Friday, December 4, 2015

FDA Investigates Multistate Outbreak of E. coli O26 Infections Linked to Chipotle Mexican Grill Restaurants


Update: December 4, 2015

Three additional states have reported people infected with the outbreak strain of Shiga toxin-producing  Escherichia coli O26 (STEC O26) since the last update, Illinois, Maryland, and Pennsylvania.
Fifty-two people infected with the outbreak strain of STEC O26 have now been reported from a total of nine states:  California (3), Illinois (1), Maryland (1), Minnesota (2), New York (1), Ohio (3), Oregon (13), Pennsylvania (1), and    Washington (27).
The epidemiologic evidence available at this time suggests that a common meal item or ingredient served at  Chipotle Mexican Grill restaurants in several states is a likely source of this outbreak.
 The investigation is still ongoing to determine what specific food is linked to illness.
What is the Problem and What is Being Done About It?  

The FDA and the Centers for Disease Control and Prevention (CDC) along with state and local officials are investigating an outbreak of E. coli O26 infections that have been linked to food served at Chipotle Mexican Grill restaurants in several states.

As of December 4, 2015, the CDC reports a total of 52 people infected with the outbreak strain of STEC O26 from a total of nine states: California (3), Illinois (1), Maryland (1), Minnesota (2), New York (1), Ohio (3), Oregon (13), Pennsylvania (1), and Washington (27). There have been 20 reported hospitalizations. There have been no reports of hemolytic uremic syndrome (HUS) and no deaths. Of the three most recent illnesses reported in November, only one ill person, whose illness started on November 10, reported eating at Chipotle Mexican Grill in the week before their illness began.

Investigators are also using whole genome sequencing, an advanced laboratory technique, to get more information about the DNA fingerprint of the STEC O26 bacteria causing illness. To date, whole genome sequencing has been performed on STEC O26 isolates from 21 ill people from California (2), Minnesota (2), New York (1), and Washington (16). All 21 isolates were highly related genetically to one another. This provides additional evidence that illnesses outside the Pacific Northwest, could be related to the illnesses in Washington.

Chipotle Mexican Grill has reopened all of its restaurants in Washington and Oregon that had been closed  in response to the investigation. Chipotle Mexican Grill worked in close consultation and collaboration with health officials throughout the investigation to determine whether it was appropriate to reopen these restaurants. Chipotle reports  taking the following actions, among others, prior to opening:

Confirming that all microbial testing performed by the company did not yield coli (more than 2,500 tests of Chipotle's food, restaurant surfaces, and equipment all showed no E. coli)

Confirming that no employees in these restaurants were sickened from this incident
Expanded testing of fresh produce, raw meat, and dairy items prior to restocking restaurants
Implementing additional safety procedures, and audits, in all of its 2,000 restaurants to ensure that robust food safety  standards are in place
Working closely with federal, state, and local government agencies to ensure that robust food safety standards are in place
Replacing all ingredients in the closed restaurants
Conducted additional deep cleaning and sanitization in all of its closed restaurants (will conduct deep cleaning and sanitization  additionally in all restaurants nationwide)
The FDA continues to work with Chipotle Mexican Grill restaurants as well as federal, state and local agencies in gathering information about the supply chain(s). The FDA will continue to provide updates on the investigation as they become available.

What are the Signs & Symptoms of E. coli O26?

People usually get sick from STEC (Shiga toxin-producing coli) 2-8 days (average of 3-4 days) after swallowing the organism (germ).
Most people infected with STEC develop diarrhea (often bloody) and abdominal cramps.
Most people recover within a week.
Some illnesses last longer and can be more severe, resulting in a type of kidney failure called hemolytic uremic syndrome (HUS).
HUS can occur in people of any age, but is most common in young children under 5 years, older adults, and people with weakened immune systems.
Symptoms of HUS can include fever, abdominal pain, pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and decreased urination.
People who experience these symptoms should seek emergency medical care immediately.
STEC infection is usually diagnosed by testing of a stool sample for Shiga toxins.
Clinical laboratories are required in some states to send Shiga toxin-positive specimens from ill people to the state public health laboratory for identification of STEC and PulseNet testing.
Who is at Risk?

People of any age can become infected. Very young children and the elderly are more likely than others to develop severe illness and HUS, but even healthy older children and young adults can become seriously ill. In this particular outbreak, the age range of ill patients is 1 - 67 years.

What Do Consumers Need To Do?

Consumers who have recently become ill after eating at a Chipotle should contact their health care provider.

Who Should be Contacted?

Contact your healthcare provider if you have diarrhea that lasts for more than 3 days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

The FDA encourages consumers with questions about food safety to call 1-888-SAFEFOOD Monday through Friday between 10 a.m. and 4 p.m. Eastern time, or to consult the FDA website.

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