Image result for Food SafetyApart from the controls stated under the Pennington recommendations, thorough cooking food to at least 70C (USA) or 75C (UK) core temperature will kill the pathogen. Why there are temperature differences between the USA and UK is unknown. Temperatures above 60C will kill E coli, as with most food safety pathogens.
The majority of illnesses and deaths attributable to EHEC relate to developing countries. In the UK there are adequate potable water and toilet facilities. In developing countries 1.1 billion people are without clean drinking water and 2.4 billion people without adequate sanitation.
These countries do not have enough money to finance any education or awareness programmes to control EHEC. Many people live in poverty and, because of poor diets, cannot fight EHEC infection. Diagnosis of infection can be quite difficult and time consuming in developed countries. In developing countries diagnosis is quite often too late, due to lack of equipment, expertise and logistical problems of location. Quite often people suffering from EHEC are living in the deserts, forests, mountain ranges, where there are no direct communication routes.
Spread of EHEC has been quite extensive in the last 30 years from its roots in the USA to spreading to a global audience. This is due to more travel, import/export of contaminated foodstuffs and poor hygiene control when the pathogen emerges. Where countries have identified EHEC, doctors have prescribed antibiotics, resulting in antibiotic resistant strains.
The ideal situation regarding control of EHEC would be localised elimination followed by global eradication. However, as E coli is a natural commensal of humans and EHEC a symbiont of ruminants, elimination and eradication is going to be impossible due to its ubiquitous nature.
The only way forward is by more vigorous controls. In the UK, for example, the regulations should be tighter with stiffer penalties for the food industry. Food safety training should be given a priority in schools and industry, especially in abattoirs and fruit and salad farms. It has been suggested that all raw meat in the UK is contaminated with pathogens including EHEC. Although the infection can be killed by thorough cooking, cross contamination caused by touching the infected raw meat, not washing hands, and touching other surfaces causes many problems. If high risk food such as sandwiches, cooked meats, buffet items are placed on the contaminated surface, the EHEC are transferred to the food. It has been shown that EHEC can survive for up to 60 days on a stainless steel surface, which has not been adequately cleaned. Raw food must be kept separate from ready to eat, high risk food.
Commensal E coli has evolved into EHEC and emerged as a new pathogen in the USA in the early eighties to spread globally over the past 30 years. It is a deadly pathogen causing, apart from vomiting and diarrhoea, haemolytic uraemic syndrome, renal failure, permanent kidney damage, brain damage and death. It is a bigger problem in developing countries due to social, technological, economic, political and logistical reasons. It is unlikely that it will ever by eliminated or eradicated. More vigorous controls would, however, keep a tight rein on EHEC.
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