State test results of lettuce thought to be linked to an outbreak of E. Coli infections in St. Louis County have come back negative, but officials say a caterer’s food is still on their radar.

Health officials have reported that 106 people, including students from Rockwood Summit High School and adults from the community, have been confirmed as outbreak patients. The patients attended five separate events catered by Andre’s Banquet Center. Patients attended two school band events, two funerals and a veterans event catered by the business.

When the outbreak was first reported on Nov. 14 there were 14 patients.

Tests run by the Missouri Department of Health and Senior Services detected no traces of E. coli in an unopened package of iceberg lettuce collected at Andre’s Banquet Center. However, the business is not yet in the clear.

“A negative test result for the lettuce does not conclusively rule out the salad as the source of the E. coli outbreak,” according to a statement from the St. Louis County Health Department said. 

“This is because bacteria like E. coli often occur in isolated pockets within food products, making it possible for a sampling event to miss the pathogen entirely . . . A negative result does not necessarily indicate the absence of the bacteria or eliminate Andre’s as a potential source.”

As of Nov. 21, county hospitals reported that two of the outbreak patients had developed hemolytic uremic syndrome, or HUS, a rare but serious disease that can occur as a complication of an E. coli infection. The disease affects the body’s blood clotting system and can lead to kidney failure.

John Armengol Jr., owner of Andre’s, released a statement following the announcement of the negative test result:

“While I am relieved to learn of the Missouri State Public Health Laboratory’s negative test results, I will continue to cooperate with the state and local health departments as they now work to determine the source of E. coli that has caused illnesses in the region and which has resulted in individuals who did not attend any events affiliated with Andre’s contracting E Coli.”

The county health director said the source of the E. Coli was not from a school cafeteria.

“One thing I can say is it’s not a cafeteria-related event,” St. Louis County Health Director Kanika Cunningham said. “It was an off-site event, and we’re working with that particular entity and working with that location to identify the source.”

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FDA, CDC, and state partners continue investigating a multistate outbreak of E. coli O157:H7 linked to slivered onions served on Quarter Pounder burgers at McDonald’s restaurants in certain states. As of November 13, 2024, 104 people infected with the outbreak strain of E. coli O157:H7 have been reported from 14 states. Colorado – 30, Montana – 19, Wyoming – 6, Kansas 3, North Carolina 1, Iowa 1, Missouri 8, Michigan 1, Nebraska 12, New Mexico 10, Oregon 1, Utah 8, Washington 1 and Wisconsin 1.

Of 98 people with information available, 34 have been hospitalized, and 4 people developed HUS, a serious condition that can cause kidney failure. One death has been reported from an older adult in Colorado. This person is not one of those who developed HUS. Of the 81 people interviewed, 80 (99%) report eating at McDonald’s. Seventy-five people were able to remember specific menu items they ate at McDonald’s. 63 of 75 people (84%) reported a menu item containing fresh slivered onions. 

FDA, Colorado Department of Agriculture (CDA), and Colorado Department of Public Health and Environment (CDPHE) have collected onion and environmental samples from McDonald’s stores, distribution centers, and firms of interest for laboratory analysis. At this time, one FDA sample of recalled onions has tested positive for E. coli, but it is a non-O157:H7 Shiga toxin-producing E. coli (STEC) and does not match the outbreak strain or any other clinical illnesses. Whole genome sequencing (WGS) analysis determined that the sample is positive for E. coli O168:H8 and contains the Shiga toxin gene stx2a. Additional sample results are pending. More information will be provided in this update as it becomes available.

FDA has completed onsite inspections at a Taylor Farms processing center in Colorado and an onion grower of interest in Washington state.

The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many 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 determine if a sick person is part of an outbreak

More people have been confirmed as infected with E. coli in an outbreak traced to McDonald’s Quarter Pounder hamburgers.

There are now 75 patients, up from 49 earlier this week. One of the patients has died, according to the Centers for Disease Control and Prevention. Thirteen states now have patients, up from 10 previously reported. Of 61 patients with information available, 22 have been hospitalized. Two patients have developed hemolytic uremic syndrome, a serious condition that can cause kidney failure.

Of the 42 patients interviewed, all reported becoming sick after eating at McDonald’s. The most recent person to become ill had illness onset on Oct. 10.

The Food and Drug Administration is investigating the outbreak and has determined that slivered onions are the most likely source of the E. coli O157:H7 that is making people sick.

Taylor Farms, the supplier of fresh onions to McDonald’s, has initiated a recall of its yellow onions. The onions were distributed by US Foods, the country’s largest supplier of food and supplies to food service operators and were also sent to other food service customers. 

McDonald’s has stopped serving Quarter Pounder sandwiches in the outbreak states. It has also stopped using slivered onions, according to company officials.

The number of sick people is likely to increase because for every one patient identified in an E. coli outbreak there are 26 who go undiagnosed. This is because some people do not seek medical attention and others are not specifically tested for E. coli.

Patients in this outbreak live in Colorado, Kansas, Utah, Wyoming, Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, Oklahoma, Michigan, Wisconsin, Washington and Oregon, according to a map from the CDC. 

The Flathead City-County Health Department has increased the numbers of those sickened with E. coli O157:H7 for 14 to 22. Illnesses have been reported in Montana residents as well as people who visited Montana over the 4th of July week including Arizona, Oregon, Wyoming, Florida, Virginia and Canada.

On July 25th, FCCHD and DPHHS received confirmatory testing results of clinical and food samples verifying ground beef as the exposure of concern. Specifically, the source of the outbreak was wagyu beef from one lot number. All cases reported eating undercooked or made-to-order burgers made with wagyu beef at one of multiple restaurants in Flathead County. The last known date of consumption was July 14, 2024.

Lower Valley Processing products are the source of the outbreak and were labeled with “Lower Valley Processing, Co.,” establishment number “EST. 007” inside the Montana mark of inspection on the product labels, and lot numbers 1398, 1399 and 1400. In addition, Range Land & Cattle has been implicated as well.

All potentially affected products have been removed from the marketplace by public health officials, the Department of Livestock and Lower Valley Processing. Some products may have been sold direct to consumers prior to discovery of potential contamination.

The following restaurants are associated with the 14 cases of reported illness in this outbreak: Gunsight Saloon; Hops Downtown Grill; Tamarack Brewing Company; the Lodge at Whitefish Lake; and Harbor Grille. Furthermore, based on information provided through case investigation, one individual has died after exposure to wagyu beef consumed at Harbor Grille. 

The Flathead City-County Health Department (FCCHD), the Montana Department of Public Health and Human Services (DPHHS), and other local health departments, are working together to investigate an E.coli O157:H7 outbreak originating in Flathead County.

To date, the investigation has identified at least 14 individuals associated with the outbreak. Many of the cases experienced moderate to severe symptoms, and one death has occurred. Preliminary investigative findings indicate that ground beef containing the E.coli bacteria may be the exposure of concern. State partners continue to test clinical and food samples for laboratory confirmation.mp

The FCCHD and DPHHS investigation has determined that the ground beef identified as the potential source of the outbreak was sold directly to several restaurants from a distributor. The product was not available for purchase by consumers in grocery store settings. Public health staff worked directly with all affected facilities to remove any remaining product. The last known date of consumption of the product was July 14th, 2024.

“We send our condolences to all family and friends that have been affected by this death,” said Jennifer Rankosky, Health Officer of the Flathead City-County Health Department. “Our staff continue to work diligently through this investigation and were able to identify a suspect source early to mitigate risks and prevent others from getting sick.”

E. coli O157 infections can be caused by a person eating a product that is contaminated with this strain of bacteria. Symptoms of E. coli infection include severe stomach cramps, bloody diarrhea, vomiting, fever, and chills. In severe cases, the infection can also damage organs. Symptoms of E. coli infection occur between one and ten days after exposure, with an average of three to four days after exposure. Individuals that may be experiencing these symptoms are encouraged to contact their healthcare provider.

E. coli infections can be prevented by taking the following precautions:

• Cook ground beef and pork to a minimum internal temperature of 160°F. Do not eat rare or undercooked ground beef.

• Always carefully wash hands with soap and warm water after using the bathroom and changing diapers, and before handling or eating any food.

• Always wash hands after contact with farm animals, animal feces, and animal environments.

• Wash raw fruits and vegetables before eating.

• Keep raw meat separate from produce and other foods when shopping for and storing groceries.

• Avoid unpasteurized beverages. FCCHD encourages individuals to take precautionary measures to prevent foodborne illness.

For more information about E. coli and illness prevention tips, visit https://www.cdc.gov/ecoli/about/index.html.

E. coli:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. colioutbreaks 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 Kiner, Stephanie 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.

Additional Resources:

As of 25 June, there have been a further 19 cases associated with the recent outbreak of STEC O145 since the last update a week ago, bringing the total number of confirmed cases to 275 in the UK. All currently confirmed cases had symptom onset dates before 4 June. Although case reporting rates are declining, we expect to see more cases linked to this outbreak as further samples are referred to us from NHS laboratories and whole genome sequencing is conducted.

Confirmed case totals:

  • 182 in England
  • 58 in Scotland
  • 31 in Wales
  • 4 in Northern Ireland (evidence suggests that they acquired their infection in England)

Based on information from 249 cases to date, 49% were admitted to hospital.

Through surveillance, UKHSA has identified 2 individuals in England who died within 28 days of infection with the STEC outbreak strain. Based on the information available from health service clinicians one of these deaths is likely linked to their STEC infection. Both individuals had underlying medical conditions. The deaths occurred in May.

Cargill Meat Solutions, a Hazleton, Pa., establishment, is recalling approximately 16,243 pounds of raw ground beef products that may be contaminated with E. coliO157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The raw ground beef items were produced on April 26-27, 2024. The following products are subject to recall [view labels]:

  • 2.25-lbs. plastic-wrapped trays containing “93% LEAN 7% FAT ALL NATURAL LEAN GROUND BEEF” with lot code 117 and establishment number “EST. 86P” printed on the back of the label.
  • 1.33-lbs. plastic-wrapped trays containing four “PRIME RIB BEEF STEAK BURGERS PATTIES” with lot code 118 and establishment number “EST. 86P” printed on the back of the label.
  • 2.25-lbs. plastic-wrapped trays containing “85% LEAN 15% FAT ALL NATURAL ANGUS PREMIUM GROUND BEEF” with lot code 117 and establishment number “EST. 86P” printed on the back of the label.
  • 2.25-lbs. plastic-wrapped trays containing “80% LEAN 20% FAT ALL NATURAL GROUND BEEF CHUCK” with lot code 118 and establishment number “EST. 86P” printed on the back of the label.
  • 1.33-lbs. plastic-wrapped trays containing four “80% LEAN 20% FAT ALL NATURAL GROUND BEEF CHUCK PATTIES” with lot code 118 and establishment number “EST. 86P” printed on the back of the label.
  • 1.33-lbs. plastic-wrapped trays containing four “90% LEAN 10% FAT ALL NATURAL GROUND BEEF SIRLOIN PATTIES” with lot code 118 and establishment number “EST. 86P” printed on the back of the label.

The products subject to recall all bear the USDA mark of inspection on the front of the product label, and establishment number “EST. 86P” printed on the back of the product label. These items were shipped to Walmart retail locations nationwide.

The establishment reported the issue to FSIS after they identified that previously segregated product had been inadvertently utilized in the production of ground beef.

There have been no confirmed reports of adverse reactions due to consumption of these products. Anyone concerned about an illness should contact a healthcare provider.

E. coli O157:H7 is a potentially deadly bacterium that can cause dehydration, bloody diarrhea and abdominal cramps 2-8 days (3-4 days, on average) after exposure the organism. While most people recover within a week, some develop a type of kidney failure called hemolytic uremic syndrome (HUS). This condition can occur among persons of any age but is most common in children under 5-years old and older adults. It is marked by easy bruising, pallor, and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately.

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

On 04/26/2024, Gibson Farms recalled Organic Light Halves and Pieces shelled walnuts because Gibson Farms received information that they may have the potential to be contaminated with E. Coli 0157:H7. E. coli O157:H7 causes a diarrheal illness often with bloody stools. Although most healthy adults can recover completely within a week, some people can develop a form of kidney failure called Hemolytic Uremic Syndrome (HUS). HUS is most likely to occur in young children and the elderly. The condition can lead to serious kidney damage and even death.

The Organic Light Halves and Pieces shelled walnuts were sold to distributors located in CA and WA. Gibsons Farms Organic Light Halves and Pieces shelled walnuts were sold in bulk boxes in Net Wt. 25 lbs quantities and can be identified by lot 3325-043 & 3341-501 with expiration dates 5/21/25 & 6/7/25.

Gibson Farms, Inc. has voluntarily recalled the product(s) after being notified by the CDC of 12 recorded illnesses allegedly linked to the consumption of organic halves and pieces shelled walnuts. A full investigation is currently under way to determine the potential source of the contamination.

Gibson Farms requests consignees to hold and discontinue selling their existing stock of lot 3325-043 and lot 3341-501 and return any remaining inventory of the recalled products to our local warehouse Gibson Farms 1190 Buena Vista Rd Hollister Ca 95023. If you have distributed or sold this product to other retailers, please notify your clients as to the status of this product. Any retailers that have received the recalled walnuts are recommended to do the following:

  • Retailers that received recalled products and do not clean and sanitize bulk bins between refilling them, should discard the contents of the bin and clean and sanitize it before refilling.
  • Retailers that received recalled product from a distributor but do not know the brand or lot code information, you should hold product, sanitize your bins, and contact your supplier.

FDA has reason to believe that the following retail locations received the walnuts, included in the recall by Gibson Farms. These products may have been repacked from their original packaging or sold in bulk. This list may not include all retail establishments that have received the recalled product or may include retail establishments that did not actually receive the recalled product. Therefore, it is important that you use the product-specific identification information, available here, in addition to this list of retail stores, when you check the food you have to see if it has been recalled.

Retail Locations that Received Gibson Farms Walnuts

Summary

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.

Illnesses

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.