E. coli 0121 Outbreak Naha, Japan
On October 2nd, an E. coli outbreak was reported at a childcare facility in Naha, Japan. The strain implicated in the infection was Enterohemorrhagic E. coli 0121. The first case identified was from a nurse who worked at the childcare center. Ten people in total became ill with mild gastrointestinal symptoms. Seven of the cases were children. The source of the infection is still unknown.
Japan may be particularly sensitive when it comes to E. coli outbreaks, especially among school-aged children. Back in 1996, one of the worst E. coli outbreaks ever seen worldwide occurred in Sakai City Japan. Ultimately, an astonishing 9,451 people became ill from the bacteria, and 12 people died. Most of those affected by the outbreak were school children.
The causative strain was identified as E. coli O157:H7; however, the source of E. coli was not identified until three years later when scientists conducted studies aimed at tracing the source. In their report they concluded that radish sprouts from a single farm were responsible for the outbreak. The sprouts had been shipped to various schools to be included in the children’s lunches.
This extreme example, and the more recent outbreak show the difficulties in attributing an E. coli outbreak to a particular source. Without knowing the origin of an outbreak, it is more difficult to get it under control, and can quickly get out of hand as seen in 1996 incident. This is an important idea to consider as last year alone Japan experienced 4153 cases of EHEC (according to the National Institute of Infectious Disease).
Despite current conditions, there may be good news for future improvements to Japan’s E. coli testing. According to a study reported in Food Safety News, the global market for E. coli testing is predicted to increase by nearly one billion dollars by 2022, with Asia being the region expected to see the most growth. Technologies are being developed to make E. coli testing quicker and more cost effective.
It will be interesting to see if faster, and more frequent testing can have any significant impact in preventing or minimizing future outbreaks. It is easy to wonder if Japan had had more funding or technology devoted to testing for E. coli back in 1996 if the outbreak would have reached the staggering number of cases that it did. Even now, this recent outbreak shows the continued difficulty in tracking the spread of E. coli infections. Luckily, this time the outbreak stopped at 10 cases.
What do you think?
Could faster and more effective methods of testing help prevent infections and stop major outbreaks?
Also, even though the market is showing an increasing demand for E. coli testing should resources go to developing these technologies, or should money go to other areas along the food safety/disease prevention chain?
DeniseZhang, 
JorgeMadrigalPons, 
teewong, and 6 others are discussing. 
AngeliMalimban, 
ya gao, 
CindyDai, and 4 others are discussing. 
shinnie 6:12 pm on October 16, 2015 Permalink |
Hi Kristina, interesting article! I know that E. coli O157:H7 is said to be one of the most common serotype implicated in foodborne illness in Japan (as well as North America) but it is quite shocking to learn that the Big Six established by the U.S. also cause many foodborne illnesses in other parts of the world. Aside from the O121 strain that you mentioned, I found through Dr. Wang’s slides that O111 has also caused an outbreak in Japan with 56 cases and 4 deaths– both of these strains belong to the Big Six! Granted, the O111 outbreak happened largely because of the patients eating a raw beef dish called “yukhoe” and we all know that not cooking food properly enables microbes to obtain “cross-protection” as well as thrive in mild environments. I think it would be interesting to see how much beef (huge E. coli reservoir) the Japanese population consumes on average, and maybe compare that number to Canada who is a gigantic beef producer and consumer (I think they mostly eat sea food?) and then we can establish whether or not it is worth the money to invest in these technologies. I also wonder what strains Japan health government tests for, and if the procedures they use are similar to the ones we employ in North America? I know currently Canada only tests for O157, but U.S. has already started testing for the Big Six in many beef products. I am thinking that Canada will start to adopt the same policies. To answer your questions, I definitely think that faster and more effective methods of testing will help prevent infections and prevent major outbreaks, but at the same time this requires a lot of resources and knowledge. If E.coli is one of the major pathogens causing illness, hospitalization, and deaths in Japan, I fully support implementing better technology for disease prevention for that purpose, but if another type of bacterium or toxin is at work, maybe it will be better to invest money on the technologies that test for those pathogens instead. All in all, I don’t think this will be difficult for Japan to do since the country is one of the most technologically developed!
csontani 7:21 pm on October 17, 2015 Permalink |
it’s definitely not a big surprise that E. coli can contribute to such an extreme outbreak. I personally think that Japan now has more fund to improve their food safety since they are more developed as a country. If they found a case of E. coli again in the future, they will definitely stop the spreading much faster if they have figured out a more efficient and faster way to detect the source for E. coli. Not only in Japan, but other countries should also consider improving their detection methods for E. coli since the Big Six is becoming more of a concern and not only O157:H7.
WinnieLiao 9:29 am on October 21, 2015 Permalink |
It seems like other E. coli strains has “moved out” of the North American zone and starting to become an issue also in Asia. As Shinnie mentioned above, cattles are a main reservoir for E. coli. This can gradually become a concern for not only Japan but also US and Canada. Canada has large beef industry, and if E. coli problems are not resolved and taken into precaution, this may lead to an economic and reputation loss for Canadians in the future. Also we note that Japanese consume a lot of raw meats, from raw fish to raw beef. To me this means that many other pathogens other than E. coli can also make their way to the tables, causing protruding food safety issues. In the short term, I would consider faster and more effective methods of testing a good way of investigating food borne outbreaks in order to obtain the results faster and develop a coherent database. However, the result of preventing infections and stopping major outbreaks can only be accomplished in the long term, when resources become more available and preventive steps can fully be developed. I would also agree to the fact that funding should be put into the food safety/disease prevention program, especially in the training and education sector; food safety training for those working in the food plant, and public education for safe handling of foods purchased.
ayra casuga 10:15 am on October 24, 2015 Permalink |
Very intriguing article! This case definitely illustrates the severity of having an outbreak source directly linked to a vulnerable group for E.coli. More specifically, the fact that the E.coli infested radish sprouts were directly sent to schools for children’s lunches has caused the large amount of people becoming infected. Although this incident was terrible, the positive outcome is the fact that Japan is starting to pay more attention to food-borne illnesses and how to prevent another case similar or worse from happening again.
As what Winnie had mentioned, I do believe that a good portion of their funding should go towards improving their food safety/disease prevention as a whole because of their reputation of eating a variety of their products raw. For example, the raw seafood they consume could easily be contaminated with seafood toxins. Therefore, the funding should not all go primarily to better E.coli control, but better standards towards all food products that are high risk for the majority of the population. Specifically for the case of children, I do believe more stringent cooking procedures are needed. Perhaps the school lunch program must ensure that all food products being served to children are properly cooked rather than left raw.
EmilyChow 7:29 pm on October 24, 2015 Permalink |
Great post! I find it interesting how it took 3 years for an advanced nation such as Japan to identify the source of the E. coli outbreak. Since Japan has such a large population density, many people can get sick every time there is an outbreak incident so I do think there is importance in developing fast testing methods to quickly identify the source in order to prevent any more people getting infected. On the other hand, I believe there would be a more significant impact if resources and funding went towards food safety and disease prevention. If more people were educated, especially those who handle foods in the processing industry or restaurant business, many incidences of food poisoning would not occur. Overall I believe both are important but it’s better to prevent infections from happening in the first place.
cvalencia 12:26 pm on November 3, 2015 Permalink |
Very informative article! I don’t know how big the population is in that area of Japan (if it’s like how it is in Tokyo), but the number of those who became ill is staggering. And we all know that children are very vulnerable in becoming ill from foodborne pathogens. This just shows how extra precautions should be taken to ensure the food is safe, especially if the food is going to be served to vulnerable populations, such as children, pregnant women and the elderly. It is also quite surprising that it took them a long time to discover the source of the illness. I guess with the rapid detection systems that we recently learned in class, it will be faster now to determine the source of illness. Do you know if E. coli has been a big problem in Japan? Or is this one the worst case that they encountered?
teewong 12:03 am on December 15, 2015 Permalink |
Wow, I am surprised by the fact that they even found out the source of contamination after 3 years! I am glad though, because even though more than 9000 people were infected with the O157:H7, very little people died from this outbreak. However, it must have impacted and raised awareness in a lot of people that even fresh produce can cause tremendous harm! I feel that more technologies should be developed in testing pathogens in the producer side, so that they could eliminate the risk before they even reach the consumers. Consumers should also be educated with the food safety practices so the chances of getting infections could be minimized!
JorgeMadrigalPons 11:58 am on December 15, 2015 Permalink |
It’s surprising that more than 9000 people got infected with sprouts from a single farm. With the technology nowadays, some new effective detection systems have been created. Hopefully, these new systems can detect outbreaks more rapidly, to prevent the spreading of outbreaks like the one discussed in your blog.
DeniseZhang 8:24 pm on December 15, 2015 Permalink |
I don’t think an outbreak can that easily be controlled without finding out the source of contamination. As long as the contamination is not eliminated, there are always chances for the outbreak to occur again. Fortunately that we have learned more about E.coli now. Now we know how to avoid and control its transmission, things will become much easier than before.