CDC, several states, the U.S. Department of Agriculture’s Food Safety and Inspection Service, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Shiga toxin-producing E. coli O103 infections. This investigation includes E. coli O103 infections recently reported by the Kentucky Department of Public Health.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on E. coli bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE. WGS performed on E. coli from ill people in this outbreak showed that they are closely related genetically. This means that the ill people are more likely to share a common source of infection.

As of April 4, 2019, 72 people infected with the outbreak strain of E. coli O103 have been reported from five states – Georgia, Kentucky, Ohio, Tennessee and Virginia. CDC is reporting the 72 illnesses that PulseNet has confirmed are part of this outbreak. States are investigating additional illnesses that might be a part of this outbreak.

Illnesses started on dates from March 2, 2019, to March 29, 2019. Ill people range in age from 1 to 74 years, with a median age of 17. Fifty-five percent are female. Of 47 people with information available, 8 (17%) have been hospitalized. No deaths and no cases of hemolytic uremic syndrome (HUS) have been reported.

This investigation is still ongoing and a specific food item, grocery store, or restaurant chain has not been identified as the source of infections. State and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before their illness started.