Health Law

E. coli O145 and HUS illness: did the romain lettuce cause it?

By Drew Falkenstein

At least 29 confirmed and probable E. coli O145 illnesses have been linked to romaine lettuce manufactured and delivered by Freshway Foods.  Freshway has recalled romaine lettuce due to the outbreak in 23 states and the District of Columbia.  The outbreak has also caused at least 3 hemolytic uremic syndrome (HUS) illnesses, and likely more. 

The fact that this outbreak was caused by E. coli O145 instead of E. coli O157 makes knowing the true scope of the outbreak nearly impossible.  The reason is that E. coli O145 is not as common as E. coli O157, and it is not regularly tested for by doctors and medical laboratories. As a result, outbreaks associated with E. coli O145 are more difficult to detect, and individual illnesses are often not confirmed as being due to infection by E. coli O145.  

Far and away the most common cause of hemolytic uremic syndrome in children is E. coli O157:H7.  Thus, proof of a claim that an HUS illness occurred as part of the current E. coli O145 outbreak is hindered, to some extent, because of the argument that the illness more likely occurred as a result of infection by the far more common E. coli O157. 

This is not an insurmountable obstacle, however.  In such a situation, the claim would likely be proved by demonstrating a recent exposure to the implicated product, or by a test intended to detect the presence of antibodies that have formed in response to the E. coli O145 bacteria.  Had the individual been infected by E. coli O157, the correct antibodies would not have formed and would thus not be present. 

Full post as published by Food Poison Blog on May 10, 2010 (boomark / email).