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Hamburger Hazard
May 24, 2000
image: Dr. Howard Trachtman

Memorial Day weekend is the traditional start of the barbecue season. But coming on the heels of Canada’s worst outbreak of E. coli bacteria, the millions of Americans who are getting ready to fire up the grill should beware the danger that an undercooked burger can present.

This special report brings us one family’s nightmare, plus tips on how you can protect yourself, your family and friends from the devastating effects of E. coli infection and its complications.

Why does E. coli cause such misery?

Escherichia coli lives in the intestinal tract of humans and animals such as cattle. The presence of most E. coli strains in the intestine is beneficial, as the bacteria crowd out more undesirable bacterial species.

Diagram of man and his intestines
E. coli can damage the intestines, kidneys, heart, lungs and brain.
image: Dr. Howard Trachtman

But when certain strains of E. coli, such as O157:H7, infect a person, or when normal strains of the bacteria escape the intestinal tract, gastrointestinal distress can afflict the unlucky person. E. coli O157:H7, the bacteria that spread in tainted hamburger in the Northwest in 1993, works its malevolence because it produces a toxin known as shigatoxin. When this toxin enters the bloodstream, it damages blood vessels in the kidneys, brain, intestines, and other organs, and complications can result.

This week in Ontario, Canada, an infant and three elderly people died, 20 others were hospitalized, and 500 more may have been infected with dangerous E. coli. Authorities said the outbreak had reached "epidemic proportions.’’

One family’s E. coli scare

Little Kaitlyn Sluyk (pronounced "slyke") and her parents, Debra and James, know firsthand the perils of contaminated foods. Last month, four-year-old Kaitlyn woke up with severe stomach cramps and bloody diarrhea. Alarmed, the Sluyks, who live on Long Island in New York, called their physician, who directed the family to go immediately to the emergency room. James notes that he and Debra "were pretty nervous" about Kaitlyn’s illness, but believed that she would recover quickly with expert medical care.

Instead, the Sluyks faced every parent’s worst nightmare: a previously healthy child with a potentially fatal disease. Kaitlyn was diagnosed with hemolytic uremic syndrome (HUS), a complication of E. coli infection. The cause? An undercooked hamburger.

HUS, which occurs in 5 to 10 percent of all E. coli infections, currently has no treatment and no cure. It can cause kidney failure (40 percent of its victims need dialysis), seizures, inflammation of the pancreas, heart failure, and even death for one to three percent of sufferers. Its main victims are children aged two to five. Even more alarming, an upcoming article in the New England Journal of Medicine says that the use of antibiotics to treat E. coli infections may increase the risk of HUS occurrence.

Dr. Howard Trachtman, director of pediatric nephrology at Schneider Children’s Hospital (SCH), where Kaitlyn was taken, says that HUS is "one of the most terrifying diseases that we see. What’s frightening about this disease is that it occurs in children who, ostensibly, were perfectly healthy a week before. And it occurs with a rapidity and suddenness that’s really... awesome."

How to Protect Yourself and Your Family

•Wash your hands thoroughly with soap before you begin cooking.

•Cook ground beef until all the pink disappears, or better yet, use a meat thermometer and cook to at least 155°F. (Some experts believe that the color of the meat is not always an accurate indicator of doneness.)

•Don’t sample any raw ground beef.

•Don’t put cooked hamburgers on a plate that held the raw ground beef patties.

•Defrost meats in the refrigerator or the microwave. Don’t let meat sit on the counter to defrost.

•Keep raw meat and poultry separate from other foods. Use hot water and soap to wash cutting boards and dishes if raw meat and poultry have touched them. A solution of bleach and water can also be used to disinfect plastic cutting boards; remember to rinse the board!

•Don’t drink raw (unhomogenized) milk.

•Keep food refrigerated or frozen until ready to cook; refrigerate leftovers immediately or throw them away.

•Keep hot food hot and cold food cold.

•If you have a bout with diarrhea, wash your hands carefully and often with hot water and soap.

source: American Association of Family Physicians

An experimental drug may be the answer

Kaitlyn was fortunate to be admitted to SCH, as Trachtman happens to be coordinating a groundbreaking multi-hospital study of a new drug that may alleviate the catastrophic illness. "It’s a cleverly designed drug," says Trachtman. "What it is, is silicon dioxide particles -- particles of sand -- that are chemically linked to the molecule that binds the toxin from the bloodstream to the surface." The drug binds with the toxin and carries it safely away to be excreted.

The Sluyks, desperate for anything which could help their critically ill daughter, gave permission for Kaitlyn to receive the experimental treatment, although they knew she may have received a placebo rather than the drug. After six days in the hospital, Kaitlyn went home, "well on the way to recovery," Trachtman notes.

The study for the drug, called Synsorb PK, will continue through 2002, after which the data will be evaluated and analyzed.

Hamburger’s not the only food hazard

"Meat is not the only culprit," warns Trachtman. "There’s a whole wide range of foods that people should be alerted to," such as turkey, deer and other meats, plus vegetables that were exposed to water contaminated with E. coli.

However, with proper food handling techniques, you can still host those beloved backyard barbecues. "[People] should invite their friends over, they should do what they want," says Trachtman. "But they should try to implement [safe food handling]."

Elsewhere on the web:

E. coli Genome (STN2)

FDA’s "Bad Bug Book"

Lois Joy Galler Foundation for families touched by HUS

Ask the Doctor—Q and A about HUS

USDA Food Safety Information Sevice

Synsorb Corporation



by Debra Utacia Krol


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