Fast Food Nation - Eric Schlosser [112]
Children under the age of five, the elderly, and people with impaired immune systems are the most likely to suffer from illnesses caused by E. coli 0157:H7. The pathogen is now the leading cause of kidney failure among children in the United States. Nancy Donley, the president of Safe Tables Our Priority (STOP), an organization devoted to food safety, says it is hard to convey the suffering that E. coli 0157:H7 causes children. Her six-year-old son, Alex, was infected with the bug in July of 1993 after eating a tainted hamburger. His illness began with abdominal cramps that seemed as severe as labor pains. It progressed to diarrhea that filled a hospital toilet with blood. Doctors frantically tried to save Alex’s life, drilling holes in his skull to relieve pressure, inserting tubes in his chest to keep him breathing, as the Shiga toxins destroyed internal organs. “I would have done anything to save my son’s life,” Donley says. “I would have run in front of a bus to save Alex.” Instead, she stood and watched helplessly as he called out for her, terrified and in pain. He became ill on a Tuesday night, the night after his mother’s birthday, and was dead by Sunday afternoon. Toward the end, Alex suffered hallucinations and dementia, no longer recognizing his mother or father. Portions of his brain had been liquefied. “The sheer brutality of his death was horrifying,” Donley says.
As Lee Harding learned, adults in perfect health can be stricken by the pathogen, too. Six months after seemingly recovering from his bout of E. coli 0157:H7 food poisoning, Harding began to urinate blood. He was diagnosed as having a kidney infection, one that he believes was facilitated by residual tissue damage from the Shiga toxins. Although the infection soon passed, Harding still experiences occasional pain three years after eating a Hudson Beef hamburger. Nevertheless, he considers himself lucky.
Antibiotics have proven ineffective in treating illnesses caused by E. coli 0157:H7. Indeed the use of antibiotics may make such illnesses worse by killing off the pathogen and prompting a sudden release of its Shiga toxins. At the moment, little can be done for people with life-threatening E. coli 0157:H7 infections, aside from giving them fluids, blood transfusions, and dialysis.
Efforts to eradicate E. coli 0157:H7 have been complicated by the fact that it is an extraordinarily hearty microbe that is easy to transmit. E. coli 0157:H7 is resistant to acid, salt, and chlorine. It can live in fresh water or seawater. It can live on kitchen countertops for days and in moist environments for weeks. It can withstand freezing. It can survive heat up to 160 degrees Fahrenheit. To be infected by most food-borne pathogens, such as Salmonella, you have to consume a fairly large dose — at least a million organisms. An infection with E. coli 0157:H7 can be caused by as few as five organisms. A tiny uncooked particle of hamburger meat can contain enough of the pathogen to kill you.
The heartiness and minute infectious dose of E. coli 0157:H7 allow the pathogen to be spread in many ways. People have been infected by drinking contaminated water, by swimming in a contaminated lake, by playing at a contaminated water park, by crawling on a contaminated carpet. The most common cause of foodborne outbreaks has been the consumption of undercooked ground beef. But E. coli 0157:H7 outbreaks have also been caused by contaminated bean sprouts, salad greens, cantaloupe, salami, raw milk, and unpasteurized apple cider. All of those foods most likely had come in contact with cattle manure, though the pathogen may also be spread by the feces of deer, dogs, horses, and flies.
Person-to-person transmission has been responsible for a significant proportion of E. coli 0157:H7 illnesses. Roughly 10 percent of the people sickened during the Jack in the Box outbreak did not eat a contaminated burger, but were infected by someone who did. E. coli 0157:H7 is shed in the stool, and people infected with the bug, even those showing no outward sign