Food Safety Partnership:
Epidemiology Update
June 7, 2010
Erin Hedican
Etiologies of 2010 Outbreaks
Confirmed foodborne - 20 total*
Pathogen
Number (%)
Norovirus
Salmonella
Clostridium perfringens
E. coli O157
Susp. bacterial toxin
13 (65%)
2 (10%)
2 (10%)
1 (5%)
1 (2%)
*Data are preliminary
2010 Outbreak Settings
Confirmed foodborne - 20 total*
Setting
Number (%)
Restaurant
Contaminated product
Church
Private event
14 (70%)
3 (15%)
2 (10%)
1 (5%)
*Data are preliminary
E. Coli O157 outbreak
(May 2010)
• May 18: lab notified epi of two PFGE
matches
• May 19: both cases had been interview,
no common exposure
– One reported raw milk consumption
• PulseNet search found no recent
human matches
E. Coli O157 outbreak
(May 2010)
• May 20: notified of a third matching
isolate
– No raw milk or other commonalities
• May 21: possible connection between
farm and school
• May 24: re-interviewed first case,
reported consuming milk at family
gathering
E. Coli O157 outbreak
(May 2010)
• May 25: visited school, fourth case
reported to epi
– Toddler, HUS
• May 26: MDH/MDA staff visited farm
– Issued first press release
E. Coli O157 outbreak
(May 2010)
• June 1: notified that 9 samples were
positive for O157
– 3 animal [2 calves,1 sheep], 5 manure from
various parts of farm
• 3 food products from farm Stx +
– Cheddar, gouda, bulk vat rinse
• June 3: 8 samples were
indistinguishable by PFGE to cases
– Issued second press release
Pulse Field Gel Electrophoresis on E. coli O157 Isolates, June 3, 2010
PFGE-XbaI
2005 patient (for comparison)
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Environmental 1
Environmental 2
Environmental 3
Environmental 4
Environmental 5
Animal 1
Animal 2
Animal 3
E. Coli O157 outbreak
(May 2010)
• 7 cases
– 5 confirmed
– 2 probable (1 secondary)
• 4 hospitalized, 1 HUS
• 5 consumed products from Hartmann’s
dairy farm
[data as of June 8]
Raw milk associated outbreaks
in Minnesota, 1980 – 2007
County
Pathogen
Number of
Cases
Setting
Group
1981
Scott
Campylobacter jejuni
25
Farm
School Group
1984
Crow Wing
Brainerd Diarrhea
122
Dairy
Community
1989
Polk
Campylobacter jejuni
8
Farm
School Group
1992
Itasca
Campylobacter jejuni
50
Church Picnic
2000
Kittson
Campylobacter
8
Farm
Firefighters
2001
Otter Tail
Campylobacter jejuni
4
Farm
Ministry Group
Year
Picnic
Attendees
Percent of sporadic cases of Campylobacter,
Cryptosporidium, E. coli O157, and Salmonella
reported to MDH reporting domestic raw milk
consumption, 2001-2007
Year
Campylobacter
Cryptosporidium
2001
40 (5.0)
5 (2.8)
2002
27 (3.4)
2003
E. coli O157
Salmonella
Total
4 (2.4)
8 (1.5)
57 (3.4)
3 (1.9)
2 (1.4)
3 (0.6)
35 (2.2)
36 (4.4)
7 (5.3)
1 (0.9)
6 (1.4)
50 (3.4)
2004
39 (5.2)
5 (3.7)
1 (1.2)
2 (0.4)
47 (3.2)
2005
32 (4.9)
4 (2.6)
2 (2.4)
7 (1.7)
45 (3.4)
2006
42 (5.6)
3 (1.5)
1 (0.8)
5 (0.9)
51 (3.2)
2007
44 (6.0)
10 (3.7)
2 (1.8)
5 (1.0)
61 (3.8)
Total
260 (4.9)
37 (3.0)
13 (1.6)
36 (1.1)
346 (3.2)
Raw milk sales
• Law forbids the distribution of raw milk
beyond the location where it was
produced
• Legal to buy it from the farm directly
• However, still can’t sell a contaminated
product
Questions?