The Scottish Outbreak

Scotland underwent a major E.coli O157:H7 outbreak in December 1996 and January 1997, with over 400 people infected and 20 deaths. The majority of the dead were elderly citizens who died after eating cooked meat at a lunch for retirees at a church in Wishaw. The meat is suspected from coming from a butcher shop in the same community, which had since been closed while health officials conducted their investigation.

With this outbreak it appeared that the government was in trouble, since the citizens of Scotland and England no longer trusted what the government was telling them about the safety of their food. For the elections scheduled for the following May 1, the British oddsmakers were giving 4 to 1 odds that Prime Minister John Majors' party will not be re-elected.  He wasn't.

There is a difference between what happened in Japan and what happened in Scotland. And there are some odd statistics that add to the mix.

Approximately 10% of the people who are infected with the E.coli O157:H7 bacteria contract a disease known as hemolytic uremic syndrome, or HUS for short, and of those, 10% die no matter what is done for them. Regrettably my son Eric was in that 1% of all E.coli O157:H7 victims who die.

Japan had 10,000 people infected, and claimed to have only 11 die. Statistically they should have had 100 die. The conclusions drawn can be many, but I will ask you to consider these: 1) the Japanese may be guilty of misinformation, 2) the Japanese medical treatment is superb, or 3) the overwhelming majority of victims were school children, older than the profile for young E.coli victims.

I will give the Japanese government the benefit of the doubt on #1, ah, maybe they missed one or two here and there, but they couldn’t have missed 89, right?

That leads us to #2. From what I got as an impression from Japanese doctors I was in contact with, was that they didn’t have the technological advances in diagnosis and remedies as the American’s and the Canadian’s did. But this was out of necessity, since 19 retirees died in a Canadian retirement home in 1985, and 500 people got sick in 1993 eating hamburgers in the Pacific Northwest of the United States. And it has been only recently that the largest pharmaceutical concern in Japan had purchased the rights to market Synsorb Pk, which appears to be the best drug not yet for sale which is given to victims of E.coli poisoning so that the body may eliminate it naturally.

So, that leaves us with #3. "School age" children are usually between the ages of 5 and 18, and E.coli O157:H7 is statistically more prominent before the age of 5. Oh, I know there are exceptions to this, my son was 13 when he died. But bear with me here. Scotland has 400 infections, from which you can statically expect 4 deaths, but they’ve had 20, and increase of 500%!!! So, maybe the elderly are more susceptible to E.coli poisoning than anyone realized. And maybe even more of our elderly are dying from this than we currently recognize, maybe many, many more! You've all heard the story, within a period of two weeks, a retiree rapidly deteriorates and dies. It's usually blamed on the flu. Maybe they died of food poisoning? Regrettably, they finally become another totally uncounted and very silent minority. In this country our elderly do not get the same press coverage as when a child dies, as proven with the recent American Odwalla apple juice outbreak.

Playing these numbers is how I came up with my conclusion. If you have a better scenario, let me know.

But Scotland is the same when it comes to the rest of the world when it came time to inform its citizens as to what was happening to them. They failed miserably. It's a story heard over and over and over again, the department in charge didn’t want to create a consumer panic, and they felt obligated to protect the interests of business before the interests of its citizens. As in Australia and Japan, expect a few heads to roll when this plays out, scapegoats or not.

Several times the announcement has been made that the outbreak is on the down side, when as if almost by cue, another hospital reports another batch of admissions. Or the salmonella outbreak, or the meningitis outbreak in England, or the stepping up of the elimination of suspected "mad cows" throughout the British Isles in order to appease the European beef market. Something’s going on here.

But what can we do? We could adopt methods found in two opposite sides of the planet. In New Zealand, before animal is led to slaughter, it is given a thorough, yet humane, cleaning. And in The Netherlands, animals are given rectal swabs to determine if they are infected with pathogenic E.coli. The new rapid tests provide results within hours instead of days.

We also need to look at manure. E.coli O157:H7 have been shown to live for 70 days in manure. This contaminated manure is then used to fertilize fruits and vegetables and maybe contaminate them also. Or rain runoff from an area where cattle congregate into what eventually becomes someone's drinking or swimming water. We know the heating E.coli to 160 degrees will kill the bacteria, but another method might be irradiation. There have been numerous tests to prove the elimination of pathogenic bacteria when exposed to radiation, yet at levels low enough so that there is nothing radioactive.

The Japanese captured an ordinary housefly from which they were able to culture E.coli O157:H7, and we all know where flies like to live! This recent Scottish outbreak has produced a sheep farmer who was apparently infected by his sheep, since he claimed to have no contact with cattle in the previous two weeks. And a nurse reportedly contracted the bacteria from an infected patient. Remember it takes only 10 bacteria to create an infectious dose, and one billion of these bacteria can live on the head of a pin!

Some hard choices need to be made in the future. We can learn from our past mistakes, or we can ignore those valuable lessons. I say, "Let’s learn!"

The first Scottish E.coli crisis has raged on for more than five weeks and claimed 16 lives.

Almost every day has brought a new twist in the outbreak, which has become one of the worst on record. Here is the chronology of a tragedy:

• November 17: Wishaw church lunch for local retirees. Scientists later found gravy supplied by butcher John M Barr & Son contained traces of the E.coli 0157 bacteria.
• November 22: Environmental health experts visit John Barr to warn him of a possible link between suspected cases of E.coli and products supplied by his shop.
• November 26: Church elder Harry Shaw, 80, becomes the first person to die from suspected E.coli. He had attended the church lunch on November 17.
• November 27: John Barr, voted Best Butcher in Scotland, closes his shop as a major investigation is launched. Lanarkshire Health Board issues first list of all outlets supplied by Barr's. Alexander Gardiner, 69, of Wishaw, who was also at the lunch dies, along with Marian Muir, 79, of Cleland.
• November 28: By lunchtime, two more deaths are reported, Jessie Rogerson, 71, of Wishaw, and Nan Criggie, 69, from Bonnybridge - the first person to die outside the Lanarkshire area.
• December 1: Monklands Hospital, Airdrie, closes to GP admissions and sets up a third ward to cope with the rising number of E.coli sufferers.
• December 2: Scottish Office launch major newspaper advertising campaign warning of the need for high standards of food hygiene in a bid to prevent spread of E.coli.
• December 3: It is confirmed that meat was supplied by Barr to an 18th birthday party on November 23 organized by the MacFarlane family, from Wishaw, despite being advised not do so by Lanarkshire Health Board the day before. Moira Jackson, 72, another retiree at the church lunch, dies in Monklands Hospital.
• December 4: Law Hospital, Carluke, apologizes to MacFarlane family from Wishaw over "inaccurate advice" it gave. Staff there told Mrs. MacFarlane to "go ahead and have a good time at the party" when she contacted them with concerns over the meat supplied by Barr's. James Henderson, 74, of Wishaw, who attended the lunch, dies in Monklands Hospital.
• December 5: Scotland's Lord Advocate, Lord Mackay of Drumadoon, announces a fatal accident inquiry is to be held into the E.coli deaths.
• December 6: Arthur Nicol, 79, a resident at Bankview nursing home, Banknock, dies in Falkirk District Infirmary.
• December 8: Advertisements appear in national newspapers, stating that loss adjusters MPC are planning a public meeting to organize block claims for people affected by the outbreak. Grangemouth retiree Mary Paisley, 83, dies at Bankview nursing home after being released from Falkirk District Infirmary.
• December 9: Scottish Secretary Michael Forsyth addresses the Scottish Grand Committee meeting in Hamilton on the outbreak. Another Bankview resident, Christina Wright, 87, from Bonnybridge, dies.
• December 10: A second butcher's shop, John Mulvaney, of New Stevenston, is closed amid fears of cross-contamination of meat products from cold meat bought from Barr's.
• December 11: The death toll reaches 11 and equals the Japanese outbreak as the second worst E.coli fatality rate with the death of Bert Swantson, 70, who dies in Glasgow's Stobhill Hospital. He was the sixth retiree at the Wishaw lunch to die. Loss adjusters MPC hold a public meeting in Wishaw to judge opinion for block claims.
• December 12: Government sets up special Cabinet committee to monitor the outbreak. Josie Foster, 83, of Wishaw, dies, to become the 12th victim.
• December 13: Unnamed auxiliary nurse, from Lothian, confirmed as suffering from E.coli after treating victims in a special ward at Falkirk Royal Infirmary.
• December 16: The number of people showing symptoms of E.coli reaches 400. Strathclyde Police investigate attack when the front window of Barr's shop was shattered.
• December 17: An unnamed elderly woman becomes the 13th victim as Forth Valley Health Board confirms she died at the Bankview nursing home, Banknock - the fourth resident to die there.
• December 19: Sarah Cameron, 78, from Wishaw, and Arthur Smith, 76, from New Stevenston are the 14th and 15th victims. Mrs. Cameron had attended the Wishaw retirees' lunch.
• December 23: John Barr and his lawyer, George Moore, meet environmental health officials from North Lanarkshire Council to discuss results of tests on meat at his shop.
• December 24: Scottish Secretary Michael Forsyth visits hospitals treating E.coli patients to thank staff for their efforts during the outbreak.
• December 28: A 91-year-old woman from Netherton, near Wishaw, dies in Monklands Hospital, Airdrie.
• January 15, 1997: An elderly woman who was a resident of Bankview nursing home, in Banknock near Stirling, dies.