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. 

Unknown E. coli Outbreak: Public Health is investigating a new outbreak of people infected with Shiga toxin-producing E. coli (also known as STEC) in King County. All but one case has been reported since June 26, 2022. Currently all of the cases are among people are from East African communities.

The investigation is ongoing. The majority of ill people have reported eating multiple types of meat, including goat and ground beef, during their exposure period but we cannot rule out other possible sources at this time. Confirmed cases have been linked through genetic fingerprinting results (whole genome sequencing) which indicate that they have the same genetic strain, meaning they likely have a common source of infection. Probable cases have been linked epidemiologically (share a common food source and live with a confirmed case) but have not yet been confirmed via genetic fingerprinting. Updates will be posted when more information is available.

All people developed symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. All but one of the cases had illness onsets from June 20-August 17, 2022. One additional person was identified by WGS with an onset in December 2021. Three children developed a type of kidney complication called hemolytic uremic syndrome (HUS). All people have recovered or are currently recovering.

Torero’s Mexican Restaurant E. coli Outbreak: Public Health is investigated an outbreak of Shiga toxin-producing E. coli(also known as STEC) associated with diarrhea and abdominal pain at Torero’s Mexican Restaurant in Renton.

Since September 5, 2022, 3 people from 3 separate meal parties reported becoming ill after eating food from Torero’s Mexican Restaurant in Renton on September 3, 2022 and September 7, 2022. All of the people developed one or more symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. We did not identify any ill employees.

Environmental Health Investigators visited the restaurant on September 30, 2022. Investigators identified inadequate handwashing facilities and improper storage of raw meats as potential risk factors for this outbreak. All critical violations were corrected during the inspection. On October 3, 2022, Environmental Health Investigators revisited the facility and ensured proper compliance with food handling practices. 

No ill employees were identified at the time of the inspection. Investigators reviewed with restaurant management the requirement that ill staff 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 during food preparation. 

All of the cases had confirmatory testing indicating infections with Shiga toxin-producing E. coli (STEC) via culture. All confirmed cases had the same strain of STEC, based on genetic fingerprinting (whole genome sequencing or WGS) at the Washington State Public Health Laboratory.

Unknown E. coli Outbreak: Public Health is investigating an outbreak of three people infected with Shiga toxin-producingE. coli O157:H7 (also known as STEC). Between October 4 – 16, 2022, 3 people from 3 separate households reported becoming ill. Cases have been among people ranging in age from 18 to 36 years old. Symptoms reported include diarrhea and abdominal pain.

The investigation is ongoing, and no source has been identified. Two of the three ill people report eating dishes that were prepared with raw or undercooked beef, but we cannot rule out other possible sources at this time.

Confirmed cases have been linked through genetic fingerprinting results (whole genome sequencing) which indicate that they have the same genetic strain, meaning they likely have a common source of infection.

All three people developed one or more symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. Cases had illness onset dates from September 21 – October 12, 2022. All the cases are from separate households.

All of the cases have confirmatory testing indicating infections with Shiga toxin-producing E. coli O157:H7 via culture. All confirmed cases have the same strain of Shiga toxin-producing E. coli O157:H7, based on genetic fingerprinting (whole genome sequencing or WGS) at the Washington State Public Health Laboratory.

Summary

Public Health is investigating an outbreak of three people infected with Shiga toxin-producing E. coli O157:H7 (also known as STEC). Between October 4 – 16, 2022, 3 people from 3 separate households reported becoming ill. Cases have been among people ranging in age from 18 to 36 years old. Symptoms reported include diarrhea and abdominal pain.

The investigation is ongoing, and no source has been identified. Two of the three ill people report eating dishes that were prepared with raw or undercooked beef but we cannot rule out other possible sources at this time.

Confirmed cases have been linked through genetic fingerprinting results (whole genome sequencing) which indicate that they have the same genetic strain, meaning they likely have a common source of infection.

Illnesses

All three people developed one or more symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. Cases had illness onset dates from September 21 – October 12, 2022. All the cases are from separate households.

Public Health actions

Public Health is conducting interviews with the people ill with STEC to identify any common exposures and provide guidance to help prevent further spread. 

On November 2, 2022, Environmental Health Investigators visited two locations listed by some of the ill people as places they ate during their likely exposure period. Environmental Health Investigators took environmental samples (i.e. swabs) during their inspections and STEC has not been detected in the environmental samples tested so far. Additional test results are pending.

Public Health is working with the United States Department of Agriculture (USDA) and Washington State Department of Health to complete further testing, to identify related cases in other counties, and to begin traceback of products in common. Traceback is used to identify points of contamination in the food supply chain.

Laboratory testing

All of the cases have confirmatory testing indicating infections with Shiga toxin-producing E. coli O157:H7 via culture. All confirmed cases have the same strain of Shiga toxin-producing E. coli O157:H7, based on genetic fingerprinting (whole genome sequencing or WGS) at the Washington State Public Health Laboratory.

THE OUTBREAK:

The CDC reports that as of October 7 2022, 20 people infected with the outbreak strain of E. coli O121 have been reported from 6 states. Illnesses started on dates ranging from July 13, 2022, to September 13, 2022.

Sick people range in age from less than 1 to 71 years, with a median age of 31, and 79% are female. Of 14 people with information available, 5 have been hospitalized, including 1 who developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

The true number of sick people in this outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because some people recover without medical care and are not tested for E. coli. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Among 18 people interviewed, 15 reported shopping at ALDI stores. Among these 15 ALDI shoppers, 6 reported eating Earth Grown brand frozen falafel purchased from ALDI in the week before getting sick.

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.

THE RECALL:

Cuisine Innovations Unlimited, LLC of 180 Lehigh Avenue, Lakewood, NJ, is voluntarily recalling its Earth Grown Vegan Traditional Falafel and Garlic & Herb Falafel Distributed & Sold Exclusively by Aldi, Batavia, IL due to the possible presence of Shiga toxin-producing E. coli.

Shiga-toxin-producing E. coli is an organism that can cause foodborne illness in a person who eats a food item contaminated with it. Symptoms of infection may include stomach cramps, diarrhea, and vomiting. The illness primarily impacts elderly individuals, children, and people with weakened immune systems. Most healthy adults and children rarely become seriously ill.

The voluntarily recalled Earth Grown Vegan Traditional Falafel And Garlic & Herb Falafel Distributed & Sold Exclusively by Aldi, Batavia, IL were distributed in ALDI retail stores in the following states:  Alabama, Arizona, Arkansas, California, Connecticut,  Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia, and Wisconsin.

The product comes in a bag in a box marked with any of the following Lot numbers: 1472, 1481, 1531, 1532, 1541, 1552, 1561, 1581, 1601, 1611, 1612, 1661, 1682, 1732, 1752, 1762, 1782, 1802, and 1812, and would have been shipped to stores after June 24, 2021.  The lot number can be found in the “Best if used by” area on the outside flap of the box.  There has been no further production of this product.

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns that ground beef products in HelloFresh meal kits may be associated with Escherichia coli (E. coli) O157:H7illness. A recall was not requested because the products are no longer available for purchase.

The meal kits containing ground beef for this public health alert were shipped to consumers from July 2-21, 2022. The following products are subject to the public health alert:     

• 10-oz. plastic vacuum-packed packages containing “GROUND BEEF 85% LEAN/15% FAT” with codes “EST#46481 L1 22 155” or “EST#46481 L5 22 155” on the side of the packaging.

 The ground beef packages bear “EST.46841” inside the USDA mark of inspection and on the plastic ground beef package.

FSIS, the Centers for Disease Control and Prevention, and state public health partners are investigating an outbreak of E. coli O157:H7 and raw ground beef is the probable source of the reported illnesses. Traceback information identified that multiple case-patients received ground beef produced at establishment M46841 and distributed by HelloFresh in meal kits from July 2-21, 2022. Traceback of materials used to produce the ground beef is ongoing and FSIS continues to work with suppliers and public health partners on the investigation.

FSIS is concerned that some product may be in consumers’ freezers. Consumers who have purchased these products are urged not to consume them. These products should be thrown away.