CDC, several states, the U.S. Food and Drug Administration, and the U.S. Department of Agriculture’s Food Safety and Inspection Service are investigating a multistate outbreak of Shiga toxin-producing E. coli O157:H7 infections. This investigation includes E. coli O157:H7 infections recently reported by the New Jersey Department of Health.
Public health investigators are using the PulseNet(https://www.cdc.gov/pulsenet/index.html) 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 using techniques called pulsed-field gel electrophoresis(https://www.cdc.gov/pulsenet/pathogens/pfge.html) (PFGE) and whole genome sequencing(https://www.cdc.gov/ncezid/dfwed/keyprograms/tracking-foodborne-illness-wgs.html) (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE.
Illnesses reported by investigators in New Jersey also included ill people who had a diagnostic test(https://www.cdc.gov/foodsafety/challenges/cidt.html) showing they were infected with E. coli bacteria. Laboratory testing is ongoing to link their illnesses to the outbreak using DNA fingerprinting. Some people may not be included in CDC’s case count because no bacterial isolates are available for the DNA fingerprinting needed to link them to the outbreak.
As of April 9, 2018, 17 people infected with the outbreak strain of E. coli O157:H7 have been reported from 7 states. A list of the states and the number of cases in each can be found on the Case Count Map page(https://www.cdc.gov/ecoli/2018/o157h7-04-18/map.html). Illnesses started on dates ranging from March 22, 2018 to March 31, 2018(https://www.cdc.gov/ecoli/2018/o157h7-04-18/epi.html). Ill people range in age from 12 to 84 years, with a median age of 41. Among ill people, 65% are female. Six ill people have been hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.
The 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.
CDC will provide more information as it becomes available.
