Summary

Public Health is investigating a new cluster of seven children infected with Shiga toxin-producing E. coli (also known as STEC) in King County. All cases are currently under 15 years of age, and three are under 5 years of age. Cases have been reported during April 22–May 1, 2021.

Our investigation is ongoing. We have identified multiple types of fresh produce, mostly organic, in common among the majority of cases but cannot yet rule out other possibilities. We are still uncertain if these cases share the same source of their infection or not. Updates will continue to be posted when more information is available.

Illnesses

All 7 children developed symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. Illness onsets occurred during April 17–29, 2021. Six children have been hospitalized; this includes two children who developed a type of kidney complication called hemolytic uremic syndrome (HUS) and both are recovering.

Public Health actions

Public Health is conducting interviews with cases and their parents/guardians to help identify any common exposures. We are also working with the Washington State Department of Health to complete further testing, to help identify possible related cases in other counties, and to begin traceback of any products in common.

Public Health message

Fruits and vegetables can sometimes have germs like STEC on them, and many types have been associated with outbreaks in the past. You should always wash all fresh produce well before consuming. See this CDC link on fruit and vegetable safety for more details.

If you or your child develop painful or bloody diarrhea, diarrhea that lasts more than 3 days or is accompanied by a high fever or decreased urine, contact your healthcare provider to see if testing for STEC is indicated.

STEC and other foodborne infections occur throughout the year but may increase in frequency during late spring and summers months.

Anyone ill with suspected or known STEC should not work in or attend childcare or preschool, or work in food handling or healthcare until cleared by Public Health.

Laboratory testing

Six of the cases have preliminary testing indicating infections with E. coli O157 via PCR, and the seventh case has a positive EIA test for STEC. Further testing to confirm the strain and do genetic fingerprinting (whole genome sequencing or WGS) is underway at the Washington State Public Health Laboratory. These WGS results will help determine whether these cases were infected with the same strain of STEC.