E. coli outbreak in Minnesota: How to stay safe
Federal health officials say the current E. coli outbreak is linked to organic whole bagged carrots and baby carrots sold by Grimmway Farms.
Mychele Daniau | AFP via Getty Images
Go Deeper.
Create an account or log in to save stories.
Like this?
Thanks for liking this story! We have added it to a list of your favorite stories.
A recent string of E. coli outbreaks in Minnesota has launched multiple recalls for carrots and beef in the state. So far, 10 cases of E. coli in Minnesota have been connected to burgers sold at multiple Red Cow Restaurants in the metro and Hen House Eatery in Minneapolis. At least five people became sick from carrots sold in grocery stores across the state.
For more about how these outbreaks are happening and how to stay safe, MPR News host Nina Moini spoke with Carlota Medus, epidemiologist with the Foodborne Diseases Unit at the Minnesota Department of Health.
Use the audio player above to listen to the full conversation.
Subscribe to the Minnesota Now podcast on Apple Podcasts, Spotify or wherever you get your podcasts.
We attempt to make transcripts for Minnesota Now available the next business day after a broadcast. When ready they will appear here.
Turn Up Your Support
MPR News helps you turn down the noise and build shared understanding. Turn up your support for this public resource and keep trusted journalism accessible to all.
Audio transcript
[AUDIO LOGO] NINA MOINI: Our top story this afternoon, a recent string of E. coli outbreaks in Minnesota has launched multiple recalls for carrots and beef in the state. So far, 10 cases of E. coli in Minnesota have been connected to burgers sold at multiple Red Cow restaurants in the metro and Hen House Eatery in Minneapolis. And we've seen at least five people sick from carrots sold in grocery stores across the state. For more about how these outbreaks are happening and how to stay safe, Carlota Medus is here. She's an epidemiologist with the Foodborne Diseases Unit at the Minnesota Department of Health. Carlota, thank you for joining me this afternoon.
CARLOTA MEDUS: Well, thank you for having me.
NINA MOINI: I know there's a lot that's under investigation right now. And we don't want people to be scared, but we do want people to be informed. So would you lay out for us what all this is actually being recalled right now and investigated in Minnesota?
CARLOTA MEDUS: Oh, absolutely. Right now, we are investigating a couple of different outbreaks, unrelated to each other. So one is the E. coli O157 outbreak associated with eating undercooked burgers at various restaurants. You mentioned Red Cow, but there have been other restaurants that received the same beef. So that outbreak is very much-- the investigation is very much ongoing. And it's very likely that we will actually find more cases and even cases associated with different restaurants.
The other outbreak that you just mentioned is a different type of E. coli. It's E. coli O121, which is similar to E. coli O157, in that they both produce the same really, really bad toxin called Shiga toxin 2. That outbreak is associated with consuming carrots. And our main concern with that outbreak is that the persons in our state might still have the carrots in the refrigerator. They're no longer being sold. I mean, the cases happened a little while ago. But because carrots last forever in somebody's fridge, we don't want people eating them.
NINA MOINI: Yeah, that healthy food tends to last longer. So check your carrots, everybody. So thank you so much for breaking that down. So we've got outbreaks that are unrelated, different types. What are you finding could be the sources of these outbreaks?
CARLOTA MEDUS: Well, they would be totally unrelated to each other. So for the E. coli O157 outbreak associated with eating undercooked burgers at restaurants, that is clearly a ground beef-associated outbreak. So we know that E. coli O157 comes from the intestinal tract of cattle. And during the processing, it can end up in the burger. And when burger gets ground into ground beef that you use in your burgers, that E. coli can end up on the inside of the meat, of your patty. So if it's not cooked really hot, the E. coli can survive.
And we've known this forever and ever. But in more recent years, we've seen a decrease in the ground beef contamination, but it can still happen. So that's one of the big picture causes of E. coli O157 in ground beef.
Now, the specifics for this outbreak, we don't know yet. It is super-early in the investigation. It's a very fast-moving investigation. And there's still a lot that we don't know. We're working with other regulatory agencies, like the Minnesota Department of Agriculture, with the Food and Drug Administration-- I'm sorry, with the US Department of Agriculture, the USDA. And they will actually investigate the actual cause for this specific outbreak.
Now, carrots can be contaminated along the way. Again, E. coli, in this case O121, also ultimately comes from the intestinal tract of ruminants. So it could have been contaminated on the field or during processing. Again, we don't have all the answers yet.
NINA MOINI: Can you tell me just a little bit about your process, going through different grocery stores and restaurants? Where do you go once you start to get one or two cases? Do you have to start checking a lot more people and places?
CARLOTA MEDUS: Well, the way it works, actually, is-- so there's different things that happen. Sometimes when you see a recall, it happens because the regulatory agencies or the company itself did some testing as part of their normal food safety process. And there might not be any illnesses associated with that recall. But recalls that are associated with outbreaks are very different. What happens is that we have a pretty robust surveillance system in the United States. And particularly in Minnesota, we have a really, really good surveillance system in Minnesota.
What that means is that, if you as a person are diagnosed, when you go to your doctor, you submit a stool specimen, and you're diagnosed with E. coli O157 or a long list of other types of infections. The clinician will report it to our health department. And we conduct an investigation. We actually call people and interview them about their illness, about their exposures, whether it's food, animal, daycare, you name it. And we also get the specimen at our lab. And we cross-reference all the laboratory data to identify additional cases.
So when we see a pattern, whether it's from the interview data or from the laboratory data, we pursue it further. So we're basically starting out at the human illness side and then trying to figure it out from there.
NINA MOINI: Sure. How do you move forward with a specific restaurant or a grocery store that has faced an E. coli outbreak?
CARLOTA MEDUS: By moving forward, do you mean, how do we move forward with the investigation?
NINA MOINI: Yeah. Or then, do you go back and check again? How do how do you interact with those restaurants? Is it punitive, or how does that interaction go?
CARLOTA MEDUS: So from where I sit, I sit on the human illness side of things. So what we do is, once we investigate, we'll have a report. And we work with a regulatory agency. Sometimes it's the Minnesota Department of Health, environmental health side. They hold the licenses. Or sometimes it's a local agency. A lot of cities and counties have their-- they have the actual restaurant licenses. And it really depends on the type of outbreak. If it's something that they received and they served and people got sick, the interventions happen at the time of the outbreak. We just make sure that the restaurant is safe to continue serving food.
So if the restaurant stays open, that means that all the interventions were put in place to make the food safe. So whether it's switching the supply of beef, in this case, cooking hamburgers to a higher temperature, or if they received produce that was contaminated, removing it, and then, of course, cleaning and disinfecting and ensuring that employees didn't get sick.
The only times that there is something punitive is when the restaurant did something really horrible.
NINA MOINI: Sure.
CARLOTA MEDUS: And most of the time, the vast majority of the time, the goal is to make the food safe. So all the focus go on interventions at the time to make sure the restaurant can continue to serve food and that the food that's served is safe.
NINA MOINI: Sure. And wanting people to get back out there and continue to be patrons at these restaurants, of course, because that can be pretty devastating-- what should people be-- it is the lunch hour now. But I'm curious, how does E. coli show up in people? Who should be particularly concerned? Could you just give us a brief overview of that?
CARLOTA MEDUS: Right. So E. coli, there's many different types of E. coli. But the E. colis that we're talking about with these two outbreaks usually presents itself as diarrhea, sometimes bloody diarrhea. And it often takes three, four days before the symptoms appear after eating something that's contaminated. So you won't necessarily know that you ate something that's contaminated because it doesn't taste any different. But then you develop diarrhea a couple of days later. It could be as short as one day or longer, like seven days, but most of the time, three to four days later.
If the diarrhea is severe, lasts multiple days, or is bloody, which happens quite often with these pathogens, we urge people to reach out to their health care provider because there may be things that they can do, like be tested. They may receive IV fluids. They might monitor kidney function. So it's important to be in touch with the health care provider about the symptoms. So the gist is, if you have, something that's severe, that lasts more than a couple of days, particularly if your diarrhea is bloody, reach out to your health care provider.
NINA MOINI: But most people are OK after a bout of E. coli. Just lastly, Carlota, what advice would you give to Minnesotans concerning this outbreak overall? How concerned should they be?
CARLOTA MEDUS: Well, if you recently ate an undercooked burger at a sit-down restaurant and you developed diarrhea a couple of days later, three, four days later, I think there should be. They should pay attention, particularly if the diarrhea is bloody. And they should reach out to their health care provider. In general, I think it's a terrible idea to eat an undercooked burger. Get it a little bit more cooked. And that way, you will always be safe.
NINA MOINI: [LAUGHS] That's the folks asking for rare, maybe reconsider.
[LAUGHTER]
All right, well, Carlota, I really appreciate you coming on and just breaking this down for people. People hear E. coli, and they have all sorts of thoughts. So we do appreciate your expertise and keeping us up to date.
CARLOTA MEDUS: Well, thank you for having me on. And enjoy your lunch!
[LAUGHTER]
NINA MOINI: Thank you. [LAUGHS] Well, that was Carlota Medua, an epidemiologist with the Foodborne Diseases Unit at the Minnesota Department of Health.
CARLOTA MEDUS: Well, thank you for having me.
NINA MOINI: I know there's a lot that's under investigation right now. And we don't want people to be scared, but we do want people to be informed. So would you lay out for us what all this is actually being recalled right now and investigated in Minnesota?
CARLOTA MEDUS: Oh, absolutely. Right now, we are investigating a couple of different outbreaks, unrelated to each other. So one is the E. coli O157 outbreak associated with eating undercooked burgers at various restaurants. You mentioned Red Cow, but there have been other restaurants that received the same beef. So that outbreak is very much-- the investigation is very much ongoing. And it's very likely that we will actually find more cases and even cases associated with different restaurants.
The other outbreak that you just mentioned is a different type of E. coli. It's E. coli O121, which is similar to E. coli O157, in that they both produce the same really, really bad toxin called Shiga toxin 2. That outbreak is associated with consuming carrots. And our main concern with that outbreak is that the persons in our state might still have the carrots in the refrigerator. They're no longer being sold. I mean, the cases happened a little while ago. But because carrots last forever in somebody's fridge, we don't want people eating them.
NINA MOINI: Yeah, that healthy food tends to last longer. So check your carrots, everybody. So thank you so much for breaking that down. So we've got outbreaks that are unrelated, different types. What are you finding could be the sources of these outbreaks?
CARLOTA MEDUS: Well, they would be totally unrelated to each other. So for the E. coli O157 outbreak associated with eating undercooked burgers at restaurants, that is clearly a ground beef-associated outbreak. So we know that E. coli O157 comes from the intestinal tract of cattle. And during the processing, it can end up in the burger. And when burger gets ground into ground beef that you use in your burgers, that E. coli can end up on the inside of the meat, of your patty. So if it's not cooked really hot, the E. coli can survive.
And we've known this forever and ever. But in more recent years, we've seen a decrease in the ground beef contamination, but it can still happen. So that's one of the big picture causes of E. coli O157 in ground beef.
Now, the specifics for this outbreak, we don't know yet. It is super-early in the investigation. It's a very fast-moving investigation. And there's still a lot that we don't know. We're working with other regulatory agencies, like the Minnesota Department of Agriculture, with the Food and Drug Administration-- I'm sorry, with the US Department of Agriculture, the USDA. And they will actually investigate the actual cause for this specific outbreak.
Now, carrots can be contaminated along the way. Again, E. coli, in this case O121, also ultimately comes from the intestinal tract of ruminants. So it could have been contaminated on the field or during processing. Again, we don't have all the answers yet.
NINA MOINI: Can you tell me just a little bit about your process, going through different grocery stores and restaurants? Where do you go once you start to get one or two cases? Do you have to start checking a lot more people and places?
CARLOTA MEDUS: Well, the way it works, actually, is-- so there's different things that happen. Sometimes when you see a recall, it happens because the regulatory agencies or the company itself did some testing as part of their normal food safety process. And there might not be any illnesses associated with that recall. But recalls that are associated with outbreaks are very different. What happens is that we have a pretty robust surveillance system in the United States. And particularly in Minnesota, we have a really, really good surveillance system in Minnesota.
What that means is that, if you as a person are diagnosed, when you go to your doctor, you submit a stool specimen, and you're diagnosed with E. coli O157 or a long list of other types of infections. The clinician will report it to our health department. And we conduct an investigation. We actually call people and interview them about their illness, about their exposures, whether it's food, animal, daycare, you name it. And we also get the specimen at our lab. And we cross-reference all the laboratory data to identify additional cases.
So when we see a pattern, whether it's from the interview data or from the laboratory data, we pursue it further. So we're basically starting out at the human illness side and then trying to figure it out from there.
NINA MOINI: Sure. How do you move forward with a specific restaurant or a grocery store that has faced an E. coli outbreak?
CARLOTA MEDUS: By moving forward, do you mean, how do we move forward with the investigation?
NINA MOINI: Yeah. Or then, do you go back and check again? How do how do you interact with those restaurants? Is it punitive, or how does that interaction go?
CARLOTA MEDUS: So from where I sit, I sit on the human illness side of things. So what we do is, once we investigate, we'll have a report. And we work with a regulatory agency. Sometimes it's the Minnesota Department of Health, environmental health side. They hold the licenses. Or sometimes it's a local agency. A lot of cities and counties have their-- they have the actual restaurant licenses. And it really depends on the type of outbreak. If it's something that they received and they served and people got sick, the interventions happen at the time of the outbreak. We just make sure that the restaurant is safe to continue serving food.
So if the restaurant stays open, that means that all the interventions were put in place to make the food safe. So whether it's switching the supply of beef, in this case, cooking hamburgers to a higher temperature, or if they received produce that was contaminated, removing it, and then, of course, cleaning and disinfecting and ensuring that employees didn't get sick.
The only times that there is something punitive is when the restaurant did something really horrible.
NINA MOINI: Sure.
CARLOTA MEDUS: And most of the time, the vast majority of the time, the goal is to make the food safe. So all the focus go on interventions at the time to make sure the restaurant can continue to serve food and that the food that's served is safe.
NINA MOINI: Sure. And wanting people to get back out there and continue to be patrons at these restaurants, of course, because that can be pretty devastating-- what should people be-- it is the lunch hour now. But I'm curious, how does E. coli show up in people? Who should be particularly concerned? Could you just give us a brief overview of that?
CARLOTA MEDUS: Right. So E. coli, there's many different types of E. coli. But the E. colis that we're talking about with these two outbreaks usually presents itself as diarrhea, sometimes bloody diarrhea. And it often takes three, four days before the symptoms appear after eating something that's contaminated. So you won't necessarily know that you ate something that's contaminated because it doesn't taste any different. But then you develop diarrhea a couple of days later. It could be as short as one day or longer, like seven days, but most of the time, three to four days later.
If the diarrhea is severe, lasts multiple days, or is bloody, which happens quite often with these pathogens, we urge people to reach out to their health care provider because there may be things that they can do, like be tested. They may receive IV fluids. They might monitor kidney function. So it's important to be in touch with the health care provider about the symptoms. So the gist is, if you have, something that's severe, that lasts more than a couple of days, particularly if your diarrhea is bloody, reach out to your health care provider.
NINA MOINI: But most people are OK after a bout of E. coli. Just lastly, Carlota, what advice would you give to Minnesotans concerning this outbreak overall? How concerned should they be?
CARLOTA MEDUS: Well, if you recently ate an undercooked burger at a sit-down restaurant and you developed diarrhea a couple of days later, three, four days later, I think there should be. They should pay attention, particularly if the diarrhea is bloody. And they should reach out to their health care provider. In general, I think it's a terrible idea to eat an undercooked burger. Get it a little bit more cooked. And that way, you will always be safe.
NINA MOINI: [LAUGHS] That's the folks asking for rare, maybe reconsider.
[LAUGHTER]
All right, well, Carlota, I really appreciate you coming on and just breaking this down for people. People hear E. coli, and they have all sorts of thoughts. So we do appreciate your expertise and keeping us up to date.
CARLOTA MEDUS: Well, thank you for having me on. And enjoy your lunch!
[LAUGHTER]
NINA MOINI: Thank you. [LAUGHS] Well, that was Carlota Medua, an epidemiologist with the Foodborne Diseases Unit at the Minnesota Department of Health.
Download transcript (PDF)
Transcription services provided by 3Play Media.