Escherichia coli 0121 Outbreak Linked to Flour


Contributed by Azarene Foutouhi 

Earlier this month, General Mills voluntarily recalled a newly expanded list of flour products including Gold Medal Flour, Signature Kitchens Flour, and Gold Medal Wondra Flour after Shiga Toxin producing Escherichia coli 0121 was isolated from product samples taken from the homes of ill consumers. Thus far, the contaminated product has been linked to illness in 21 states, with Eighty-one percent of those afflicted being female, with a median age of 18. Consumers have been advised to thoroughly cook items containing flour, and to refrain from eating raw dough or batter.

While many serotypes of E. coli do not cause disease state in animals, Escherichia coli 0121, like Escherichia coli 0157 produces Shiga Toxin, which acts to inhibit protein synthesis in a mechanism similar to that of Ricin. Shiga Toxin is associated with Hemolytic Uremia Syndrome (HUS), and renal failure, both of which have no therapy and are potentially fatal. First identified in 1955, HUS has since been understood as the most common cause of acute kidney failure in young children.

Shockingly, usage of antimicrobials during the diarrheal phase of illness caused by E. coli 0121 has been shown to have a harmful effect by inducing Shiga Toxin production. As the offending bacteria rapidly multiply within the gut, they bind closely to the cells of the large intestine, and the tight proximity allows the Shiga Toxin to be absorbed and eventually encounter its receptors. Soon follows a rapid succession of cell death, clots, kidney failure, and damage to the spleen.

Some animals such as cattle and pigs entirely lack Shiga Toxin receptors, thereby resulting in food animals that constantly shed Shiga Toxin producing E. coli.

Thorpe, C. M. “Shiga Toxin–Producing Escherichia Coli Infection.” Clinical Infectious Diseases 38.9 (2004): 1298-303. Web.


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