St. John Creamery in Monroe announced on Thursday it is voluntarily recalling raw goat milk that may be contaminated with Escherichia coli (E.coli) bacteria.

A June 14 news release states the recall was initiated after “the presence of toxin-producing E.coli in retail raw goal milk dated 6/17” was discovered during routine sampling by the Washington State Department of Agriculture.

Included in the recall are half-gallon and one-pint containers of raw goat milk marked best by June 17-21.

Symptoms of E. coli infections include severe diarrhea, stomach cramps, bloody stool and, in some cases, hemolytic uremic syndrome.

“Anyone experiencing these symptoms should immediately contact a health care provider,” the new release states. “At this time, there are no known illnesses associated with the recalled product.”

Consumers are being asked to return their purchases for a full refund. These raw milk products were sold at various Western Washington retail stores, at the farm store (28408 Fern Bluff Road) and directly to customers via drop groups.

Most of the children are known to have consumed raw milk from a local cow-share dairy. Due to possible contamination with E. coli O157 and out of an abundance of caution, KCHD advises the public not to consume raw milk or any other unpasteurized products from French Broad Farm in Mascot, Tenn. at this time. Officials also recommend consumers dispose of all raw milk and unpasteurized products they may have from this farm.

Any further exposure to the farm animals in question has been mitigated as the facility is not currently operating. Therefore, no further directive on that potential source is necessary.

“Bacteria, like E. coli, cannot be seen with the naked eye,” said KCHD Director Dr. Martha Buchanan. “For some perspective, roughly 1,800 can fit on the head of a pen, and it only takes about 10 to make you sick.”

Raw milk and other unpasteurized products can contain harmful bacteria, including E. coli O157. While it is possible to get sick from many other foods, raw milk is one of the riskiest. E. coli can also be found in the feces of cattle, goats, sheep and other ruminant animals. Historically, the major source for human illness is cattle, which can carry E. coli 0157 and show no signs of illness. These bacteria, however, can cause severe diarrhea and even life-threatening complications for humans, especially children, older adults, pregnant women and those with compromised immune systems. Information on preventing E. coli can be found on the CDC’s website.

Symptoms of E. coli infection vary for each person, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some may have a low fever (less than 101 ̊F). Some infections are mild, but others can be severe.

Summary

Public Health is investigating an outbreak of Shiga toxin-producing E. coli (STEC) associated with multiple Homegrown restaurants.

Illnesses

Since May 23, 2018, we have learned that four people (one is a Snohomish County resident) have tested positive for STEC after consuming food from three different Homegrown restaurants in King County. Symptoms included abdominal cramps and diarrhea, with one person reporting bloody diarrhea.

All four ate the chicken pesto sandwich from one of the following locations: Redmond, Kirkland or Seattle (Westlake Ave). Of the four ill persons, three are adults and one is a child. Illness onsets occurred during April 24–May 6, 2018. Exact meal dates are not known for all four persons, but known meal dates occurred during April 24–26, 2018.

Public Health actions

On May 24, 2018, Environmental Health investigators visited the three Homegrown locations where the ill persons reported eating. During the field inspections, potential risk factors, including handwashing facilities violations at two of the three locations, and a cold holding temperature violation at one of the three locations, were identified and discussed with the restaurant managers.

We are also investigating the various ingredients of the chicken pesto sandwich. All Homegrown locations in King County have stopped selling this particular sandwich while the investigation is ongoing. Any remaining products related to this sandwich have been put on hold in case testing is warranted. The three restaurants were required to complete a thorough cleaning and disinfection. Investigators also reviewed the requirement that staff are not allowed to work while having vomiting or diarrhea.

Investigators revisited the restaurants on May 25, 2018, to confirm cleaning and disinfection were completed appropriately. We are currently investigating whether any employees had a recent diarrheal illness. We will post updates once we have further details.

Laboratory testing

Three of the four people who got sick tested positive for STEC O26. All three had the same genetic fingerprint, suggesting that they have a common source of infection; genetic fingerprinting for the other ill person cannot be completed. This genetic fingerprint has never been seen in the United States before, making it unique to this outbreak.

According to the CDC, as of May 15, 2018, 172 people infected with the outbreak strain of E. coli O157:H7 have been reported from 32 states.  Alaska (8), Arizona (8), California (39), Colorado (3), Connecticut (2), Florida (1), Georgia (4), Idaho (11), Illinois (2), Iowa (1), Kentucky (1), Louisiana (1), Massachusetts (3), Michigan (5), Minnesota (12), Mississippi (1), Missouri (1), Montana (8), Nebraska (1), New Jersey (8), New York (5), North Dakota (2), Ohio (6), Oregon (1), Pennsylvania (21), South Dakota (1), Tennessee (3), Texas (1), Utah (1), Virginia (1), Washington (7), and Wisconsin (3).

Illnesses started on dates ranging from March 13, 2018 to May 2, 2018.

Ill people range in age from 1 to 88 years, with a median age of 29. Sixty-five percent of ill people are female. Of 157 people with information available, 75 (48%) have been hospitalized, including 20 people who developed hemolytic uremic syndrome, a type of kidney failure.

One death was reported from California.

Illnesses that occurred after April 21, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

According to the FDA, the last shipments of romaine lettuce from the Yuma growing region were harvested on April 16, 2018, and the harvest season is over. It is unlikely that any romaine lettuce from the Yuma growing region is still available in people’s homes, stores, or restaurants due to its 21-day shelf life. The most recent illnesses reported to CDC started when romaine lettuce from the Yuma growing region was likely still available in stores, restaurants, and in peoples’ homes.

The FDA has identified Harrison Farms of Yuma, Arizona, as the grower and sole source of the whole-head romaine lettuce that sickened several people in an Alaskan correctional facility, but has not determined where in the supply chain the contamination occurred.

The traceback investigation indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor. While traceback continues, the FDA will focus on trying to identify factors that contributed to contamination of romaine across multiple supply chains.  The agency is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching consumers.

There are 149 cases in 29 states: Alaska (8), Arizona (8), California (30), Colorado (2), Connecticut (2), Florida (1), Georgia (5), Idaho (11), Illinois (2), Kentucky (1), Louisiana (1), Massachusetts (3), Michigan (4), Minnesota (10), Mississippi (1), Missouri (1), Montana (8), New Jersey (8), New York (4), North Dakota (2), Ohio (3), Pennsylvania (20), South Dakota (1), Tennessee (1), Texas (1), Utah (1), Virginia (1), Washington (7), and Wisconsin (2). Six are reported ill in Canada

Illnesses started on dates ranging from March 13 to April 25, 2018. Ill people range in age from 1 to 88 years, with a median age of 30. Sixty-five percent of ill people are female. Of 129 people with information available, 64 (50%) have been hospitalized, including 17 people who developed hemolytic uremic syndrome, a type of kidney failure. One death was reported from California.

Illnesses that occurred after April 17, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported.

The CDC reports as of May 1, 2018, 121 people infected with the outbreak strain of E. coli O157:H7 have been reported from 25 states. A list of the states and the number of cases in each can be found on the Case Count Map page. Illnesses started on dates ranging from March 13, 2018 to April 21, 2018. Ill people range in age from 1 to 88 years, with a median age of 29. Sixty-three percent of ill people are female. Of 102 people with information available, 52 (51%) have been hospitalized, including 14 people who developed hemolytic uremic syndrome, a type of kidney failure. One death was reported from California.

Illnesses that occurred after April 11, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

There are 98 cases in 22 states: Alaska (8), Arizona (5), California (16), Colorado (2), Connecticut (2), Georgia (1), Idaho (10), Illinois (1), Louisiana (1), Michigan (3), Mississippi (1), Missouri (1), Montana (8), New Jersey (7), New York (2), Ohio (3), Pennsylvania (18), South Dakota (1), Tennessee (1), Virginia (1), Washington (5), and Wisconsin (1). The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to leafy greens. People in the previous outbreak were infected with a different DNA fingerprint of E. coli O157:H7 bacteria.

The most recent information collected by the FDA, in conjunction with federal, state, and local partners, indicates that the romaine lettuce that ill people ate was likely grown or originated from the winter growing areas in or around the Yuma region. This region generally supplies romaine lettuce to the U.S. during November-March each year.

The FDA has identified Harrison Farms as the source of the whole-head romaine lettuce that made several people ill at a correctional facility in Alaska. However, the agency has not determined where in the supply chain the contamination occurred. The FDA is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching the Alaska correctional facility where it was served.

As of April 25, 2018, 84 people infected with the outbreak strain of E. coli O157:H7 have been reported from 19 states. Alaska 5, Arizona 5, California 13, Colorado 2, Connecticut 2, Georgia 1, Idaho 10, Illinois 1, Louisiana 1, Michigan 2, Missouri 1, Montana 7, New Jersey 7, New York 2, Ohio 3, Pennsylvania 18, South Dakota 1, Virginia 1, Washington 2.

Illnesses started on dates ranging from March 13, 2018 to April 12, 2018. Ill people range in age from 1 to 88 years, with a median age of 31. Sixty-five percent of ill people are female. Forty-two ill people have been hospitalized, including nine people who developed hemolytic uremic syndrome, a type of kidney failure.

Illnesses that occurred after April 5, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

State and local health officials continue to interview ill people to ask about the foods they ate and other exposures before they became ill. Sixty-four (96%) of 67 people interviewed reported eating romaine lettuce in the week before their illness started.

Information collected to date indicates that romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick.

As of April 18, 2018, 53 people infected with the outbreak strain of E. coli O157:H7 have been reported from 16 states. Alaska 1, Arizona 3, California 1, Connecticut 2, Idaho, 10, Illinois 1, Louisiana 1, Michigan 2, Missouri 1, Montana 6, New Jersey 7, New York 2, Ohio 2, Pennsylvania, 12, Virginia 1 and Washington 1.

Illnesses started on dates ranging from March 13, 2018 to April 6, 2018. Ill people range in age from 10 to 85 years, with a median age of 34. Seventy percent of ill people are female. Thirty-one ill people have been hospitalized, including five people who developed hemolytic uremic syndrome.

Illnesses that occurred after March 29, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

State and local health officials continue to interview ill people to ask about the foods they ate and other exposures before they became ill. Forty-one (95%) of 43 people interviewed reported eating romaine lettuce in the week before their illness started. Most people reported eating a salad at a restaurant, and romaine lettuce was the only common ingredient identified among the salads eaten. The restaurants reported using bagged, chopped romaine lettuce to make salads. At this time, ill people are not reporting whole heads or hearts of romaine. Information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick.

As of April 12, 2018, 35 people infected with the outbreak strain of E. coli O157:H7 have been reported from 11 states. Connecticut 2, Idaho 8, Illinois 1, Michigan 1, Missouri 1, New Jersey 7, New York 2, Ohio 2, Pennsylvania 9, Virginia 1 and Washington 1.  (CDC Report)

Illnesses started on dates ranging from March 22, 2018 to March 31, 2018. Ill people range in age from 12 to 84 years, with a median age of 29. Sixty-nine percent of ill people are female. Twenty-two ill people have been hospitalized, including three people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to leafy greens. People in the previous outbreak were infected with a different DNA fingerprint of E. coli O157:H7 bacteria.

Epidemiologic evidence collected to date indicates that chopped romaine lettuce is the likely source of this outbreak. Most people reported eating a salad at a restaurant, and romaine lettuce was the only common ingredient identified among the salads eaten. The restaurants reported using bagged, chopped romaine lettuce to make salads.

Traceback investigations are ongoing to determine the source of chopped romaine lettuce supplied to restaurant locations where ill people ate. At this time, no common grower, supplier, distributor, or brand has been identified. However, preliminary information indicates that the chopped romaine lettuce was from the Yuma, Arizona growing region. Information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick.