December 7, 2021

E. coli O111: Harmful Bug in Spotlight at Minnesota Applebees

The Applebees E. coli outbreak in Minnesota has prompted a lawsuit and put a well-known but less prevalent type of pathogenic E. coli in the public spotlight this summer. E. coli O111 can be just as virulent as its better-known cousin, E. coli O157:H7, but it makes fewer appearances in outbreaks that are confirmed by public health officials. In fact, the pathogen doesn’t show up in any multi-state E. coli outbreaks tracked by the Centers for Disease Control and Prevention over the past decade, according to CDC data reviewed by Food Poisoning Bulletin.

GavelsU.S. health records show the last time that E. coli O111 made a major splash in this country was August 2008 when one person was killed and another 340 people  were sickened in a foodborne outbreak linked to Country Cottage restaurant in Locust Grove, Oklahoma. “According to the CDC, only 10 outbreaks involving E. coli 0111 had been reported nationally prior to Oklahoma’s outbreak,” the Oklahoma State Department of Health said in its final E. coli 0111 outbreak report. In the Country Cottage outbreak, 70 people were hospitalized.

So far in Minnesota, state health officials have confirmed 15 case patients, 12 of whom reported eating at Applebees restaurants in the Twin Cities metropolitan area and other regions of the state between June 23 and June 29. In addition, the CDC has stated that two more cases in two other states may also be a part of this outbreak depending on the outcome of tests that are pending. Applebees removed Oriental Chicken Salad from its menus in the state, along with certain ingredients in the salad, and has changed suppliers. The cause hasn’t been pinpointed, but epidemiologists studying the outbreak have focused on raw produce items such as cabbage, carrots and greens.

“E. coli O 111 is every bit as dangerous as E. coli O157:H7 and more states should be equipped to detect it,” said E. coli lawyer Fred Pritzker, whose Minneapolis-based law firm is spearheading the litigation against Applebees as the representative of several victims. The firm is continuing to accept additional clients from the outbreak.

Pritzker, who also was called upon as a plaintiffs’ lawyer in the Oklahoma Country Cottage outbreak, said that one of the reasons E. coli 0111 isn’t detected as often as E. coli O157:H7 is that not enough laboratories are equipped to test for it.  Compared with O157 infections, identification of O111 infections is more complex. “From a public health standpoint, the Applebees E. coli outbreak in Minnesota should amplify the need for improved diagnostic procedures for the detection of E. coli O111,” Pritzker said.

Most of what we know about toxic E. coli in food comes from outbreak investigations and studies of E. coli O157, which was first identified as a pathogen in 1982. Led by O157, there is a family of E. coli organisms including O111, 026, O145 and others that produce Shiga toxins that attack a person’s red blood cells and can lead to kidney failure, stroke, severe anemia, neurological damage, heart damage or death. Those risks are embodied in the E. coli disease known Hemolytic Uremic Syndrome, or HUS, which strikes from 5 to 15 percent of people infected by Shiga-toxin E. coli (STEC).

People of any age can become infected. Very young children and the elderly are more likely to develop HUS, but even healthy older children and young adults can become seriously ill.

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