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E. COLI O157 - USA (08): CHEESE RECALL
**************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 12 Nov 2010
Source: CDC, _E. coli_ Outbreak Investigations [edited]
<http://www.cdc.gov/ecoli/2010/cheese0157/index.html>

CDC is collaborating with public health officials in Arizona,  
California, Colorado, New Mexico, Nevada, the Food and Drug  
Administration (FDA), and the Department of Agriculture's Food Safety  
and Inspection Service (FSIS) to investigate a multistate outbreak of  
human infections due to _E. coli_ O157:H7. This is a rare strain of  
_E. coli_ O157:H7 that has never been seen before in the PulseNet  
database. PulseNet is the national subtyping network made up of state  
and local public health laboratories and federal food regulatory  
laboratories that performs molecular surveillance of foodborne  
infections.

To date, 37 persons infected with the outbreak strain of _E. coli_  
O157:H7 have been reported from 5 states. The number of ill persons  
identified in each state with this strain is as follows: AZ (19), CA  
(3), CO (10), NM (3), and NV (2). Dates of illness onset range from 16  
Oct 2010 through 27 Oct 2010. Patients range in age from 1 to 85 years  
and the median age is 16 years. There have been 15 reported  
hospitalizations, 1 case of hemolytic uremic syndrome (HUS), and no  
deaths.

Laboratory testing conducted on 2 opened packages of Bravo Farms Dutch  
Style Gouda Cheese purchased at Costco from 2 different case patient's  
homes has identified _E. coli_ O157:H7 matching the outbreak strain.  
Preliminary laboratory testing conducted on an unopened (intact)  
package of Bravo Farms Dutch Style Gouda Cheese obtained from a Costco  
retail location has identified _E. coli_ O157:H7. Preliminary  
laboratory testing conducted on 21 additional opened packages of Bravo  
Farms Dutch Style Gouda Cheese purchased at Costco from 2 other case  
patient's homes has indicated the presence of _E. coli_ O157:H7.  
Additional laboratory testing is currently ongoing to confirm these  
results.

FDA is working with its state partners to investigate Bravo Farms and  
to identify potential sources of contamination. FDA has collected  
product samples for testing.

Additional investigative activities are ongoing and include:
- conducting surveillance for additional illnesses that could be  
related to the outbreak;
- gathering and testing food products that are suspected as possible  
sources of infection to see if they are contaminated with bacteria;
- following epidemiologic leads gathered from interviews with  
patients, food purchase information, or from patterns of processing,  
production, and/or distribution of suspected products;
- investigating where in the distribution chain the point of  
contamination could have occurred.
Costco is cooperating and assisting with this ongoing investigation.

On 5 Nov 2010, Bravo Farms voluntarily recalled all Dutch Style Gouda  
cheese because it may be contaminated with _E. coli_ 0157:H7. The  
product was distributed primarily through Costco in Southern  
California, Nevada, Arizona, Utah, Colorado, and New Mexico in 1.5 lb.  
pieces. It was also distributed through various retail stores within  
California in 8 oz. pieces.

An unopened (intact) package of Mauri Gorgonzola cheese tested as part  
of this ongoing investigation identified _E. coli_ O157:H7, which does  
not match the outbreak strain. This cheese was cut, packaged and  
distributed by DPI Specialty Foods. On 10 Nov 2010, DPI Specialty  
Foods voluntarily recalled and warned consumers not to eat Mauri  
Gorgonzola cheese with sell-by dates of 01/13/11 and 01/14/11. The  
strain of _E. coli_ O157:H7 identified in the gorgonzola cheese is  
rare with no human illnesses observed in the PulseNet database for the  
past several years.

Based on current information, there is a link with the consumption of  
one of several cheeses offered for sampling and sale at the "cheese  
road show" that was held at Costco Warehouses between 5 Oct and 1 Nov  
2010 in Arizona, California, Colorado, New Mexico, and Nevada. This  
cheese is Bravo Farms Dutch Style Gouda Cheese (Costco Item 40654),  
manufactured by Bravo Farms of Traver California.

Consumers who have any of this cheese should not eat it. Instead, they  
should return the cheese to the place of purchase or dispose of it in  
a closed plastic bag placed in a sealed trash can. This will prevent  
people or animals, including wild animals, from eating it.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Over a week, the number of linked cases has increased from 25 to 37  
located in the same states previously noted. - Mod.LL]

[To see the label, go to:
<http://www.aboutlawsuits.com/wp-content/uploads/bravocheese_220.jpg>
- Mod.JW]

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