"E. coli O157:H7 is more significant than other well-recognized foodborne pathogens for reasons including the severe consequences of infection that affect all age groups, its low infectious dose, its unusual acid tolerance, and its apparent special but inexplicable association with ruminants [cattle, deer, and sheep] that are used for food," wrote Robert L. Buchanan, Ph.D., and Michael P. Doyle, Ph.D., the document's authors.

Less than ten E. coli O157:H7 cells may cause foodborne illness in people. Infectious doses associated with this pathogen in outbreaks have been consistently low?a characteristic associated with the organism's acid tolerance, according to Buchanan and Doyle.

Unlike most other pathogens, E. coli O157:H7 has been known to survive for several weeks to months in acidic foods such as fermented sausage and apple cider, and experimentally, in foods like mayonnaise and cheddar cheese. The survival time in these foods is greatly extended at refrigeration temperatures (32 F-40 F) as opposed to room temperature. Recent studies have also indicated that acid tolerance may increase the pathogen's resistance to other stresses such as heat, radiation, and antimicrobials.

"[E. coli O157:H7's] low infectious dose in combination with the disease severity means that successful prevention strategies must focus on reducing or eliminating the presence of the microorganism, rather than on preventing pathogen growth as is done in more traditional approaches," Buchanan and Doyle wrote.

The Hazard Analysis and Critical Control Point (HACCP) system can reduce the risk of E. coli O157:H7 infections, but it is not infallible, especially due to the pathogen's nature.

"For example, the low incidence of E. coli O157:H7 in foods makes direct microbiological testing for the pathogen as a means of verifying the effectiveness of a HACCP program of limited benefit," Doyle and Buchanan wrote. "Most desirable is a process that includes a step lethal to the pathogen." Current effective lethal steps include heat pasteurization for milk and juices and ionizing radiation for meat (if approved) and fresh fruits and vegetables.

Ionizing radiation is a promising technology because it can eliminate E. coli O157:H7 while maintaining the raw character of foods. Though approved for use with poultry, pork, and fresh produce in the United States to control various pathogens, this technology is extremely underutilized. Approval for its use with beef and seafood is pending.

The use of steam to briefly heat carcass surfaces to temperatures that will kill E. coli O157:H7 without cooking the meat is a new, promising food safety method. Steam pasteurization has been reported to achieve up to a 1000-fold reduction of E. coli O157:H7 on treated carcasses.

Beyond these processing measures, the only way to eliminate E. coli O157:H7 is by cooking ground beef and venison to at least 160 F at home and in foodservice kitchens. Unpasteurized juices, if consumed at all, should be also heated to 160 F.

Growers of produce should not fertilize plants with fresh manure. In an editorial accompanying IFT's Scientific Status Summary, I. Kaye Wachsmuth, Ph.D., wrote, "The tradition of recycling manure for vegetable gardening has caused E. coli O157:H7 illness; the pathogen can survive longer than the traditional 60-day holding period."

Though potentially deadly to humans, E. coli O157:H7 is not pathogenic to cattle. Despite this, the bacteria have the ability to persist in and reinfect cattle, even those that have a strong immune response to it, Buchanan and Doyle wrote. Results of two major U.S. surveys indicated that about 3 percent of dairy calves and 2 percent of feedlot cattle had E. coli O157:H7. Young animals tend to carry the pathogen more frequently than adults.

Though ground beef has been most often associated with E. coli O157:H7 outbreaks in the United States, other implicated foods include raw milk, apple cider, dry-cured salami, lettuce, produce from manure-fertilized gardens, potatoes, radish and alfalfa sprouts, yogurt, sandwiches, and water.

Note: If no author is given, the source is cited instead.

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