Outbreak of E. coli Infections – Unknown Source 2

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Posted on November 23, 2020 at 2:00 PM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating several multistate outbreaks of E. coli O157:H7 infections. This outbreak is different from two other E. coli O157:H7 outbreaks CDC is currently investigating (E. coli outbreak with unknown source 1 and E. coli outbreak with unknown source 3).

Latest Outbreak Information
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At A Glance
  • Since the last update on October 28, 2020, 16 ill people were added to this investigation.
  • CDC is not advising people avoid any particular food at this time.
  • Investigators are working to collect different types of data to identify the source of this outbreak.
  • CDC will provide updates as they become available.
Advice to Consumers
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Take action if you have symptoms of an E. coli infection:

  • Talk to your healthcare provider.
  • Write down what you ate in the week before you got sick.
  • Report your illness to your local or state health department.
  • Help us solve the outbreak by answering public health officials’ questions about your illness.

Follow these general ways to prevent getting sick from E. coli:

  • Wash your hands after using the restroom or changing diapers, before and after preparing or eating food, and after contact with animals.
  • Cook meats thoroughly. Use a food thermometer to check that the meat has reached a safe internal temperatureexternal icon.
  • Don’t cross-contaminate food preparation areas. Thoroughly wash hands, counters, cutting boards, and utensils after touching raw meat.
  • Wash fruits and vegetables before eating, unless the package says the contents have been washed.
  • Avoid raw milk, other unpasteurized dairy products, and unpasteurized juices.
Symptoms of E. coli Infection
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  • People usually get sick from Shiga toxin-producing E. coli (STEC) 2 to 8 days (average of 3 to 4 days) after swallowing the germ.
  • Symptoms often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may have a fever, which usually is not very high (less than 101˚F/38.5˚C).
  • Some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS).
  • Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing HUS, and a benefit of treatment has not been clearly demonstrated.
  • For more information, see Symptoms of E. coli Infection.
Investigation Details

November 23, 2020

Since the last update on October 28, 2020, 16 ill people were added to this investigation.

As of November 19, 2020, a total of 39 people infected with the outbreak strain of E. coli O157:H7 have been reported from 18 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates ranging from August 10, 2020, to October 23, 2020. Ill people range in age from 1 to 85 years, with a median age of 38 years, and 62% are female. Of 30 ill people with information available, 19 people were hospitalized and 4 people developed hemolytic uremic syndrome (HUS), a type of kidney failure. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 2 to 4 weeks. Please see the Timeline for Reporting Cases of E. coli O157 Infection for more details.

Investigation of the Outbreak

Investigators are continuing to collect different types of data to identify the source of this outbreak.

State and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before they got sick. Of the 22 ill people interviewed to date, all reported eating a variety of leafy greens, like spinach (16), romaine lettuce (15), iceberg lettuce (12), and mixed bag lettuce (8). No single type or brand of leafy greens or other food item has been identified as the source of this outbreak. CDC is not advising people avoid any particular food at this time.

This investigation is ongoing, and CDC will provide more information as it becomes available.

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