Missouri Department of Health & Senior Services
Contact: MARGARET T. DONNELLY
DIRECTOR
April 13, 2012
On April 5, 2012, the Missouri Department of Health and Senior Services (DHSS) issued a Health Advisory entitled “Shiga Toxin-Producing Escherichia coli (STEC) Cases in Central Missouri". This Health Update provides additional information on the situation.
DHSS is continuing to investigate an increase in cases of Shiga toxin-producing Escherichia coli (STEC) in Central Missouri during late March and early April, 2012. Thirteen cases of E. coli O157:H7 have been identified with onset of illness during this time period. Seven of the thirteen cases have matching pulsed-field gel electrophoresis (PFGE) patterns; three cases have pending PFGE results, which are expected next week. Of the seven cases with matching PFGE patterns, five have reported consumption of raw dairy products from the same farm. In addition, one of the cases for whom PFGE results are pending also reported raw dairy consumption from the same farm. One of the cases a two-year old child reportedly developed hemolytic uremic syndrome (HUS), a severe, life-threatening condition that may result in permanent kidney damage in some of those who survive. It was previously reported that a seventeen month-old child also had HUS, but this case has been found to have a different PFGE pattern.
There are three additional symptomatic cases under investigation for whom laboratory results are pending, or not available.
The investigation is ongoing and the source of infection has not been confirmed. All potential sources of exposure are being considered, but, as stated above, it is known that six cases have consumed unpasteurized milk and/or raw milk products from the same farm before onset of their illness. Missouri law specifically allows a farmer to sell raw milk or cream in Missouri, either at the farm where it originated, or after being delivered to the customer for that individual’s own use.
DHSS recommends that any person who has signs or symptoms of STEC infection should seek medical care. Health care providers should determine if testing for STEC infection is warranted.