March 3, 2017
CDC is collaborating with public health and regulatory officials in several states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) infections.
Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet, coordinated by CDC, is the national subtyping network of public health and food regulatory agency laboratories. PulseNet performs DNA fingerprinting on STEC 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. In this outbreak, the outbreak strain was defined by PFGE. The DNA fingerprint of the outbreak strain has never been seen before in the PulseNet database.
Twelve people infected with the outbreak strain of STEC O157:H7 have been reported from five states. A list of the states and the number of cases in each can be found on the Case Count Map page.
Illnesses started on dates ranging from January 6, 2017 to February 15, 2017. Ill people range in age from 2 to 48 years, with a median age of 8. Eleven (92%) of the 12 ill people are younger than 18 years old. Among ill people, 58% are male. Six ill people have been hospitalized and four people developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.
This outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after February 8, 2017 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 3 weeks. Please see the Timeline for Reporting Cases of E. coli O157:H7 Infection for more details.
Investigation of the Outbreak
Epidemiologic evidence available at this time indicates that I.M. Healthy brand SoyNut Butter is a likely source of this outbreak. SoyNut Butter is a nut-free substitute for peanut butter.
In interviews, ill people or their family members answered questions about the foods they ate and other exposures in the week before they became ill. Nine (100%) of the nine people reached for interview reported either eating I.M. Healthy brand SoyNut Butter at home (five people) in the week before they became ill or attending a childcare center that served I.M. Healthy brand SoyNut Butter or I.M. Healthy brand granola coated with SoyNut Butter (four people). This proportion is significantly higher than expected when compared to the approximately 6% of ill people interviewed during past outbreak investigations who reported eating a ground nut butter or spread other than peanut butter.
I.M. Healthy brand SoyNut Butter may be contaminated with E. coli O157:H7 and could make people sick. CDC recommends consumers do not eat any I.M. Healthy brand SoyNut Butter varieties or sizes or I.M. Healthy brand granola coated with SoyNut Butter. Childcare centers, schools, and other institutions should not serve I.M. Healthy brand SoyNut Butter or I.M. Healthy brand granola coated with SoyNut Butter. Multiple varieties and sizes of I.M. Healthy brand SoyNut butter and I.M. Healthy brand granola coated with SoyNut Butter are sold nationwide in stores, online, and to institutions. The products have a shelf life of 2 years.
This investigation is ongoing and quickly changing. CDC will provide updates when more information is available.