September 23, 2014

Outbreak of HUS E. Coli Linked to Spartanburg, South Carolina Mexican Restaurant

The South Carolina Department of Health and Environmental Control (DHEC) has issued a health advisory alerting doctors and other health care providers about an outbreak of shiga toxin-producing E. coli (STEC) cases linked to a Spartanburg-area Mexican restaurant.

During the last week of April, 2012, eleven people became ill with E. coli 0157:H7 infections. The restaurant has not yet been named and, according to Adam R. Myrick, Public Information Officer of the South Carolina Department of Health and Environmental Control, the agency “doesn’t plan to name the restaurant at this point.” The DHEC is working to determine if specific food items might be involved. 

The department has interviewed three patients so far. Of those three people, two have developed hemolytic uremic syndrome (HUS), a serious illness that can lead to kidney failure and death.

This bacteria, E. coli 0157:H7, produces toxins called “shiga toxins”. These compounds cause ulcers in the colon that produce the bloody diarrhea typically found with this infection. The toxin can then enter the bloodstream and travel to the kidneys, brain, and spinal cord, where it interferes with cell’s ability to produce proteins.

There are actually two types of HUS. One strikes children and is called hemolytic uremic syndrome. The other, often called “adult-HUS” because it affects adults, is thrombotic thrombocytopenic purpura (TTP), a condition where blood clots form in blood vessels in the central nervous system and kidneys. The patient’s platelet count becomes very low, he bleeds very easily, and bruises form on the skin. These conditions develop about a week after diarrhea begins.

Complications of HUS include abnormal kidney function, kidney failure, diabetes mellitus, central nervous system disturbances, stroke, seizures, heart disease, and death.

Complications of TTP include stroke, hemolytic anemia, heart failure, kidney failure, pancreatitis, perforated colon, enlarged liver, and even coma and death.

Symptoms of a STEC infection include gastroneteritis, diarrhea, often bloody, abdominal cramps, and fever. If anyone has eaten at a Mexican restaurant in Spartanburg county and develops these symptoms, see a doctor as soon as possible. Treatment for STEC infections includes supportive care. Antibiotics are usually not recommended, since studies have shown they can increase the chances of developing HUS.

The agency is currently interviewing eight other patients with symptoms consistent with this type of infection.

All illnesses that present with clinical symptoms consistent with a STEC infection must be reported to public health officials within 24 hours. Stool samples are collected and tested for the presence of the bacteria.

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