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For Release:
December 04, 2006

Fred M. Jacobs, M.D., J.D.

For Further Information Contact:
Gretchen Michael
(609) 984-7160

DHSS Investigating E. coli Outbreak in Three Counties


The New Jersey Department of Health and Senior Services is investigating 25 confirmed cases of infection with E. coli 0157, and 12 probable cases of the disease in Middlesex, Somerset and Union counties, Commissioner Fred M. Jacobs, M.D., J.D., announced today.

Among the cases, there are also two confirmed cases of hemolytic uremic syndrome, which is one of the uncommon but serious complications of infection with E. coli 0157.

The source of the outbreak has not yet been identified.  Public health investigators obtained food histories from 22 of the cases, and found that 20 were associated with eating at a fast food franchise in three counties.

Taco Bell has announced that it voluntarily closed its South Plainfield restaurant where a number of the patients had eaten.  The closure was made at the request of the Middlesex County Health Department.  Taco Bell has also provided samples of its food for testing and food handling employees have submitted stool samples for testing.

“We are working closely with the Middlesex County health department, with neighboring states and with the federal Centers for Disease Control and Prevention (CDC) to identify all cases of infection and determine the source of this outbreak,” Commissioner Jacobs said.

Cases range in age from infant to age 51, and some patients have been hospitalized.  The infected people became ill between November 20 and November 29.  Yesterday, New York State officials notified the Department of a similar cluster there with similar onset dates.  No additional New Jersey cases with have been identified so far with an outset date later than Nov. 29.

Middlesex County health officials notified the state Department of Health and Senior Services of nine cases on November 29.  DHSS officials notified the federal CDC today.  Earlier today, Somerset and Union counties notified DHSS of other suspect cases with an onset of mid-November that are associated with a fast food franchise in Somerset and Union counties.

The 25 confirmed cases are pending further test results to determine if they were infected with the H7 strain, which is known to cause more serious illness.  The probable cases are based on the results of preliminary lab testing and clinical symptoms.

DHSS has asked regional epidemiologists to re-examine any E. coli cases dating back to November 1 to determine if they may be part of the outbreak.

The DHSS laboratory is testing more than a dozen samples, and results are not expected before Wednesday.  The laboratory will also perform molecular testing to determine if the strains of E.coli infecting the cases are related.

A conference call with county and local health officials from around the state was held today at 2 p.m. and there will be subsequent updates given during the outbreak.

Escherichia coli 0157:H7 are bacteria that normally live in the intestines of healthy people and animals, primarily cattle. Most strains of the bacteria are harmless. E. coli 0157:H7 is a specific strain of E. coli that causes illness.


A person becomes infected with E. coli 0157:H7 by swallowing the bacteria. This can occur when someone eats food contaminated with E. coli 0157:H7, most frequently undercooked ground beef and raw milk. Transmission also can occur directly from person to person in families, child care centers and custodial institutions. Outbreaks have also been traced to contaminated water.


The elderly and children under five years of age are at greatest risk of developing a serious illness from E. coli 0157:H7 infection.

The symptoms of E. coli 0157:H7 infection can vary. Some individuals have no symptoms. Others may have mild to severe diarrhea, which may contain blood. Abdominal cramps, nausea and vomiting may occur. Usually there is little or no fever present. A small number of patients develop complications, such as hemolytic uremic syndrome.

Hemolytic uremic syndrome is an infrequent and serious complication of E. coli infection, particularly in children under five years old. It is characterized by renal failure, or loss of kidney function. Many patients also develop anemia or a bleeding problem. Hospitalization and dialysis is usually necessary until kidney function recovers. Many patients have some permanent partial loss of kidney function after they have recovered.

Death due to E. coli 0157:H7 infection occurs infrequently, usually as a result of a complication of the infection.

Symptoms of illness usually appear about three days after swallowing the bacteria, but can range from one to eight days.

Most individuals who become ill with E. coli 0157:H7 infection recover on their own within a week. Some however, may require hospitalization to administer intravenous fluids to prevent dehydration. Antibiotics may be prescribed by a physician to treat severe cases of illness.

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