According to the St. Louis Post-Dispatch, Five people have become ill with E. coli after visiting Grant’s Farm since late May, the Missouri Department of Health and Senior Services said Friday. The DHSS, along with the state and federal departments of agriculture and St. Louis area health agencies, is investigating what specifically led to the Shiga toxin-producing E. coli, or STEC.

Shiga toxin is harmful to humans. Symptoms can begin one to 10 days after exposure and can include severe stomach cramps, bloody diarrhea, vomiting and sometimes a low fever. Most people get better in about a week, according to the DHSS, but some infections can be severe or even life-threatening.

Grant’s Farm is participating in the investigation and is allowing investigators to take samples from the animals. Grant’s Farm already takes part in routine visits from state inspectors that provide oversight for the health of all the animals in the park, according to a DHSS statement.

While the investigation is taking place, the health department’s preliminary recommendation to Grant’s Farm is to remind patrons of the importance of washing their hands after having direct contact with animals.

“At Grant’s Farm, the safety of our patrons, our employees, and our animal population is our highest priority,” a Grant’s Farm official said in a statement. “Out of an abundance of caution, we will also be taking further safety measures, including the addition of several more hand-washing/antibacterial stations, and increased signage to remind our visitors of the importance of proper hygiene after coming into contact with the animals.”

Five to 10% of those infected with STEC can develop a serious kidney condition called hemolytic uremic syndrome, which requires hospitalization and can be fatal. Antibiotic treatment of STEC might increase a person’s risk for developing the syndrome and is not recommended, according to the DHSS.

King Arthur Flour has recalled 14,218 cases of 5-pound bags of its unbleached all-purpose flour because the products may be contaminated with E. coli, the company announced. The products were shipped to stores nationwide.

The Centers for Disease Control and Prevention is currently investigating an outbreak of E. coli O26 related to flour. Seventeen people in eight states have been sickened, and three have been hospitalized.

There are no reports of illnesses connected to King Arthur Flour.

Two people reported eating raw dough or batter made with flour or baking mixes from the supermarket chain ALDI, which recalled 5-pound bags of its Baker’s Corner All Purpose Flour in late May.

The Food and Drug Administration is investigating which other brands may be involved in the outbreak.

The recalled King Arthur bags are marked with one of three “best used by” dates and one of six lot codes:

• A best used by date of 12/07/19 and lot code L18A07C;

• A best used by date of 12/08/19 and lot code L18A08A or L18A08B;

• Or a best used by date of 12/14/19 and lot code of L18A14A, L18A14B, or L18A14C.

Check the bottom of the side panel, below the Nutrition Facts box, to find the “best used by” date and lot number, the company advises. If you have any of the affected product in your home, don’t use the flour—return it to the store or throw it away.

The recalled products were shipped only to stores. No King Arthur products sold online are involved in the recall, nor are any products sold through its Baker’s Catalogue; Baker’s Store in Norwich, Vt.; or Baking School in Burlington, Wash. Any remaining products in the recall have been pulled from grocery store shelves, says King Arthur spokesperson Gwen Adams, but consumers could still have the products in their homes.

King Arthur says it was alerted by one of its suppliers, ADM Milling Co., that the wheat used in the recalled products has been linked to the ongoing E. coli outbreak.

E. coli contamination in flour often begins when the wheat used to make it is tainted with animal waste while in the field, says James E. Rogers, Ph.D., director of food safety research and testing at Consumer Reports.

“Consumers should resist the temptation to eat raw dough or batter,” Rogers says. Bacteria that can cause foodborne illness can lurk in both uncooked flour and raw eggs. And don’t let kids make homemade play dough with raw flour either.

“When it comes time to cook, make sure to cook food thoroughly,” Rogers says, because cooking will kill the bacteria. And carefully clean any prep areas, dishes, and utensils used in cooking. Wipe raw flour off any countertops, and wash dishes with warm, soapy water or run them through a hot dishwasher cycle.

As of May 24, 2019, 17 people infected with the outbreak strain of E. coli O26 have been reported from 8 states.

Illnesses started on dates ranging from December 11, 2018 to April 18, 2019. Ill people range in age from 7 to 86 years, with a median age of 23. Sixty-five percent of ill people are female. Of 17 people with information available, 3 have been hospitalized. No deaths have been reported

Illnesses might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

Epidemiologic and laboratory evidence indicates that flour is a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of seven people who were interviewed, four (57%) reported eating, licking, or tasting raw, homemade dough or batter. Two people with detailed information reported eating raw dough or batter made with flour or baking mixes from ALDI.

Investigators with the Rhode Island Department of Health collected records and flour samples at a bakery where an ill person reported eating raw dough. Records indicated that the bakery used Baker’s Corner All Purpose Flour from ALDI. The outbreak strain was isolated from an unopened bag of Baker’s Corner All Purpose Flour collected at the bakery.

WGS results showed that the E. coli O26 strain identified in the Baker’s Corner All Purpose Flour sample was closely related genetically to the E. coli O26 strain identified in ill people. These results provide additional evidence that people in this outbreak got sick from eating flour.

On May 23, 2019, ALDI, in association with ADM Milling Co., recalled 5 lb. bags of Baker’s Corner All Purpose Flour sold at retail locations in the following states because they may be contaminated with E. coli: Connecticut, Delaware, Massachussetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, and West Virginia.

This investigation is ongoing. FDA is working to determine whether other brands or lots of flour may be potentially contaminated and need to be recalled.

Florida 5, Georgia 49, Illinois 1, Indiana 1, Kentucky 69, Minnesota 1, Mississippi 1, Ohio 12, Tennessee 55 and Virginia 2

Since the last update on April 26, 2019, 19 more ill people were added to this outbreak.

As of May 13, 2019, 196 people infected with the outbreak strain of E. coli O103 have been reported from 10 states. CDC is reporting the 196 illnesses that the PulseNet laboratory network has confirmed are part of this outbreak. States are investigating additional illnesses that might be a part of this outbreak. A list of the states and the number of confirmed cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates from March 1, 2019, to April 19, 2019. Ill people range in age from less than 1 year to 84 years, with a median age of 19. Fifty-two percent are female. Of 174 people with information available, 28 (16%) have been hospitalized. No deaths and two cases of hemolytic uremic syndrome have been reported.

This multistate investigation began on March 28, 2019, when officials in Kentucky and Georgia notified CDC of this outbreak. Epidemiologic and laboratory evidence indicates that ground beef is the likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of the 147 people interviewed, 115 (78%) reported eating ground beef. This percentage is significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy people. Ill people bought or ate ground beef from several different grocery stores and restaurants. Many ill people bought large trays or chubs of ground beef from grocery stores and used the meat to make dishes like spaghetti sauce and sloppy joe.

Officials in Tennessee collected ground beef from a restaurant where ill people reported eating. Laboratory testing identified the outbreak strain of E. coli O103 in the ground beef collected in Tennessee.

Two companies recalled raw ground beef products because they may be contaminated with E. coli. Grant Park Packing in Franklin Park, Ill., recalled approximately 53,200 pounds of raw ground beef products on April 24, 2019. K2D Foods, doing business as Colorado Premium Foods, in Carrollton, Ga., recalled approximately 113,424 pounds of raw ground beef products on April 23, 2019. These products were sold to restaurants and institutions.

USDA-FSIS and state regulatory officials continue to collect products for testing and continue their traceback investigations to determine the source of ground beef supplied to grocery stores and restaurants where ill people ate. At this time, no common supplier, distributor, or brand of ground beef has been identified that could account for the whole outbreak.

As of April 25, 2019, 177 people infected with the outbreak strain of E. coli O103 have been reported from 10 states. CDC is reporting the 177 illnesses that the PulseNet laboratory network 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 1, 2019, to April 14, 2019. Ill people range in age from less than 1 year to 84 years, with a median age of 18. Fifty-one percent are female. Of 143 people with information available, 21 (15%) have been hospitalized. No deaths and no cases of hemolytic uremic syndrome have been reported.

Illnesses that occurred after March 29, 2019, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

This multistate investigation began on March 28, 2019, when officials in Kentucky and Georgia notified CDC of this outbreak. Epidemiologic and laboratory evidence indicates that ground beef is the likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of the 125 people interviewed, 100 (80%) reported eating ground beef. This percentage is significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy people. Ill people bought or ate ground beef from several different grocery stores and restaurants. Many ill people bought large trays or chubs of ground beef from grocery stores and used the meat to make dishes like spaghetti sauce and sloppy joe.

Officials at USDA-FSIS, in Kentucky, and in Tennessee collected ground beef from a restaurant and an institution where ill people reported eating. Laboratory testing identified the outbreak strain of E. coli O103 in the ground beef collected in Tennessee. E. coli O103 was identified in the ground beef collected in Kentucky, but laboratory results are pending to determine if it is closely related to the E. coli O103 identified in ill people.

State Ill People
Florida 3
Georgia 41
Illinois 1
Indiana 1
Kentucky 65
Minnesota 1
Mississippi 1
Ohio 10
Tennessee 52
Virginia 2
Total 177

Two companies recalled raw ground beef products because they may be contaminated with E. coli. Grant Park Packing in Franklin Park, Ill., recalled approximately 53,200 pounds of raw ground beef products on April 24, 2019. K2D Foods, doing business as Colorado Premium Foods, in Carrollton, Ga., recalled approximately 113,424 pounds of raw ground beef products on April 23, 2019. These products were sold to restaurants and institutions.

FSIS reported moments ago, K2D Foods, doing business as (DBA) Colorado Premium Foods, a Carrolton, Ga. establishment, is recalling approximately 113,424 pounds of raw ground beef products that may be contaminated with E. coli O103, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.  This is a Class I Recall.

The raw ground beef items were produced on March 26, March 29, April 2, April 5, April 10, and April 12, 2019.  The following products are subject to recall:

  • Two 24-lb. vacuum-packed packages in cardboard boxes containing raw “GROUND BEEF PUCK” with “Use Thru” dates of 4/14/19, 4/17/19, 4/20/19, 4/23/19, 4/28/19, and 4/30/19.

The products subject to recall bear establishment number “EST. 51308” inside the USDA mark of inspection on the boxes. These items were shipped to distributors in Ft. Orange, Fla. and Norcross, Ga. for further distribution to restaurants.

FSIS and its public health partners, including the Centers for Disease Control and Prevention (CDC) and the Tennessee Department of Health, have been investigating an outbreak of E. coli O103. Unopened, intact ground beef collected as part of the ongoing investigation from a restaurant location, where multiple case-patients reported dining, tested positive for E. coli O103. At this time, there is no definitive link between this positive product and the ongoing E. coli O103 outbreak. Further traceback and product analysis continues to determine if the recalled products are related to the E. coli O103 outbreak.

According to the CDC, a total of 156 people infected with the outbreak strain of E. coli O103 have been reported from 10 states – Minnesota, Illinois, Indiana, Ohio, Kentucky, Tennessee, Virginia, Mississippi, Georgia and Florida.

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 exposure to 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.

FSIS is concerned that some product may be in refrigerators or freezers of restaurants. Restaurants that have purchased these products are urged not to serve them.

Since the last update on April 9, 2019, 13 more ill people were added to this outbreak.

As of April 12, 2019, 109 people infected with the outbreak strain of E. coli O103 have been reported from six states. CDC is reporting the 109 illnesses that the PulseNet laboratory network has confirmed are part of this outbreak. States are investigating additional illnesses that might be a part of this outbreak. A list of the states and the number of confirmed cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates from March 2, 2019, to March 26, 2019. Ill people range in age from less than 1 year to 83 years, with a median age of 18. Fifty-three percent are female. Of 81 people with information available, 17 (21%) have been hospitalized. No deaths and no cases of hemolytic uremic syndrome have been reported.

Illnesses that occurred after March 20, 2019, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

This multistate investigation began on March 28, 2019, when officials in Kentucky and Georgia notified CDC of this outbreak. Preliminary epidemiologic information suggests that ground beef is the source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Sixty-three (84%) of 75 people interviewed reported eating ground beef. This percentage is significantly higher than results from a survey Cdc-pdf[PDF – 787 KB] of healthy people. Ill people bought or ate ground beef from several different grocery stores and restaurants. Many ill people bought large trays or chubs of ground beef from grocery stores and used the meat to make dishes like spaghetti sauce and sloppy joe.

Traceback investigations are ongoing to determine the source of ground beef supplied to grocery stores and restaurants where ill people ate. At this time, no common supplier, distributor, or brand of ground beef has been identified

As of April 8, 2019, 96 people infected with the outbreak strain of E. coli O103 have been reported from five states. CDC is reporting the 96 illnesses that the PulseNet laboratory network 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 26, 2019. Ill people range in age from 1 to 81 years, with a median age of 17. Fifty-one percent are female. Of 67 people with information available, 11 (16%) have been hospitalized. No deaths and no cases of hemolytic uremic syndrome 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. Federal and state regulatory officials use that information to guide efforts to identify a contaminated food and trace it to its source. Learn more about how public health and regulatory agencies investigate a foodborne disease outbreak.

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.

Kentucky, Tennessee, Georgia, Ohio and Virginia linked in growing E. coli Mystery

According to the Kentucky Department of Health and press reports, an E. coli outbreak in Kentucky has now doubled to more than 40 cases. The department confirmed Thursday that Kentucky now has at least 46 cases involving a strain of E. coli O103.

The department issued a news release last Friday, saying that 20 Kentuckians had tested positive for a Shiga-toxin producing strain that can lead to kidney failure. The number of known hospitalizations remains at six.

Some two dozen counties, including Shelby and Fayette, have reported cases in this outbreak, according to the department. Many of the initial patients were in central Kentucky but there also have been cases in northern, eastern and western Kentucky.

Cases also have been identified in Tennessee, Georgia, Ohio and Virginia, according to the department. A representative of the U.S. Centers for Disease Control and Prevention had no immediate information to convey Thursday.

The specific source of the outbreak is still being investigated, but a food source is suspected based on the interview responses of affected individuals, according to the department.

“Exposure to E. coli bacteria can be debilitating and potentially life-threatening, especially for small children and individuals with weakened immune systems,” Kentucky Public Health Commissioner Jeffrey Howard said last week. “With this in mind, the Department for Public Health has taken swift action to identify patients, ensure appropriate testing, and follow-up care as we work to determine the source of the outbreak.”

Also, health care providers across the state “have been alerted to this potential threat and are working with us to make sure patients are identified and are receiving appropriate care,” he said. “Meanwhile, we encourage all Kentuckians to be aware of the signs and symptoms of E. coli illness and to seek care if they are ill.”

People generally become ill two to five days after consuming tainted food, according to the department. Symptoms of infection include stomach cramps and diarrhea, which is sometimes bloody.

It’s also possible to develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). The condition requires hospitalization because the kidneys may stop working, according to the CDC.

“Clues that a person is developing HUS include decreased frequency of urination, feeling very tired and losing pink color in cheeks and inside the lower eyelids,” the CDC notes. “Most persons with HUS recover within a few weeks, but some suffer permanent damage or die.”

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