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E COLI EHEC - USA (18): (MINNESOTA) LAKE SWIMMING Update!!

E COLI EHEC - USA (18): (MINNESOTA) LAKE SWIMMING

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A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org>

Date: Wed 21 Aug 2019
Source: Bring Me the News [edited] <https://bringmethenews.com/minnesota-news/69-now-sickened-in-e-coli-outbreak-at-lake-nokomis>


There have now been 69 people to have fallen sick from the _Escherichia coli_ outbreak at Lake Nokomis. Health officials put out an alert earlier this month [August 2019] after 3 children became sick with the bug after swimming at the lake, prompting the closure of both its beaches.

The Minnesota Department of Health said on Friday [16 Aug 2019] it had received 49 confirmed cases of _E. coli_-related illness since the outbreak, and on Tuesday [20 Aug 2019] revealed that this number had grown to 69. Those affected went swimming at the south Minneapolis lake between 16 Jul and 11 Aug 2019, with the Shiga-toxin producing _E. coli_ taking up to 16 days to show symptoms. [We generally consider 10 days to be the long end of the incubation period. - Mod.LL]

Both beaches at the lake have been closed and will remain that way for the rest of the season, as part of MDH's response to contain the outbreak. Of the total cases, 20% affected children aged 10 and younger. Fortunately, nobody has required hospitalization.

The Star Tribune reports that with other beach closures at Bde Maka Ska and Lake Hiawatha, among others, this summer, it is the most beach closures seen in the city since it started testing for bacteria in 2003. The MDH advises anyone showing symptoms of a Shiga-toxin _E. coli_ infection -- diarrhea (often bloody), stomach cramps, no or low-grade fever -- should see a healthcare provider.

[byline: Adam Uren]

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communicated by: ProMED-mail <promed@promedmail.org>

[This has become a substantial outbreak.

It is important to understand that there are many different kinds of _E. coli_. The organism is an important component of the human intestinal tract and can perform important functions helpful to its host. These strains can cause human infections if they "escape" from the usual location into the urinary tract, gall bladder, or abdominal cavity. They are also what are mentioned when a beach is closed for _E. coli_ contamination. In this circumstance, officials are measuring the organism or "coliforms" in the water to reflect human sewage contamination.

In addition, some strains of _E. coli_ can produce toxins that can induce diarrhea, and much of so-called travelers' diarrhea is caused by these strains. All of these strains are human bacteria, not zoonotic organisms, that is, not spread from animal hosts. One _E. coli_ group called Shiga toxin producing or enterohemorrhagic _E. coli_ (EHEC), the organism likely to be involved here, is zoonotic. Spread in a number of ways, including via undercooked ground beef, contaminated vegetables, and direct or direct contact with farm animals including contaminated water, EHEC can cause significant disease and even death.

In the spring of 2000, in Walkerton, a town of 5000 in southern Ontario, an outbreak of _E. coli_ O157:H7 infection claimed 7 lives -- 6 adults and a child -- and over 200 were seen at local area hospitals.

Swimming-associated transmission is illustrated in the following references:

1. Keene WE, McAnulty JM, Hoesly FC, et al. A swimming-associated outbreak of hemorrhagic colitis caused by _Escherichia coli_ O157:H7 and _Shigella sonnei_. N Engl J Med. 1994; 331(9): 579-84; available at <http://www.nejm.org/doi/full/10.1056/NEJM199409013310904>.
2. CDC. Lake-associated outbreak of _E. coli_ O157:H7 - Illinois. MMWR 1996; 45(21): 437-9; available at <https://www.cdc.gov/mmwr/preview/mmwrhtml/00042070.htm>.
3. Ackman D, Marks S, Mack P, et al. Swimming-associated hemorrhagic colitis due to _Escherichia coli_ O157:H7 infection: evidence of prolonged contamination of a fresh water lake. Epidemiol Infect. 1997; 119:1-8; available at <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808815/>.
- Mod.LL

HealthMap/ProMED-mail map of Lake Nokomis, Minnesota, United States: <http://healthmap.org/promed/p/65184>.]

[See Also:
E. coli EHEC - USA (17): (MN) lake swimming http://promedmail.org/post/20190815.6622983
E. coli EHEC - USA (16): (SD) http://promedmail.org/post/20190731.6598318
E. coli EHEC - USA (15): (ME) O26, ex Iceland (SL) http://promedmail.org/post/20190722.6581313
E. coli EHEC - USA, Canada: O103, O121, ground bison, alert, recall http://promedmail.org/post/20190717.6572099
E. coli EHEC - USA (14): (CO) O157, restaurant http://promedmail.org/post/20190713.6566584
E. coli EHEC - USA (13): (CA) county fair, fatal http://promedmail.org/post/20190705.6554115
E. coli EHEC - USA (12): (CA) county fair, fatal http://promedmail.org/post/20190701.6545757
E. coli EHEC - USA (11): (MO) http://promedmail.org/post/20190623.6534267
E. coli EHEC - USA (10): O26, flour, alert, recall http://promedmail.org/post/20190615.6522440
E. coli EHEC - USA (09): (IL) http://promedmail.org/post/20190611.6513053
E. coli EHEC - USA (08): flour, alert, recall http://promedmail.org/post/20190527.6488348
E. coli EHEC - USA (07): O103, ground beef, CDC, recall http://promedmail.org/post/20190514.6468615
E. coli EHEC - USA (06): O103, ground beef, CDC, recall http://promedmail.org/post/20190424.6436748
E. coli EHEC - USA (05): O103, ground beef, CDC http://promedmail.org/post/20190413.6420590
E. coli EHEC - USA (04): O103, CDC http://promedmail.org/post/20190410.6414420
E. coli EHEC - USA (03): O103, CDC http://promedmail.org/post/20190405.6406761
E. coli EHEC - USA (02): O103, multistate spread http://promedmail.org/post/20190404.6404859
E. coli EHEC - USA: (KY) O103 http://promedmail.org/post/20190329.6393053

2018
---
E. coli EHEC - USA, Canada: O157, romaine lettuce http://promedmail.org/post/20181122.6159743
E. coli EHEC - USA (28): O157, romaine lettuce http://promedmail.org/post/20181120.6156581
E. coli EHEC - USA (27): (UT) http://promedmail.org/post/20181028.6113669
E. coli EHEC - USA (26): O26, ground beef, alert, recall http://promedmail.org/post/20180920.6041171
E. coli EHEC - USA (25): (WA) raw milk http://promedmail.org/post/20180909.6016693
E. coli EHEC - USA (24): (FL) O26, grocery chain ground beef, alert, recall http://promedmail.org/post/20180831.5998786
E. coli EHEC - USA (23): (OK) possible recreational water exposure http://promedmail.org/post/20180801.5941698
E. coli EHEC - USA (22): (WA) restaurants http://promedmail.org/post/20180708.5893948
E. coli EHEC - USA (21): (TN) O157, 2 clusters, 2 sources http://promedmail.org/post/20180706.5891482
E. coli EHEC - USA (20): O157, romaine lettuce, water source http://promedmail.org/post/20180702.5882323
E. coli EHEC - USA (19): (UT, AZ) O157, 2017 http://promedmail.org/post/20180616.5858104
E. coli EHEC - USA (18): (TN) raw milk, more cases http://promedmail.org/post/20180614.5856110
E. coli EHEC - USA (17): (OR) O111, daycare center http://promedmail.org/post/20180613.5854733
E. coli EHEC - USA (16): (TN) raw milk http://promedmail.org/post/20180607.5844304
E. coli EHEC - USA (15): O157, romaine lettuce, more cases, fatal http://promedmail.org/post/20180604.5837662
E. coli EHEC - USA (14): (WA) sandwich shops http://promedmail.org/post/20180527.5820803
E. coli EHEC - USA (13): O157, romaine lettuce, increasing cases, fatality http://promedmail.org/post/20180517.5799620
E. coli EHEC - USA (12): O157, romaine lettuce, increasing cases, fatality http://promedmail.org/post/20180510.5791677
E. coli EHEC - USA (11): (OK) day care center http://promedmail.org/post/20180502.5780250
E. coli EHEC - USA (10): O157, romaine lettuce, fatality http://promedmail.org/post/20180502.5780249
E. coli EHEC - USA (09): O157, romaine lettuce http://promedmail.org/post/20180427.5771229
E. coli EHEC - USA (08): (CA) military outbreak, undercooked beef, 2017 http://promedmail.org/post/20180425.5769489
E. coli EHEC - USA (07): O157, romaine lettuce http://promedmail.org/post/20180425.5769488
E. coli EHEC - USA (06): O157, romaine lettuce http://promedmail.org/post/20180421.5761217
E. coli EHEC - USA (05): O157, romaine lettuce http://promedmail.org/post/20180418.5756056
E. coli EHEC - USA (04): O157, romaine lettuce http://promedmail.org/post/20180413.5745944
E. coli EHEC - USA (03): O157, expansion of NJ outbreak http://promedmail.org/post/20180411.5738813
E. coli EHEC - USA (02): (NJ) poss. restaurant chain link, RFI http://promedmail.org/post/20180405.5728398
E. coli EHEC - USA: O157, leafy greens http://promedmail.org/post/20180110.5550773

Published 01-10-2017 in Focus on , last update 29-08-2019

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