Public Health is investigating an outbreak of Shiga toxin-producing E. coli O157:H7 (also known as STEC). Three of the five people who got sick had testing that matched by genetic fingerprinting. This means they most likely got sick from the same source. Based on information collected, we found one common source for all sick people which was a store-made guacamole purchased at PCC Community Markets – West Seattle Co-op on February 10, 2024. Even though we think this is the most likely source of illness, we do not know for certain. We did not find out how the guacamole might have been contaminated with STEC and did not have any left to test. This outbreak appears to be over.


Since February 21, 2024, Public Health has learned about five people who got sick between February 14 – February 28, 2024. All five people had symptoms of STEC, including diarrhea (often bloody), stomach cramping, nausea, and vomiting. We have not found any employees sick with symptoms of STEC from PCC Community Markets – West Seattle Co-op.

Public Health actions

Disease Investigators conducted in-depth interviews with the five sick people to find common exposures and help prevent ongoing spread of STEC. Environmental Health Investigators visited the grocery on March 15, 2024. Investigators reviewed with restaurant management the requirement that staff who have symptoms of vomiting and diarrhea are not allowed to work until they are symptom-free for at least 24 hours. Investigators provided education about preventing the spread of STEC — including proper handwashing, preventing bare hand contact with ready-to-eat foods, and preventing cross contamination between raw meat and ready-to-eat food during food preparation. When food workers have STEC, they need further testing before going back to work to make sure they are not contagious.

Laboratory testing

Four people who became sick had testing that was positive for STEC O157:H7. Three people also had further testing showing they matched by whole genome sequencing or WGS (like genetic fingerprinting) at the Washington State Public Health Laboratory. One person who became sick did not have any testing done.

As of February 16, 2024, a total of 10 people infected with the outbreak strain of E. coli have been reported from four states – California, Utah, Colorado and Texas. Illnesses started on dates ranging from October 18, 2023, to January 29, 2024. Of 9 people with information available, 4 have been hospitalized and 1 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS). WGS showed that bacteria from sick people’s samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 8 people interviewed, 6 (75%) reported eating RAW FARM LLC brand raw cheddar cheese. This percentage was significantly higher than the 4.9% of respondents who reported eating any raw milk cheese in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggests that people in this outbreak got sick from eating RAW FARM LLC brand raw cheddar cheese.

CDC advises people not to eat, sell, or serve RAW FARM brand raw cheddar cheese while the investigation is ongoing.

An infected food handler has been identified as the most likely source of an E. coli outbreak at an Illinois high school that saw 16 students sickened and two hospitalized.

A breakdown in hand washing protocol was the most likely cause of the illnesses, according to a 152-page report from the McHenry County Department of Health. An infected food handler was identified by laboratory testing of stool samples.

The outbreak at Huntley High School occurred in September this year. The county health department released its final report this week. The school district superintendent stated the health department’s report.

“This was an unfortunate situation that resulted in unintentional consequences. The well-being of our students and staff is our top priority. We will continue to partner with MCDH to do everything possible to ensure health and safety, including reinforcing safe food handling and sanitation practices in our cafeterias and adding additional layers of oversight as proactive measures at all Huntley 158 school cafeterias,” the district statement says.

A total of 1,526 students or staff of Huntley High School were interviewed either by Communicable Disease staff or via outbreak investigation questionnaires. Sixteen cases were identified. Fifteen out of 16 patients ate at the cafeteria on the same day.

The county health department clearly concluded that a food handler at the high school was responsible for the outbreak.

“The most likely mode of transmission of STEC (Shiga toxin-producing E. coli) in the HHS cafeteria was through an infected food handler. At the time of the investigation, an HHS food handler who worked at both the cold sandwich station, providing garnishes — lettuce and cheese — to the sandwiches, and at the cookie station was confirmed by (laboratory testing), to have been intermittently shedding STEC, Shiga toxin 2,” according to the health department report, which went on to say that the outbreak was likely larger than that documented.

“. . . Since most infections are self-limiting, most individuals do not seek health care and are not tested. Since it has been documented that STEC can be shed for up to 62 days, it is likely that the food handler was previously mildly ill and did not associate that illness with this outbreak investigation. Since shedding of the pathogen declines over time, it is not unexpected that a culture could not be performed.”

The county investigation found that of the 15 outbreak patients who ate at the cafeteria, all 15 ate a sandwich from the cold sandwich station and all cases with information available for lettuce ate lettuce on their sandwich.

County officials notified the Illinois Department of Health, the Food and Drug Administration, and the Centers for Disease Control and Prevention when the outbreak was declared. The state and federal officials thought the school outbreak might be part of a more significant multistate outbreak.

“The outbreak of STEC at HHS was linked to a multistate outbreak by WGS (whole genome sequencing),” according to the county report. 

“However, this does not imply that the source for the multistate outbreak, which is unidentified to date, is the same as for the outbreak at HHS. The multistate outbreak and the outbreak at HHS likely share a common source, with a student or staff member of HHS becoming ill with STEC after exposure to the source of the multistate outbreak at an external location. Once introduced into HHS, STEC was transmitted primarily through the HHS cafeteria.”

The county report states that the high school kitchen, regarding food safety measures, is in relatively good shape. Although some infractions, such as a faulty dishwasher, were found, those problems were resolved.

“The HHS kitchen cafeteria is well organized, with designated food handling responsibilities, and there is a clear culture of hand washing among the food handlers. Unfortunately, even an occasional breakdown in hand washing procedures or technique can result in the transmission of illness,” the county report says. 

“During observations of the food handling procedures at HHS, two food handlers failed to utilize a barrier to turn off the hand sink. This confirms that even in a kitchen with trained staff, where hand washing is encouraged, a breakdown in technique can occur, mainly when staff are extremely busy and distracted by multi-tasking.

“In this illness outbreak, the likeliest scenario is that the infected food handler failed to wash their hands correctly, or thoroughly enough, or frequently enough, which resulted in contamination of either surfaces (trays, utensils, food packaging, etc.) or food items at the cold sub sandwich station and cookie station. . .  Without a further cooking step after contamination, the pathogen remained viable, resulting in illness following consumption. STEC can be present for up to 16 months on surfaces without proper sanitization.”

According to news reports, Miguel’s Cocina in San Diego’s 4S Ranch neighborhood had a “soft” reopening Friday night 10 days after voluntarily closing its doors in response to an E. coli outbreak that, as of Friday, has sickened at least 35 people including 10 who had to be hospitalized.

The news of the soft opening was confirmed Friday evening by San Diego County Health and Human Services (HHSA) Agency director of communications Tim McLain. The restaurant plans to return to normal operations Saturday.

Those who fell ill, or their families, reported eating at Miguel’s 4S Ranch location from October 6 to October 18 and developed symptoms from October 13 to October 19, according to the HHSA.

County health officials are still investigating the specific food items that were the source of the Shiga-toxin-producing E. coli (STEC) at the restaurant. 

The number of E. coli cases and hospitalizations linked to the outbreak at Miguel’s has increased since the first was reported and could continue to do so. At least one of the cases has developed into the more severe complication of the infection called hemolytic uremic syndrome.   

The McHenry County Department of Health (MCDH) and Huntley Community School District 158 are working collaboratively to respond to a recent outbreak of Shiga Toxin-Producing E. coli (STEC) at Huntley High School. There are now currently nine confirmed cases of STEC, all of which involve students. The first case was identified on Sunday, September 17. At this time, there is insufficient evidence to indicate the source of the illness. The MCDH is actively monitoring for potential cases; there are no other known McHenry County STEC cases outside of this outbreak.

In a letter to parents, students, and staff, Huntley Community School District 158 officials reiterated that the situation is being taken seriously and that the safety and well-being of students and staff is of the utmost importance.

 Huntley High School officials are fully cooperating with the MCDH as they continue their investigation into potential exposures, both internally and externally, as the source of the outbreak has not yet been identified.

 Given the highly contagious nature of E. coli, students are strongly encouraged to practice frequent handwashing. In addition to this, Huntley High School science teachers have been providing students with essential information about E. coli. Furthermore, the school has taken proactive measures to ensure a safe environment, including the posting of handwashing signage throughout the school and the provision of readily accessible hand sanitizer stations in all classrooms and common areas.

 STEC is a bacterial infection known to cause gastrointestinal illness in humans. This strain of E. coli bacteria grows and lives in the intestines of people and animals. Transmission of STEC can occur due to contact with contaminated food, contaminated water, people, and animals. Symptoms and characteristics of STEC include:

  • Diarrhea (often bloody)
  • Fever
  • Abdominal cramping and body aches
  • Vomiting
  • Headaches

Symptoms typically start within 3-4 days of exposure to STEC but may take up to 10 days to develop. Most individuals infected with STEC feel better within 5-10 days from the onset of the illness with rest fluids.

To prevent and stop the spread of infection, the MCDH recommends washing hands with soap and water when preparing and eating food, having contact with animals or their environment, and after bathroom use or changing a diaper; avoiding swallowing water from ponds, lakes, and untreated swimming pools; and washing and cooking foods properly and avoid unpasteurized (raw) dairy products and juices. Those infected should not handle, prepare, or cook food for others until 48 hours after symptoms have resolved.

Post Outbreak Inspection Reports:

September 18:

Onsite for inspection in regards to a complaint. Water and ice samples were obtained. Refer to RFS #3879 for further notes. Items #1-29 have been marked in compliance to document a complaint report, not all items were evaluated. A signature for a representative of the school could not be obtained due to connectivity problems within the establishment.

September 19:

Onsite in regard to a complaint. Items #1-29 have not all been evaluated and have been marked in compliance. For further notes refer to RFS complaint #3879

Item #16
Section 16 (Pf) Hot water sanitizing rinse at dish machine is less than 180°F. Repair/replace unit so that hot water rinse is maintained between 180°F to 194°F. Reference 4- 501.112.
The automatic dish machine was not registering the appropriate rinse temperature: Correct by 9/29/23 The facility can utilize the auto dish machine for washing and rinsing of equipment, etc., sanitation must take place in the 3-compartment sink.

Item #24
Section 24 (Pf) If time without temperature control is used as the public health control for a working supply of TIME/TEMPERATURE CONTROL FOR SAFETY FOOD before cooking, or for READY-TO-EAT TIME/TEMPERATURE CONTROL FOR SAFETY FOOD that is displayed or held for sale or service: Written procedures shall be prepared in advance, maintained in the FOOD ESTABLISHMENT and made available to the REGULATORY AUTHORITY upon request that specify: Provide a written procedure for the TCS foods that are held out of temperature control. Reference 3-501.19 (A)(1).
The facility has begun to utilize time as a public health control for the hot sub sandwiches and there is not written procedure on hand: Correct by 9/29/23.

Item #24
Section 24 (Pf) If time without temperature control is used as the public health control up to a maximum of 4 hours: The FOOD shall be marked or otherwise identified to indicate the time that is 4 hours past the point in time when the FOOD is removed from temperature control.

All TCS foods that are held under time as a public health control shall have a system of identification to indicate the time of 4 hours past the point of when the TCS foods were removed from temperature control. Reference 3-501.19 (B)(2)

The hot sub sandwiches were not marked with a discard time of 4 hours past the time it was removed from temperature control. Staff indicates that all hot sub sandwiches are purchased prior to the end of lunch service which is within the 4-hour time limit after removal. The facility is to identify the time regardless of whether items will be sold out during the 4-hour time frame or not: Correct by 9/29/23.

September 21:

Section 56 (C) Intake/exhaust air ducts (vents) with accumulation of dust. Intake and exhaust air ducts shall be cleaned and filters changed so they are not a source of contamination by dust, dirt, and other materials. Reference 6-501.14.

Observed the vent covers over the file cabinet area and in the dry storage area soiled with dust. Correct by next routine inspection.

337 culture positive E. coli O157:H7 primary cases.

12 remain in hospital.

11 have developed acute kidney failure – hemolytic uremic syndrome (HUS)

6 of the HUS patients remain on dialysis

22 secondary cases have been reported in family members of primary cases

“Based on the epidemiology of the cases we’ve seen to date, it is highly likely the source of this outbreak is food that was distributed from the central kitchen,” AHS said. “At this point, AHS has not been able to identify a food item that was the source. We continue to investigate.”

AHS said four daycares have not had anyone who tested positive for E. coli: Fueling Brains Bridgeland, Little Oak Early Education, Almond Branch and Braineer Academy.

Those four will be able to reopen Monday, providing no one tests positive for E.coli. The remaining seven daycares will have their closure orders rescinded Tuesday. Young children under five and staff will require clearance from health officials.

There are 11 Calgary daycares which have been issued a closure order until further notice following an outbreak of the shiga toxin-producing E. coli.

  • Fueling Brains Braeside.
  • Fueling Brains West 85th.
  • Fueling Brains New Brighton.
  • Fueling Brains Centennial.
  • Fueling Brains Bridgeland.
  • Fueling Brains McKnight.
  • Braineer Academy.
  • Kidz Space.
  • Little Oak Early Education (formerly Mangrove).
  • Almond Branch School.
  • VIK Academy in Okotoks, Alta.

What to know about E. coli during an Outbreak

What Parents need to know about E. coli induced HUS

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli outbreaks and hemolytic uremic syndrome (HUS). The E. coli lawyers of Marler Clark have represented thousands of victims of E. coli and other foodborne illness infections and have recovered over $850 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our E. coli lawyers have litigated E. coli and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products. The law firm has brought E. coli lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s. We have proudly represented such victims as Brianne KinerStephanie Smith and Linda Rivera.

If you or a family member became ill with an E. coli infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli attorneys for a free case evaluation.


The latest:

Marler Clark has been retained by three students to investigate the outbreak

No source confirmed

42 people sick

37 probable

5 culture confirmed

According to press reports, the Arkansas Department of Health has shared an update on the recent E. coli outbreak in Northwest Arkansas, stating that it is “past its peak.”

The update says that the outbreak appears to have started two weeks ago and currently appears to be past its peak with no new symptoms reported since August. 25.

The ADH confirmed that 42 people have been identified as part of the outbreak out of more than 3,200 surveyed. Of that number, 37 are probable cases based on reported E. coli symptoms while five cases have been confirmed with positive tests. 

ADH revised its case count of those hospitalized, confirming that a total of four people have been hospitalized during the outbreak. Two of those people remain hospitalized while two have been discharged.

Since the last update on August 25, 2022, 13 more illnesses have been reported to CDC. As of August 31, 2022, a total of 97 people infected with the outbreak strain of E. coli O157:H7 have been reported from six states – Ohio, Michigan, Indiana, New York, Pennsylvania and Kentucky.

Note: The State of Ohio is reporting 24 cases, but Wood County alone is reporting 23, so the actually number for Ohio is likely 48.

Note: The State of Michigan is reporting 58 cases though the CDC, but earlier it reported at least 98, so the actual number in Michigan is at lease 100.

The CDC is reporting confirmed cases (by WGS) as follows: Indiana (11), Kentucky (1), Michigan (58), New York (1), Ohio (24) and Pennsylvania (2).

Illnesses started on dates ranging from July 26, 2022, to August 15, 2022.

Sick people range in age from 3 to 94 years, with a median age of 22 years, and 55% are male. Of 81 people with information available, 43 have been hospitalized and 10 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

State and local public health officials have been interviewing people about the foods they ate in the week before they got sick. Among 67 people with detailed food history, 54 (81%) reported eating at a Wendy’s restaurant in the week before their illness started. The Wendy’s restaurants where sick people ate are in Indiana, Michigan, Ohio, and Pennsylvania. People reported eating a variety of menu items, including burgers and sandwiches. Of 54 people with detailed information about what they ate at Wendy’s, 37 (69%) reported eating romaine lettuce served on burgers and sandwiches. 

A total of 24 people infected with the outbreak strain of E. coli O121 were reported from 6 states.

Illnesses started on dates ranging from July 13, 2022, to October 24, 2022. Sick people ranged in age from under 1 to 71 years, with a median age of 30, and 74% were female. Of 22 people with information available, 5 were hospitalized and 1 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths were reported.

On October 7, 2022, the Michigan Department of Agriculture and Rural Development collected Earth Grown frozen falafel for testing from a sick person’s home. WGS done at the Michigan Department of Health & Human Services showed that the E.coli in the falafel were closely related to bacteria from sick people. This means that people likely got sick from eating frozen falafel.

On October 7, 2022, Cuisine Innovations of Lakewood, New Jersey, recalled Earth Grown Vegan Traditional Falafel and Garlic & Herb Falafel. According to ALDI, Cuisine Innovations is the sole supplier of Earth Grown brand frozen falafel sold in ALDI stores.

CDC advises people to not eat, sell, or serve recalled frozen falafel.

Frozen Earth Grown Vegan Traditional Falafel and Garlic & Herb Falafel

  • Sold in ALDI stores.
  • Boxes have any of the following lot numbers: 1472, 1481, 1531, 1532, 1541, 1552, 1561, 1581, 1601, 1611, 1612, 1661, 1682, 1732, 1752, 1762, 1782, 1802, or 1812.
  • See recall notice for additional information.

Elkhorn Valley Packing, a Harper, Kan. establishment, is recalling approximately 3,436 pounds of boneless beef chuck product that may be contaminated with Shiga toxin-producing E. coli (STEC) O103, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The boneless beef chuck items were packed on Feb. 16, 2023. The following product is subject to recall [view label]:     

  • Various weights corrugated boxes containing “Elkhorn Valley Pride Angus Beef 61226 BEEF CHUCK 2PC BNLS; Packed on 2/16/23.” The complete list of serial numbers and box count numbers for the boneless beef chuck product that are subject to recall can be found here.

The product subject to recall bears establishment number “EST. M-19549” inside the USDA mark of inspection. These items were shipped to distributors, federal establishments, retail locations, and wholesale locations, which includes hotels, restaurants, and institutions, in Connecticut, Illinois, Indiana, Maryland, Massachusetts, Michigan, New Jersey, New York and Pennsylvania.

The problem was discovered when FSIS was conducting routine FSIS testing of ground beef derived from this product and the sample confirmed positive for STEC O103. There have been no confirmed reports of adverse reactions due to consumption of these products.

Many clinical laboratories do not test for non-O157 STEC, such as O103, because it is harder to identify than STEC O157:H7. People can become ill from STECs 2–8 days (average of 3–4 days) after consuming the organism.

Most people infected with STEC O103 develop diarrhea (often bloody) and vomiting. Some illnesses last longer and can be more severe. Infection is usually diagnosed by testing of a stool sample. Vigorous rehydration and other supportive care is the usual treatment; antibiotic treatment is generally not recommended. Most people recover within a week, but, rarely, some develop a more severe infection. Hemolytic uremic syndrome (HUS), a type of kidney failure, is uncommon with STEC O103 infection. HUS can occur in people of any age but is most common in children under 5 years old, older adults and persons with weakened immune systems. It is marked by easy bruising, pallor and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately.

Distributors and other customers who have purchased these products for further processing should not use them or further distribute them.