The Centers for Disease Control and Prevention said Friday it has yet to determine the source of an E. coli outbreak that has infected 72 people in five states — an admission one expert in food-borne illness called “perplexing,” considering how many have become sick.

The recent spate of sickness, which began March 2, is directly linked to a strain of E. coli known as “O103,″ according to the CDC. Eight people have been hospitalized as a result of the O103 outbreak, however, no deaths have been reported. The patients’ ages range from 1 to 74 years old with a median age of 17.

Symptoms of E. coli infection often include severe stomach cramps, diarrhea and vomiting, typically occurring three days after consuming the bacteria. The states affected by the outbreak are Ohio, Virginia, Kentucky, Tennessee and Georgia.

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Bill Marler, a food safety lawyer from Seattle with more than 25 years of experience, told The Washington Post there’s “no question” the patients in this case share one common source of infection. It’s “concerning,” he said, that the CDC has yet to pinpoint the source to a specific food item, grocery store or restaurant chain.

“Given the size and the number of states that are involved, what you’re seeing is very unusual,” Marler said. “If it was five people or 10 people, that’s a little harder to figure out. But when there’s 72 people and they’re being interviewed by epidemiologists, it’s pretty unusual you don’t have a culprit.”

He added: “The real question is, what do 72 people have in common over five states? It has to be something.”

That something, Marler said, is likely a food or water product that people can’t remember they ate. State and local health officials are required to interview ill patients and determine what they consumed in the week leading up to their symptoms, but recalling one’s dietary choices is oftentimes easier said than done, he said.

Condiments, garnish, toppings, and spices can all contain traces of E. coli. But it’s unlikely the patients in this outbreak were keeping track of all the additives in their recent diets, he added.

“That’s probably why it’s taking longer to figure out — because people can’t remember what was in their meal,” Marler said.

Citing a CDC data set that dates back to 1998, Marler noted outbreaks of E. coli O103 are relatively uncommon. Eighteen such outbreaks have been reported in the United States since 2000, with the highest number of reported illnesses being 29 during a 2010 outbreak in Minnesota.

That makes this O103 outbreak by far the largest in recent memory, he said.

It’s likely that number will grow. Marler said the CDC estimates that for every person reported sick, there are 5 to 10 ill people who have not been accounted for. “I would expect to see the numbers at least double in the next 10 days unless immediate action is taken this weekend,” he said.

Thirty-six of the reported illnesses in this case stem from Kentucky. Last week, local health officials issued an alert for a “sudden increase in O103 cases” in the state, according to the Mercer County Health Department, which wrote in a Facebook post the illnesses were found in “children and teenagers with extensive exposure to fast food.”

If that’s true, Marler said, it corresponds to the dietary habits of many 17-year-olds: the reported median patient age.

“It definitely does underscore it’s probably some convenience, fast food consumed by kids,” he said. One silver lining, he added, is that people in this age range are typically healthy and not prone to further complications from E. coli.

To avoid disease, the CDC advises that people cook foods thoroughly, wash fruits and vegetables and limit consumption of raw or unpasteurized juice and dairy products. Hand washing can also help prevent contamination.

But Marler says people fearing illness should go one step further: avoid uncooked food items entirely, at least until the CDC draws its conclusion.

“It won’t kill you not to have a salad or smoothie made with fresh fruits and vegetables,” Marler said. “You can live without that for a couple days as this shakes out.”

Lena H. Sun contributed to this report.

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Why E. coli keeps getting into our lettuce

This public health corps deploys to disasters, disease outbreak. The White House wants to cut it by 40 percent</s>Health officials are investigating an E. coli outbreak that has sickened 72 people across five states, federal health agencies said Friday.

Eight people have been hospitalized, the Centers for Disease Control and Prevention said in a statement announcing the outbreak. The CDC is working with the Food and Drug Administration and Department of Agriculture's Food Safety and Inspection Service to investigate the outbreak.

They have not yet pinpointed a specific food, grocery store or restaurant chain that's responsible for the infections. Therefore, the CDC is not recommending people avoid a particular food.

E. coli O103 is the particular strain involved in the cases, which were reported between March 2 and March 29, the CDC said. The people infected range between the ages of 1 to 74, with 17 being the median age.

Last year, an E. coli outbreak linked to romaine lettuce sickened 62 people across 16 states and Washington, DC.</s>FILE PHOTO: A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo

(Reuters) - The Centers for Disease Control and Prevention (CDC) and several other U.S. agencies are investigating an E.coli outbreak in five states, the CDC said https://www.cdc.gov/ecoli/2019/o103-04-19/map.html on Friday.

The CDC, the U.S. Department of Agriculture's Food Safety and Inspection Service, the U.S. Food and Drug Administration and several states are investigating the outbreak of toxin-producing E.coli O103 infections.

Escherichia coli, or E.coli bacteria, normally lives in the intestines of healthy people and animals. Although many strains of the bacteria are harmless, certain strains can cause severe abdominal cramps, bloody diarrhea and vomiting.

Georgia, Kentucky, Ohio, Tennessee and Virginia are the five states that have reported E.coli infections relating to particular strain of the bacteria.

As many as 72 people from these states have reported infections and eight have been hospitalized as of April 4, 2019, the agency said. No deaths were reported.

The investigation is still going on and the reason for the outbreak is yet to be identified, the agency said.</s>
• An E. coli outbreak has sickened at least 72 people in five states, the CDC announced on Friday.
• Eight people who have been infected have been hospitalized.
• Investigators have not identified any specific food item, grocery store, or restaurant chain as the source of the infections.

E. coli has sickened more than 70 people in five states, and health officials continue to search for the source.

72 people have been infected with an outbreak strain of E. coli O103, the Centers for Disease Control and Prevention announced on Friday. Eight people have been hospitalized.

Investigators are still attempting to pinpoint the source of the outbreak and have not identified any specific food item, grocery store, or restaurant chain as the source of the infections. Illnesses started on the dates from March 2 to March 29.

“CDC is not recommending that consumers avoid any particular food at this time,” the CDC said in a statement. “Restaurants and retailers are not advised to avoid serving or selling any particular food.”

Analysis of the E. coli strain indicates that the ill people appear to share a common source of infection.

With more than 70 people sickened, this E. coli outbreak is already larger than the most recent major E. coli outbreak, which was linked to romaine lettuce and resulted in 43 reported illnesses across 12 states in late 2018. Previously, in April 2018, the FDA revealed that romaine lettuce harvested in the Yuma, Arizona, region was contaminated with E. coli in a separate outbreak that left five people dead and sickened at least 210.

Read more: Romaine lettuce sales are down more than $71 million so far this year as the industry has been pummeled with food-poisoning outbreaks

So far, there have not been any deaths reported in connection to the most recent E. coli outbreak.

E. coli infections often induce severe stomach cramps, diarrhea, and vomiting. Roughly 5% to 10% of people who are infected develop hemolytic uremic syndrome, a potentially life-threatening kidney complication.

To prevent an E. coli infection, the CDC recommends that people wash their hands, cook meat thoroughly, and avoid cross-contamination of food. Experts also advise people to avoid raw milk and water, unpasteurized juices, and some other high-risk foods.</s>The Centers for Disease Control and Prevention and several other US agencies are investigating an E. coli outbreak in five states, the CDC said here on Friday.

The CDC, the US Department of Agriculture’s Food Safety and Inspection Service, the US Food and Drug Administration and several states are investigating the outbreak of toxin-producing E. coli O103 infections.

Escherichia coli, or E. coli bacteria, normally lives in the intestines of healthy people and animals. Although many strains of the bacteria are harmless, certain strains can cause severe abdominal cramps, bloody diarrhea and vomiting.

Georgia, Kentucky, Ohio, Tennessee and Virginia are the five states that have reported E. coli infections relating to the particular strain of the bacteria.

As many as 72 people from these states have reported infections and eight have been hospitalized as of April 4, 2019, the agency said. No deaths were reported.

The investigation is still going on and the reason for the outbreak is yet to be identified, the agency said.</s>The Centers for Disease Control and Prevention (CDC) and several other U.S. agencies are investigating an E.coli outbreak in five states, the CDC said on Friday.

Per the agency's latest announcement, the bacteria has sickened 72 people across five states in the US.

It is not yet clear what the source of the outbreak is, but it seems to be widespread.

Eight people have been hospitalized and the CDC is warning consumers, restaurants to take precautions to prevent infections while it and other agencies search for the contamination's origin.

The CDC, the US Department of Agriculture's Food Safety and Inspection Service, the US Food and Drug Administration (FDA) and several states are investigating the outbreak of toxin-producing E.coli O103 infections.

Escherichia coli, or E.coli bacteria, normally lives in the intestines of healthy people and animals.

Although many strains of the bacteria are harmless, certain strains can cause severe abdominal cramps, bloody diarrhea and vomiting.

Georgia, Kentucky, Ohio, Tennessee and Virginia are the five states that have reported E.coli infections relating to particular strain of the bacteria.

As many as 72 people from these states have reported infections and eight have been hospitalized as of April 4, 2019, the agency said.

The investigation is still going on and the reason for the outbreak is yet to be identified, the agency said.

This outbreak comes a week after 5,000 lbs of meat were recalled over E. coli fears.

Also last week, the FDA warned that romaine growers failed to prevent last year's deadly E. coli outbrak in an 'epic and tragic' way, and warned that another outbreak is likely this summer.

Last year's romaine outbreak turned deadly because the particular strain of E. coli involved produced Shiga-toxins, which cause much more serious infections.

The mysterious current outbreak involves a different strain of E. coli, but this one, too, produces Shiga-toxins.

State health agencies and hospitals will be on high alert for illnesses related to the outbreak.

To prevent contamination and infections, the CDC is remind the public to make sure to wash their hands well, cook meats thoroughly, keep clean, separate work areas when preparing food, wash fruits and vegetables, avoid raw, unpasteurized dairy products, and stay out of the kitchen when sick.</s>The Kentucky-centered outbreak of the rare E. coli O103 strain infects 72 people in five states, according to the federal Centers for Disease Control and Prevention (CDC) in Atlanta.

Eight people with the outbreak strain have been hospitalized, the CDC report says. No cases of the hemolytic uremic syndrome (HUS) or deaths have been reported.

CDC says the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), the U.S. Food and Drug Administration (FDA), and several states are also involved in the ongoing investigation.

 The probe has yet to identify a specific food item, grocery store or restaurant that is responsible for the outbreak.

CDC’s report, coming shortly before noon on Friday, was the first information released by the federal agency since Kentucky officials a week earlier disclosed the outbreak occurrence.

“This is a rapidly evolving investigation,” CDC said. “We will update our advice if a source is identified.”

People infected with the outbreak strain of E. coliO103, by state of residence, as of April 4, 2019 (n=72)

Illness from the outbreak strain occurred from March 2 to 29, 2019. People infected range in age from 1 to 74 years, with a median age of 17. CDC finds 55 percent are female. From those available to provide information, eight or 17 percent required hospital care.

CDC’s case count of 72 is current as of April 4, 2019. Public health investigators are using the PulseNet system to identify illnesses that may be part of the 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 the illness,” CDC concluded.

Advice From CDC for Consumers, Restaurants, and Retailers

Take action if you have symptoms of an E. coli infection:
• Write down what you ate in the week before you started to get sick.
• Report your illness to the health department.
• Assist public health investigators by answering questions about your illness.
• Wash your hands. Wash hands after using the restroom or changing diapers, before and after preparing or eating food, and after contact with animals.
• Cook meats thoroughly to kill harmful germs. Cook steaks and roasts to at least 145˚F and let rest for 3 minutes after you remove meat from the grill or stove. Cook ground beef and pork to at least 160˚F. Use a food thermometer to check the temperature of the meat.
• Don’t cross-contaminate food preparation areas. Thoroughly wash hands, counters, cutting boards, and utensils after they touch raw meat.
• Wash fruits and vegetables before eating, unless the package says the contents have been washed.
• Don’t prepare food or drink for others when you are sick.
• People usually get sick from Shiga toxin-producing E. coli (STEC) 2–8 days (average of 3–4 days) after swallowing the germ.
• Some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS).
• E. coli infection is usually diagnosed by testing a stool sample.
• Antibiotics are not recommended for patients with suspected E. coliinfections 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.</s>The Centers for Disease Control and Prevention is investigating an outbreak of Shiga toxin-producing E.coli infections in Georgia, Kentucky, Ohio, Tennessee and Virginia.

The multi-state outbreak that began March 2 has sicken 72 people to date and hospitalized eight, according to the CDC.

Kentucky has the highest number of cases at 36 with Tennessee second with 21 reported infections.

Escherichia coli are bacteria found in the environment, foods and intestines of people and animals. The types of E. coli that can cause illness can be transmitted through contaminated water or food or through contact with animals or people.

The investigation by the CDC, the U.S. Department of Agriculture’s Food Safety and Inspection Service and the U.S. Food and Drug Administration, is ongoing and no specific food item, grocery store or restaurant chain has been identified as the source of infections, according to the CDC investigation notice.

The CDC is not recommending that consumers avoid any particular food at this time. Restaurants and retailers are not advised to avoid serving or selling any particular food.

States are said to be investigating additional illnesses that might be a part of this outbreak.

Those infected are said to range in age from 1 to 74 years with a median age of 17.

Although most strains of E. coli are said to be harmless, some kinds of E. coli can cause diarrhea, respiratory illness and pneumonia and other illnesses.

Most people with Shiga toxin-producing E. coli or STEC start feeling sick up to four days after eating or drinking something that contains the bacteria. However, illnesses can start anywhere from one to 10 days after exposure.

Individuals are advised to contact their healthcare provider if diarrhea lasts for more than three days or is accompanied by high fever, blood in the stool or so much vomiting that they cannot keep liquids down and pass very little urine.

A type of kidney failure can develop in individuals diagnosed with STEC.

No deaths and no cases of hemolytic uremic syndrome have been reported thus far with this outbreak, according to the CDC.

The CDC declared over in July 2018 a multi-state outbreak of E. coli infections linked to Romaine lettuce that resulted in the deaths of five people and the hospitalizations of 96, including 27 people who developed kidney failure.

Some 210 people from 36 states, including four in Massachusetts, became infected with STEC during that outbreak between March 13 and June 6, 2018.</s>An E. coli outbreak has sickened 72 people across five states.

The reported cases were in Ohio, Kentucky, Tennessee, Virginia and Georgia, the Centers for Disease Control and Prevention said in a statement announcing the outbreak. Eight people have been hospitalized, the CDC added.

The agency has not yet pinpointed a specific food, grocery store or restaurant chain responsible for the infections, and is not recommending people avoid a particular food.

Symptoms of E. coli include severe stomach cramps, vomiting and diarrhea, according to the CDC. Most people get better within five to seven days, though the illness can be severe and in some cases even life-threatening.</s>A multistate outbreak of E. coli has raised alarms and questions: As of Thursday, 72 people in five states have become ill, yet the cause of their infection remains unknown, the US Centers for Disease Control and Prevention reported Friday.

Symptoms of this bacterial infection, which usually begin about three or four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting.

Eight people involved in the mysterious outbreak have been hospitalized. No deaths have been reported. People started becoming ill March 2, and the patients range in age from 1 to 74 years old. Additional illnesses tied this outbreak may still be reported, the CDC said.

Government scientists have not identified a food item, grocery store or restaurant chain as the source of these infections. The CDC, state health departments, the US Department of Agriculture’s Food Safety and Inspection Service and the US Food and Drug Administration are investigating the outbreak.

You do not need to avoid any particular food, the CDC said, and grocery stores, retailers and restaurants do not need to avoid serving or selling any particular food.

Anyone concerned that they might have an E. coli infection should talk to their health care provider. It is important to write down everything you ate in the week before developing symptoms. A medical professional can diagnose you as well as offer advice, including washing your hands, to avoid spreading it to other people.

E. coli are a diverse family of bacteria that can be found in the environment, in foods and in the intestines of people and animals. Most strains are harmless. To avoid becoming infected with a harmful strain, the CDC recommends using proper hygiene; cooking meat at proper temperatures; avoiding raw milk, unpasteurized dairy products and juices; and not swallowing water when swimming.

Most people infected by the bacteria get better within five to seven days. Antibiotics are not recommended for patients with suspected E. coli infections until testing has been performed.
The U.S Centers for Disease Control and Prevention reports the source of E. coli O103, that has infected 72 people in five states, has not been identified. Bill Marler, a food safety lawyer in Seattle, notes this O103 outbreak is by far the largest in recent memory.