Bacteria-laced lettuce made several sick

The state Department of Health has issued advisories to Kaua‘i farmers to use more care in growing crops after seven visitors and a Kaua‘i resident became sick eating bacteria-tainted lettuce at a Kaua‘i restaurant in March.

The DOH made the announcement yesterday following an extensive five-month investigation.

The visitors had eaten salads with the Escherichia coli bacteria, and at least four visitors were hospitalized when they returned to the Mainland, DOH spokeswoman Janice Okubo said yesterday. But all of the individuals have fully recovered by now, she said.

The E. coli bacteria lives in the lower intestines of mammals, such as cattle. The bacteria can cause intestinal and extra-intestinal infections such as urinary tract infections, meningitis, peritonitis, mastitis, septicemia and Gram-negative pneumonia.

Investigators said the produce contamination was likely the result of a combination of circumstances.

One scenario was that the lettuce was grown at a farm located near a ranch with cattle, which carries the bacteria, investigators said.

They suspected the bacteria made its way from cattle fecal material to the farm during rain-produced flooding in February and March.

“We believe there was cattle nearby and that some of the heavy rain made its way to the farm area,” Okubo said.

The investigation included a nationwide posting, a statewide physician alert, a review of hospital records and extensive interviews with the affected individuals, Okubo said.

The state epidemiologist, Dr. Paul Effler, said in a statement: “Fortunately, this cluster of cases was limited to eight individuals and we were able to track down the probable cause. Not all investigations end this successfully, but our disease investigation team was persistent and diligent in putting together the pieces of this puzzle.”

He said the findings will help the agency to work with the farming and cattle industry to prevent future occurrences.

Okubo said testing of cattle stool identified the same E. coli strain that was connected with the sickness experienced by the visitors and the resident.

Following a study of restaurant records, investigators determined all the affected individuals had eaten a locally produced lettuce served at at least one island restaurant, which was not named.

The DOH has met with the state Department of Agriculture to look at ways to prevent similar occurrences, Okubo said.

The farmers connected with the matter have been informed of the test results and have been given recommendations by DOH to safeguard their crops, Okubo said.

DOH has not received any reports of illnesses related to the investigation, she said.

Some 19 cases involving E. coli bacterial infection were reported to the DOH in 2006, she said. Kaua‘i County reported two cases between 2004 and 2006.


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