This Notice has been updated to include one additional case of E.coli O157:H7 in British Columbia and to indicate the closing of the investigation.

Since our last update, one additional case has been reported in British Columbia as part of this investigation. This is not a recent case; the individual became ill in late September. In total, 28 cases were reported as part of this outbreak. Collaborative investigation efforts by provincial and federal health authorities and food regulatory partners confirmed that certain unpasteurised cheese products manufactured by Gort’s Gouda Cheese Farm in Salmon Arm, British Columbia, were identified as the source of the illnesses.

Given no new cases have occurred since the end of September, this outbreak appears to be over. The outbreak investigation is now closed.

For a list of affected cheese products, check the Canadian Food Inspection Agency’s website. Do not eat any of the recalled product. Check your refrigerator and if you have any of the recalled product in your home, return it to the point of purchase or throw it out.

The Public Health Agency of Canada, in collaboration with provincial/territorial partners, will continue to monitor for and investigate any new cases of E. coli that may be related to this outbreak as part of its routine surveillance activities.

A total of 28 cases of illness were reported as part of this outbreak; 13 in British Columbia, 10 in Alberta, 2 in Saskatchewan, 2 in Manitoba and 1 in Quebec. More information about the epidemiological investigation is also available.

More information about products that have been recalled and how the investigation has unfolded is available on the CFIA website.

As of November 10, 2013, a total of 26 persons infected with the outbreak strain of STEC O157:H7 have been reported from three states.

The number of ill persons identified in each state is as follows: Arizona (1), California (22), and Washington (3).

28% of ill persons have been hospitalized. Two ill persons have developed hemolytic uremic syndrome (HUS), and no deaths have been reported.

The STEC O157:H7 PFGE pattern in this outbreak is new to the PulseNet database.

Epidemiologic and traceback investigations conducted by local, state, and federal officials indicate that consumption of two ready-to-eat salads, Field Fresh Chopped Salad with Grilled Chicken and Mexicali Salad with Chili Lime Chicken, produced by Glass Onion Catering and sold at Trader Joe’s grocery store locations, are one likely source of this outbreak of STEC O157:H7 infections.

On November 10, 2013, Glass Onion Catering voluntarily recalled numerous ready-to-eat salads and sandwich wrap products that may be contaminated with STEC O157:H7.

Read the list of recalled products regulated by USDA’s Food Safety and Inspection Service (FSIS).

Read the list of recalled products regulated by the U.S. Food and Drug Administration (FDA).

Product shipped to Arizona, California, Nevada, New Mexico, Oregon, Texas, Utah and Washington.

Glass Onion Catering, a Richmond, Calif. establishment, is recalling approximately 181,620 pounds of ready-to-eat salads and sandwich wrap products with fully-cooked chicken and ham that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The company announced that the products are being recalled in conjunction with other foods regulated by the Food and Drug Administration (FDA). A full list of products being recalled will be available on FDA’s website.

Products regulated by FSIS bear the establishment number “P-34221” inside the USDA mark of inspection. FSIS products subject to recall include:

12 oz. packages of  “delish pan pacific chop salad”
13.4 oz. packages of  “delish California style grilled chicken salad”
9.9 oz. packages of  “delish uncured applewood smoked ham & cheese wrap”
10.5 oz. packages of “delish grilled chicken caesar wrap”
10.9 oz. packages of  “delish southwestern chicken wrap”
11.5 oz. packages of  “delish greek brand low-calorie grilled chicken wrap”
9.9 oz. packages of  “delish white chicken club wrap”
11.2 oz. packages of  “delish asian style chicken wrap”
13.4 oz. packages of  “atherstone Fine Foods Southwestern Style White Chicken Wrap with Chimichurri Sauce”
10.5 oz. packages of  “atherstone Fine Foods Asian Style White Chicken Wrap with Mango Vinaigrette”
9.9 oz. packages of  “atherstone Fine Foods Grilled White Chicken Caesar Wrap with Caesar Dressing”
10.7 oz. packages of  “super fresh Foods California Grilled Chicken Salad, Low Fat Mendocino Mustard Dressing”
10.7 oz. packages of  “Lunch Spot Southwestern Style Chicken Wrap, Chile & Lime  Dressing”
9.2 oz. packages of  “super fresh Foods Pan Pacific Chopped Chicken Salad, Ginger Soy Dressing”
10.7 oz. plastic containers of “TRADER JOE’S Field Fresh Chopped Salad with Grilled Chicken.”
11 oz. plastic containers of “TRADER JOE’S MEXICALI SALAD with Chili Lime Chicken.”

The products were produced between Sept. 23 and Nov. 6, 2013 and shipped to distributions centers intended for retail sale in Arizona, California, Nevada, New Mexico, Oregon, Texas, Utah and Washington.

FSIS began monitoring a cluster of E. coli O157:H7 illnesses on Oct. 29, 2013 then was notified by FDA on Nov. 6, 2013 that California authorities had reported case-patients consuming pre-packaged salads with grilled chicken. Working in conjunction with the Centers for Disease Control and Prevention (CDC), FDA, the California Department of Public Health, the Washington State Department of Health, and the Arizona Department of Health Services, FSIS has determined that there is a link between the grilled chicken salads and the illness cluster. Twenty-six case-patients have been identified in three states with indistinguishable E. col iO157:H7 PFGE (genetic fingerprint) patterns with illness onset dates ranging from Sept 29, 2013 to Oct. 26, 2013. Based on epidemiological information, 15 case-patients reported consumption of ready-to-eat pre-packaged salads prior to illness onset. A traceback investigation determined Glass Onion Catering was the supplier of the products implicated in the outbreak.

While uncommon to find E. coli O157:H7 in a poultry product, FSIS will continue its investigation in conjunction with the FDA to identify the source of the contamination. FSIS continues to work with the CDC, FDA and state public health partners on this investigation and will provide updated information as it becomes available.

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 routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers.

FSIS and the company are concerned that some products may be in a consumer’s refrigerators. Because this is a ready-to-eat product, FSIS advises all consumers to destroy the product.

WATE TV reports that Deputies and Health Department workers swarmed a Knox County dairy farm Thursday after health officials say several children were sickened with E. coli linked to consuming raw milk.

The owner of McBee Dairy Farm on Strong Road in Mascot says he warns all her customers about the risk. Tennesseans can legally drink raw milk if they own the cow and McBee Dairy Farm is a privately owned cow-share operation.

At least three children were hospitalized with illness from E. coli.

Fox 31 Denver reports that the Colorado Department of Public Health and Environment, the CDC and the FDA are all investigating an E. coli outbreak in the Denver metropolitan area.

In the second week of October three Jimmy John’s restaurants in the Denver Metro area reportedly served up sandwiches that sickened eight people with E. coli bacteria.

“We believe that their illness came from a produce item that was on those sandwiches that they ate,” said Alicia Cronquit, epidemiologist with the Colorado Department of Public Health and Environment.  Cronquist said all eight cases were reported between October 18th and 22nd, and all of the people impacted ate at Jimmy John’s between October 7th and 15th.

Sound familiar?

Multistate Jimmy John’s Restaurants Raw Clover Sprouts 2011

14 Sickened (possibly 19) – On February 15, 2012, the Centers for Disease Control announced an ongoing investigation into illnesses linked to the consumption of raw clover sprouts consumed at Jimmy John’s Restaurants in several states. The number of ill persons identified in each state is as follows: Iowa (5), Missouri (3), Kansas (2), Michigan (2), Arkansas (1), and Wisconsin (1). Among 11 ill persons with information available, 10 (91%) reported eating at a Jimmy John’s sandwich restaurant in the 7 days preceding illness. Ill persons reported eating at 9 different locations of Jimmy John’s restaurants in 4 states in the week before becoming ill. One Jimmy John’s restaurant location was identified where more than one ill person reported eating in the week before becoming ill. Among the 10 ill persons who reported eating at a Jimmy John’s restaurant location, 8 (80%) reported eating a sandwich containing sprouts, and 9 (90%) reported eating a sandwich containing lettuce. Currently, no other common grocery stores or restaurants are associated with illnesses. Preliminary traceback information has identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John’s restaurant locations where ill persons ate. FDA and states conducted a traceback that identified two separate sprouting facilities; both used the same lot of seed to grow clover sprouts served at these Jimmy John’s restaurant locations. On February 10, 2012, the seed supplier initiated notification of sprouting facilities that received this lot of clover seed to stop using it. Investigations are ongoing to identify other locations that may have sold clover sprouts grown from this seed lot. http://www.cdc.gov/ecoli/2012/O26-02-12/index.html

Sprouters Northwest, Jimmy John’s Restaurants Clover Sprouts 2010

7 Sickened – Sprouters Northwest of Kent, Washington, issued a product recall after the company’s clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John’s restaurants. Jimmy John’s Restaurants are a restaurant chain that sells sandwiches. Concurrent with this outbreak, a separate Salmonella outbreak (Salmonella, serotype I 4,5,12,i- ; see Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John’s Restaurants), involving alfalfa sprouts served at Jimmy John’s restaurants was under investigation. The recall of Northwest Sprouters products included: clover; clover & onion; spicy sprouts; and deli sprouts. The Sprouters Northwest products had been sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan, and Alberta. The FDA inspection found serious sanitary violations. http://www.foodsafetynews.com/2011/01/jimmy-johns-will-switch-to-clover-sprouts/, http://www.oregonlive.com/business/index.ssf/2011/01/jimmy_johns_switches_to_clover.html, http://www.thepacker.com/opinion/fresh-produce-opinion/jimmy_johns_sprout_switch_remains_puzzling_122028204.html

Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John’s Restaurants Alfalfa Sprouts 2010

140 Sickened – On December 17, the Illinois Department of Health announced that an investigation was underway into an outbreak of Salmonella, serotype I4,[5],12:i:-. Many of the Illinois cases had eaten alfalfa sprouts at various Jimmy John’s restaurants in the Illinois counties of: Adams, Champaign, Cook, DuPage, Kankakee, Macon, McHenry, McLean, Peoria, and Will counties. The sprouts were suspected to be the cause of the illnesses. On December 21, Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove sprouts from the menu as a “precautionary” measure. On December 23, the Centers for Disease Control revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts while at a nationwide sandwich chain. On December 26, preliminary results of the investigation indicated a link to eating Tiny Greens’ Alfalfa Sprouts at Jimmy John’s restaurant outlets. The FDA subsequently advised consumers and restaurants to avoid Tiny Greens Brand Alfalfa Sprouts and Spicy Sprouts produced by Tiny Greens Organic Farm of Urbana, Illinois. The Spicy Sprouts contained alfalfa, radish and clover sprouts. On January 14, 2011, it was revealed that the FDA had isolated Salmonella serotype I4,[5],12:i:- from a water runoff sample collected from Tiny Greens Organic Farm; the Salmonella isolated was indistinguishable from the outbreak strain. The several FDA inspections of the sprout growing facility revealed factors that likely led to contamination of the sprouts. http://www.cdc.gov/salmonella/i4512i-/122810/index.html

CW Sprouts, Inc., SunSprout Sprouts, “restaurant chain (Chain A),” a.k.a. Jimmy Johns 2009

256 Sickened – In February, Nebraska Department of Health and Human Services officials identified six isolates of Salmonella Saintpaul. Although this is a common strain of Salmonella, during 2008, only three cases had been detected in Nebraska and only four subtypes of this outbreak strain had been identified in 2008 in the entire USA. As additional reports were made, a case control study was conducted; alfalfa sprout consumption was found to be significantly related to illness. The initial tracebacks of the sprouts indicated that although the sprouts had been distributed by various companies, the sprouts from the first cases originated from the same sprouting facility in Omaha, Nebraska. Forty-two of the illnesses beginning on March 15 were attributed to sprout growing facilities in other states; these facilities had obtained seed from the same seed producer, Caudill Seed Company of Kentucky. The implicated seeds had been sold in many states. On April 26, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Company of Kentucky, was withdrawing all alfalfa seeds with a specific three-digit prefix.  Many of the illnesses occurred at “restaurant chain (Chain A).” http://www.cdc.gov/salmonella/saintpaul/alfalfa/, http://www.whas11.com/news/iteam/Salmonella-Outbreak-Linked-to-Louisville-Seed-Company-83577137.html, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5818a4.htm, See PDF linking outbreak to Jimmy John’s a.k.a. “restaurant chain (Chain A)”

Jimmy John’s Restaurant Alfalfa Sprouts and Iceberg Lettuce 2008

28 Sickened – Several University of Colorado students from one sorority became ill with symptoms of bloody diarrhea and cramping. Additional illnesses were reported. E. coli O157:NM(H-) was determined to be the cause. Consumption of alfalfa sprouts at the Jimmy John’s Restaurants in Boulder County and Adams County were risk factors for illness. In addition, the environmental investigation identified Boulder Jimmy John’s food handlers who were infected with E. coli and who had worked while ill. The health department investigation found a number of critical food handling violations, including inadequate handwashing. The fourteen isolates from confirmed cases were a genetic match to one another. http://www.thedenverchannel.com/news/17669936/detail.html