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September 18, 2021
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30 August 2021

Jackson County Public Health Investigating Shiga toxin-producing Escherichia coli (STEC) cases

Jackson County Public Health Investigating Shiga toxin-producing Escherichia coli (STEC) cases

Jackson County Public Health is investigating an unusually high number of Shiga toxin-producing Escherichia coli (STEC) cases. Since August 8, 2021, 16 cases have been reported to Jackson County, and 12 (75%) of these cases have been hospitalized. Age range for cases is from 11 months to 65 years of age, with the median age being 23.5. Majority of the cases are in the teens and twenties. Of the total cases 62.5% are males. 

Jackson County Public Health is working with the Oregon Health Authority on this outbreak investigation.  “Right now, we do not have a definitive hypothesis on what the source of infection may be. The genome sequencing, performed at the state public health lab, has not matched any other cases in the state or nationally,” states Dr. Jim Shames, Health Officer for Jackson County Public Health. “Therefore, we continue to do in-depth interviews with those that have tested positive to help us identify a possible source of exposure.”

Jackson County Public Health is asking medical providers to be aware of the increases in STEC cases in Jackson County and collect and test stool specimens on patients suspected to have bacterial gastroenteritis. Shiga-toxigenic Escherichia coli (including 0157, HUS, and other serogroups) are reportable infections to local and state public health.

Escherichia coli (E. coli) bacteria normally live in the intestines of people and animals. Most E. coli are harmless and actually are an important part of a healthy human intestinal tract. However, some E. coli are pathogenic, meaning they can cause illness, either diarrhea or illness outside of the intestinal tract. The types of E. coli that can cause diarrhea can be transmitted through contaminated water or food, or through contact with animals or persons. Some kinds of E. coli cause disease by making a toxin called Shiga toxin. The bacteria that make these toxins are called “Shiga toxin-producing” E. coli, or STEC for short. This pathotype is the one most commonly heard about in the news in association with foodborne outbreaks.

There are everyday steps that can help you prevent E. coli infections:

  • Practice good overall hygiene with special attention to good handwashing.
  • Wash your hands after touching animals or their environments.
  • Keep what you eat and drink away from animals.
  • Cook meats thoroughly. Prevent raw meat from contacting other food. Do this by washing hands, utensils, cutting boards and surfaces after use to prepare meat.
  • Avoid consuming raw and unpasteurized dairy and juice products.
  • Avoid school and childcare attendance, food handling and patient care if you are ill. People with diarrhea should not go to school or child care, handle food, or care for patients.

Symptoms of Shiga toxin-producing E. coli (STEC) infection vary for each person, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may have a fever, which usually is not very high (less than 101˚F/38.5˚C). Most people get better within 5 to 7 days. Some infections are very mild, but others are severe or even life-threatening.

Most people with a STEC infection start feeling sick 3 to 4 days after eating or drinking something that contains the bacteria. However, illnesses can start anywhere from 1 to 10 days after exposure. Contact your healthcare provider if you have diarrhea that lasts for more than 3 days or diarrhea that is accompanied by a fever higher than 102˚F, bloody diarrhea, or so much vomiting that you cannot keep liquids down and you pass very little urine.

About 5 to 10% of people who are diagnosed with STEC infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). HUS develops about 7 days after symptoms first appear, when diarrhea is improving. Clues that someone is developing HUS include decreased frequency of urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems. Most people with HUS recover within a few weeks, but some suffer permanent damage or die.

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