A five-year-old child and a Pig make their first Connection
[photo by Susanna Thorp of New Agriculturalist]
Case Reports: E. coli 0157 INFECTION SYMPTOMS & SPREAD
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Zoonoses: Infectious Diseases Common to People & Animals
List of Zoonotic Diseases that Humans can Catch from Animals - Prevention, Symptoms, Spread, Control
Bacteria - Fungi - Chlamydia - Viruses - Parasites
3 volume set of manuals: Contents & Review
Pet Farm Animals - Human Risk of Infection - E.coli O157 risks: Overview Literature
Proposals to ban children from farms
In Sweden the Board of Agriculture and the Farmers' union have decided on a recommendation that children under the age of 5 should not visit livestock farms unless necessary, and that no-one, regardless of age, should be served unpasteurised milk.
In Britain, Professor Hugh Pennington has proposed on BBC television that children under five years old be prevented from visiting farms. Hard times in British agriculture have led to many farmers diversifying into "open" farms for educational, leisure or holiday purposes. Increased hygienic precautions have been introduced for children visiting farms since the well-publicised death two years ago of a child who contracted E. coli 0157 during a farm visit. The family sued for negligence and were awarded a large sum in damages.
Human infections acquired on Farms
According to Prof. Hugh Pennington: E. coli infections kill 1,000 people per year and in 1999 24 deaths were attributed to infection acquired on farms in the United Kingdom (UK). It was Prof. Pennington (bacteriologist at Aberdeen University) who investigated the notorious E. coli 0157 outbreak in Scotland in 1996, which led to the deaths of 21 people. In the USA, the Centers for Disease Control estimates that 73,000 cases of infection and 61 deaths in the United States can be attributed to E. coli O157:H7 annually. Most infections have been from consumption of contaminated juice, meat and other foods.
Concerns for Children under Five
Prof. Penington is most concerned about the heightened risk of toxigenic brain and kidney damage to children in the under-five age group and has recommended that they are not taken on farm visits. Speaking on BBC television recently, he said that children of this age are more difficult to manage during visits, do not understand hygiene, suck their fingers and are also more likely to get complicated infections.
Farmers & Parents Reply
The Farmers Guardian newspaper has interviewed a number of managers of "open farms" to get their point of view. They point out that the number of children living on farms and people visiting farms is huge and infections are very rare. For example "Dairyland" in Cornwall has had two million visitors over the past 25 years to its herd of Holstein cattle.
Farmers point out that nothing in this life is completely safe - cars and other children are far more lethal to children that farm animals. They say that it is all a matter of carefully supervising children during their contact with animals. It would be a great shame to deprive millions of kids of the enormous interest, fun and education that they derive from visiting farms.
Dr. Klaas Frankena of Wageningen University in the Netherlands points out that "Risks are never zero and it is certainly much more dangerous to let your child walk home from school unattended (traffic accidents, kidnapping, sexual abuse etc). Being aware that many events in our lives have risks that are not zero (any animal, including dogs and cats!, may kick or bite or be dirty), one should teach children (and grown ups as well) how to handle such events - it is called (continuous) education)."
Do Children gain Beneficial Bacteria from Farm Animals?
Mike McDowall from Edinburgh comments:
"What about the research (BBC news recently) showing evidence that children exposed to muck and glaur are more resistant to infection and less prone to allergy problems ?
Are these not more common than E Coli 0157?
Perhaps we should be taking our under 5s onto farms and encouraging them to suck their fingers. Coprophagy (eating faeces) is commonly an essential mechanism amongst animals for acquiring beneficial gut microflora.
"On a personal note, I was the 'clean' one in our family. My brother was fed with milk from the house cow. My mother commented that there were a lot of 'bits' in it one morning. 'Oh aye, wee Tom paddles in the milk bucket in his wellies every morning. You don't give it to the bairn do you?'
Actually he seems to be the one resistant to everything!
"My sister had a reputation for putting anything into her mouth: dirt, stones, bits of wood, dog and cat feces, cattle dung, broken glass - you just couldn't stop her. She too seems resistant to everything!
"We were raised on un-pasteurised milk. Come BCG inoculation time at school (test for tuberculosis), the test showed I had antibodies to tuberculosis (TB). I was X-rayed, and clean, but already had resistance. This might be of interest in these days of multiple resistance (to antibiotics) TB."
E. coli 0157 infections in the Netherlands
J.Marije Schouten (MSc, PhD student) of the Department of Animal Sciences, Quantitative Veterinary Epidemiology Group, Wageningen University & National Institute of Public Health and the Environment (RIVM) Bilthoven writes:
In the Netherlands O157 VTEC infections caused by direct contact with farm animals was not reported until the beginning of 1998. In April that year, an outbreak occurred in a farmer's family in the middle of the country. One parent and four children developed clinical signs (diarrhoea). Three of the children suffered from Haemorrhagic colitis and one of them (four years old) even developed HUS.
Research indicated that indeed those five (of eight) family members were infected with E. coli O157. The family appeared not to have consumed risk products as raw meat or milk. Noteworthy is the fact that family members did not develop signs of infection all at the same time. This could indicate human to human transmission of the causative agent. There was a strong genotypic resemblance between the human isolates. 30% of the veal calves on the farm appeared to be positive for O157 VTEC.
There is a great probability that the described O157 VTEC explosion was not the result of consumption of contaminated food, but primarily as a result of transmission of the agent from animal to human, followed by human to human transmission.
However, after subtyping all isolates, several subtypes (phage types) that have been found in the calves seem to differ from the types found in the patients (despite a genotypic resemblance that appeared to be there initially). This fact could counter the hypotheses of direct animal to human transmission.
Question is whether the calves, that are proved to be secreting different types of E. coli O157, could also have been secreting the type that infected the patients. Maybe this occurred in such a degree, that diagnostic methods did not detect those types in the faeces of the calves (for example as a result of being overgrown in the lab by other types).
More recently, at the end of 1999, two children have become ill after visiting their grandparents' farm and playing in cattle barns. Clinical signs en serological tests indicate E. coli O157 infection. On-farm research showed that cows secreted E. coli O157. Subtyping of the isolates has not been carried out yet, so no final conclusions are drawn. These cases might be a result of direct transmission from cattle to humans, though.
E. coli 0157 infections in Sweden
Ivar Vågsholm of the Swedish Zoonosis Center writes:
There have been around 100 cases of E coli O157 per year since 1995, with a decrease during 1998 and 1999 partly due to recommendations that children less than 5 years should not visit farms during the summer season.
The route of tranmsision is usually unclear. Sometimes unpasteurised milk has been implicated. In a few cases, infection could be connected to children visiting farms. Bacteriology and genotyping has confirmed that the same bacteria was found in children as in faecal samples from the farm animals.
Effect of Diet on E. coli 0157:H7 in Cattle: review
E. coli 0157 & other verocytotoxigenic (VTEC) infections in pigs (swine)
Many 0157 outbreaks have been traced to eating contaminated beef or milk products. However evidence is appearing now that pigs might occasionally also be a source of infection. A survey of a thousand pigs at a British abattoir revealed that four were infected. In Japan an on-farm survey of pigs has recently shown that more than one per cent were infected - an infection rate only slightly lower than in cattle. E. coli 0157 has also been found in pigs in Germany and is likely to be present occasionally elsewhere also.
J. Marije Schouten of the Quantitative Veterinary Epidemiology Group, Wageningen University writes:
In a Dutch surveillance program that is being carried out, data are collected about the occurrence of E. coli O157 within farm animals. The results in swine show that from October 1998 till December 1999, only 1 of 230 pig farms investigated was positive for E. coli O157. So in the Netherlands we rarely find E. coli O157 infected pig farms, but apparently they do occur every now and then. In this surveillance program, pigs on the investigated farms are not sampled individually, but random (pool)sampling of faeces on the floor is applied. In case there are only a few shedders on a farm, these could easily be missed. Therefore, some underestimation of the number of farms housing pigs that are E. coli O157 infected could arise.
Interesting is that in a pilot of this surveillance program in 1996, seven pig farms were sampled, no E. coli O157 was found, but in five (!) of seven farms verocytotoxin producing E. coli was found.
Ivar Vågsholm of the Swedish Zoonosis Center reports:
VTEC O157 has been detected in 2 out 2500 porcine samples in Sweden. The positive findings of VTEC O157 in pigs could be associated with free-ranging pigs and putative exposure to ruminants. Other VTEC serotypes (O138 and O141) are commonly associated with edema disease and diarrhoea in Swine.
Escherichia coli O157 in Farm Animals
Editors: C S Stewart and H J Flint
Rowett Research Institute, Aberdeen, Scotland
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- Genetics and Molecular Ecology of Escherichia coli O157 J. R. Saunders, M. J. Sergeant, A.J. McCarthy, K. J. Mobbs, C. A. Hart, T. S. Marks and R. J. Sharp
- Acid Tolerance of Escherichia coli the sting in the tail? I. R. Booth, F. Thompson-Carter, S. Jordan, S. Park, L. Malcolm and J. Glover
- Escherichia coli O157:H7 and the Rumen Environment M.A . Ramussen, T. L. Wickman, W. C. Cray, Jr and T. A. Casey
- Bovine Infection with Escherichia coli O157:H7 E. A. Dean-Nystrom, B. T. Bosworth, A. D. O’Brien and H. W. Moon
- Faecal Shedding and Rumen Proliferation of Escherichia coli O157:H7 in Calves: an Experimental Model B. G. Harmon, M. P. Doyle, C. A. Brown, T. Zhao, S. Tkalcic, E. Mueller, A. H. Parks and K. Jacobsen
- Commensal–Pathogen Interactions Involving Escherichia coli O157 and the Prospects for Control S. H. Duncan, K. P. Scott, H. J. Flint and C. S. Stewart
- Animal Studies in Scotland B. A. Synge
- Escherichia coli O157: Fourteen Years' Experience in Sheffield, UK P. A. Chapman
- Escherichia coli O157 and Other Types of Verocytotoxigenic E.coli (VTEC) Isolated from Humans, Animals & Food in Germany L. Beutin
- Human Infection with Verocytotoxigenic Escherichia coli Associated with Exposure to Farms and Rural Environments R .P. Johnson, J. B. Wilson, P. Michel, K. Rahn, S. A. Renwick, C. L. Gyles and J. S. Spika
- Control of Escherichia coli O157:H7 at Slaughter V. P. J. Gannon
- The Ecological Cycle of Escherichia coli O157:H7 J. S. Walloce
- Future Directions, or Where Do We Go From Here?
Prof. T. H. Pennington
Review of the Book
Veterinary scientists, microbiologists, public health researchers, students, teachers & research workers in animal science & veterinary medicine
This book identifies research priorities and possible changes in farming practice to reduce the incidence of transmission of the potentially lethal bacterium E. coli O157 to the food chain and humans.
Topics include the factors affecting the influence and survival in farm animals, especially cattle; the epidemiology of spread from animals to humans; and the immediate spread from animals to meat, milk and the environment. Supplementary information on the association of human disease with the farm environment has been added.
The book results from a meeting on E. coliin farm animals held at the Rowett Research Institute in 1998.
Cases of food poisoning caused by E coli 0157 have been increasing in recent years. This book contains articles from papers presented at an international workshop at the Rowett Research Institute, Aberdeen, in 1998, to identify research priorities and possible changes in farming practice to reduce the incidence of transmission of E coli 0157 to the food chain and humans. The topics addressed include: factors affecting the influence and survival in farm animals, especially cattle; the epidemiology of spread from animals to humans; and the immediate spread from animals to meat, milk and the environment. Further chapters discuss the association of the human disease with farm practice, and controlling infection in the slaughterhouse.
A comprehensive, authoritative and up-to-date review of all aspects of 0157 and related strains of E.coli in livestock on farms. Recorded incidences in healthy and clinically diseased calves, cattle, goats, sheep & pigs (hogs, piglets, swine) are catalogued. Factors affecting faecal (fecal) shedding are given special attention. Particular attention is given to the notorious enterohaemorrhagic E.coli (EHEC) subgroup of verotoxigenic E.coli (VTEC). Verotoxin (VT) converting phages are believed to account for the recent emergence of 0157:H7 as a new pathogen. The book is not easily readable because of the technical complexity and detail it embraces, but it is a priceless guide to the very latest research on this group of foodborne and animal contact zoonotic disease agents.
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