Reports of a potentially dangerous E: coli infection among children in a Bronx day
care center, coupled with two Yankees players benched by parasitic infestations, seems to have turned the summer into an unplanned Food Borne Illness Awareness Month.
According to estimates by the federal Centers for Disease Control and Prevention
76 million Americans get sick each year from food--borne illnesses, more
than 300,000 are hospitalized, and 5,000 die.
The city's Department of Health and Mental Hygiene announced in the beginning of July that it is investigating a recent outbreak of E. coli 0157:H7
infection in children who attended the "For Kids Only" day care center
in the Bronx. After three children who spent time in the same first-floor
room of the center came down with confirmed cases of E. coli 0157:H7, health
inspectors visited the site. They are also investigating suspected cases
among 18 other children who attended "For Kids Only."
The day care center voluntarily closed during the investigation and has
cooperated with the health department. An article in
the New York Post reported that For Kids Only passed annual health
inspections in March 2004 and April 2003, and quoted parents who praised the
center for cleanliness and health consciousness. Toddlers in day care
centers, however, are particularly vulnerable to outbreaks of E. coli
0157:H7 and other foodborne pathogens, because they eat the same meals,
crowd together, often fail to wash hands after use of the toilet, and
frequently wear diapers, which can lead to spread of the bacteria if
caretakers fail even occasionally to handle them using precise sanitary
The health department is also investigating one confirmed case of E. coli 0157:H7 in a local
child who does not attend the day care center. All children associated with
the outbreak live in the Bronx and range in age from seven months to just
over three years.
According to city Health Commissioner Thomas Frieden, all of the affected
children "are doing well at this point." As E. coli 0157:H7 outbreaks go,
then, this one was relatively benign. The pathogen can cause much more
serious health consequences, especially among young children and the
elderly. According to the CDC, in three to five percent of cases, a complication
called hemolytic uremic syndrome (HUS) can occur several weeks after the
initial symptoms (which are themselves debilitating -- severe, bloody
diarrhea and painful stomach cramps.) HUS is the most common cause of acute kidney failure in children.
In 1999, there were 18 cases of E. coli 0157:H7 reported among New York City
residents. In 2002, only 2 cases -- both in a private home -- were reported,
the CDC, which collects statistics on foodborne disease outbreaks from
state, local and territorial health departments each year.
Some types of E. coli bacteria are normally found in the intestines of
humans and coexist harmlessly with their hosts, even performing useful
functions. E. coli 0157:H7 is not such a one. Normally found in cattle
and similar animals, it typically spreads to humans when they consume food
or water contaminated with microscopic amounts of cow feces. Hamburgers have
often been implicated in the spread of E. coli 0157:H7 outbreaks, since
ground flesh from literally hundreds of different cows may be mixed together
in a single hamburger. To paraphrase an old saying, scraps from one sick cow
can spoil the whole barrel.
Thorough cooking of meat and pasteurization of beverages like milk will
generally kill the bacteria, but are not always performed. In the notorious
1993 E. coli 0157:H7 outbreaks traced to Jack in the Box restaurants in
Washington State, the fast-food outlets failed to cook hamburgers infected
with the bacteria well enough to kill the pathogen before serving them.
About 700 customers fell sick and four died.
Once humans are infected, they can spread the infection to each other
through poor sanitary practices, such as inadequate hand-washing after use
of the bathroom and/or the handling of diapers.
The health department is asking parents of any children who attend the For Kids Only center
to be on the lookout for symptoms of E. coli 0157:H7 infection -- abdominal
pain, watery diarrhea that becomes bloody, irritability, and sometimes
fever. The department urges parents of children who develop symptoms to
immediately contact a physician. It advises parents to consult their own
physicians, but they can also call 311 or the New York City Poison Control
Center at (212) 764-7667 if they need more information or help finding
alternative day care arrangements.
The health department also asks that parents who have children with diarrhea
not take their children to daycare. And it has issued an alert to medical
care providers requesting that all suspected cases of E. coli 0157:H7
infection be immediately reported to the Department's Bureau of Communicable
Diseases by calling the Provider Hotline at 1-866-NYC-DOH1. (E. coli 0157:H7
is one of the so-called "reportable diseases" that the health department
tracks in order to identify outbreaks and register them with the national
epidemiological surveillance system.
To prevent infection with the bacteria, the city health department makes the
- Do not eat undercooked hamburger or other ground
beef products. Cook all ground beef and hamburger thoroughly. Make sure the cooked meat is brown throughout (not pink), and the juices run clear.
only pasteurized milk and milk products.
- Avoid unpasteurized apple cider.
- Make sure infected people, especially children, wash their hands carefully
with soap after using the toilet to reduce the risk of spreading the
According to the CDC, each year E. coli disease strikes 73,000 people in the
United States and kills around 60, mostly children. The elderly and the
immune-compromised are also more vulnerable to bad outcomes. Most victims,
however, recover without treatment in five to 10 days.
Meanwhile, pitcher Kevin Brown became the second New York
Yankee in short succession to be diagnosed with an intestinal parasite. He
has the dubious honor of joining teammate Jason Giambi, who was diagnosed
with a parasite a few days earlier, after being sidelined the day before for
lackluster performance. Brown had complained of fatigue and the
unintentional loss of 15 pounds since the start of the season, while Giambi
has suffered from fatigue, vomiting, and flu-like symptoms that have
significantly impaired his playing.
Intestinal parasites are contracted from contaminated food or water, and
Brown and Giambi are still trying to puzzle out where they might have picked
up the bugs. Their teammates were spooked by the second diagnosis of
parasites in their midst, but none of the other Yankees are showing
symptoms, according to a New York Times report. Parasites can be treated
with medication, which typically takes 7 to 10 days, but until the
intestinal freeloaders are banished and the players' strength has returned,
Brown and Giambi will continue to ride the bench, probably in considerable
There were 14 cases of parasitic foodborne illness reported among New York
City residents in 2002, the last year for which the CDC has published data.
All of those were caused by Cyclospora, a one-celled, microscopic parasite
that until the mid-1990s was thought to exist only in developing countries,
particularly in tropical climates. In 1996, however, cyclosporiasis broke
out in the U.S. and Canada and was eventually traced to contaminated
raspberries grown in Guatemala -- underscoring some of the hazards
associated with the post-NAFTA mass importation of produce from developing
countries, particularly Central America, where parasitic infections are
endemic. Anything eaten raw, such as fresh fruits, vegetables, and
oysters, can be particularly dodgy unless scrubbed with extreme
The range of foodborne pathogens is dizzying, and more are being identified
all the time, from bacteria to parasites to fungus. Some of the most common
bacterial sources of foodborne illness include Salmonella, which now infests
chicken eggs, is rapidly developing antibiotic-resistant strains, strikes
1,400,000 Americans annually, and kills 580; the rare but deadly Listeria
monocytogenes, which lurks in undercooked meat and sickens only 2,500
Americans per year but kills 500 of them, or 20 percent of its victims; and
Campylobacter, which lives on most raw poultry meat and infects 2,500,000
Americans annually, killing 124. Among parasitic organisms, Toxoplasma
gondii or toxoplasmosis, which most people associate with cat feces but
which can also be contracted by eating raw or undercooked meat, infects
225,000 and kills 750, and is particularly dangerous to the unborn children
of pregnant women who become infected. Among the viruses, Norwalk-like
viruses (of cruise ship fame) reign as the U.S.'s Deans of Diarrhea,
sickening 23,000,000 per year and killing 310. (A case-fatality rate of only
6.7 percent, however, means that Norwalk-like viral infections, while
extremely common, are not particularly dangerous to most people.)
The CDC's web page on foodborne illnesses lists a number of simple ways
consumers can help protect themselves from these and other pathogens that
can turn what should be gustatory pleasures into gastrointestinal
Sue Wilson is a journalist who writes frequently on health and science topics for such outlets as the New York Times, WNET, and UNICEF
The comments section is provided as a free service to our readers. Gotham Gazette's editors reserve the right to delete any comments. Some reasons why comments might get deleted: inappropriate or offensive content, off-topic remarks or spam.