not the only type of E coli that can cause illness. While it’s a particularly virulent strain, other types can also lead to gastrointestinal distress. Proper food handling and cooking are essential to prevent infection from any type of E coli.

Understanding E coli and Its Effects

E coli infections can lead to severe foodborne illness. Common symptoms include:

  • Stomach cramps
  • Diarrhea (often bloody)
  • Vomiting

Symptoms typically manifest three to four days after exposure. In severe cases, E coli can lead to serious complications, such as kidney failure, also known as hemolytic uremic syndrome (HUS).

The Emergence of REPEXH01: A Persistent Strain

A particularly concerning development is the emergence of REPEXH01,a persistent strain of STEC O157:H7. centers for Disease Control and Prevention (CDC) investigators estimate that this strain emerged in late 2015, with clinical cases detected beginning in april 2017. Since then, nine separate outbreaks of the same strain of STEC O157:H7, referred to as REPEXH01, have occured.

Researchers published their findings in the CDC’s Emerging Infectious Diseases publication, highlighting the characteristics that make this strain so concerning.

REPEHX01 belongs to E coli O157:H7 Manning Clade 8,and most isolates possess stx2a,both factors that are associated with severe clinical outcomes. Those factors, along with its harboring of multiple resistance determinants, underscore the continued need to monitor REPEXH01 and understand factors contributing to its emergence and persistence.

CDC Investigators, Emerging Infectious Diseases

Pro Tip: Food Safety at Home

Always wash your hands thoroughly before preparing food. Use separate cutting boards for raw meats and vegetables to prevent cross-contamination. Ensure that meat is cooked to the proper internal temperature to kill harmful bacteria.

The Challenge of Diagnosis

Identifying the specific pathogen causing foodborne illness can be challenging due to overlapping symptoms. Symptoms of foodborne illnesses can overlap, making it arduous to identify the exact pathogen based solely on clinical presentation, explained Dr. Nicole M Iovine, an infectious disease physician and chief hospital epidemiologist at the University of Florida. She further elaborated:

You really can’t tell which organism is infecting a patient based on symptoms alone. The symptoms are nausea, vomiting, diarrhea, abdominal pain, sometimes there’s fever, and sometimes there isn’t fever. More severe forms can have blood in the diarrhea as well, but that’s what pretty much all bacterial causes of gastrointestinal illness will cause.

Dr. Nicole M Iovine, University of Florida

Frequently Asked Questions (FAQ)

What are the main symptoms of E coli infection?
The main symptoms include stomach cramps, diarrhea (often bloody), and vomiting.
How long does it take for symptoms to appear?
Symptoms typically appear three to four days after exposure.
What is hemolytic uremic syndrome (HUS)?
HUS is a serious complication of E coli infection that can lead to kidney failure.
What is REPEXH01?
REPEXH01 is a persistent strain of STEC O157:H7 E coli associated with multiple outbreaks in the United States.

References:

  1. Investigations of Foodborne Illness Outbreaks. Food and Drug Administration (FDA). Updated May 14, 2025. Accessed May 17, 2025.
  2. Wirth JS, Leeper MM, Smith PA, et al. Genomic Characterization of Escherichia coli O157:H7 Associated with Multiple Sources, United States. Emerging Infectious Diseases. 2025;31(13):109-116. doi:10.3201/eid3113.240686.
  3. Abene S. Preventing Foodborne Illness: A Closer Look at the Recent E coli Outbreak. Contagion. November 21, 2024. Accessed May 16,2025.

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