Health Officials Scramble to Identify Source of Multistate E coli Outbreak

Updated: 4/24/2019

The US Centers for Disease Control and Prevention (CDC) is working alongside the US Department of Agriculture, US Food and Drug Administration, and health officials in several states to determine the source of a Shiga-toxin producing E coli O103 outbreak.

As of April 4, 2019, 72 individuals from 5 states have been infected with the outbreak strain. Thus far, 8 individuals have required hospitalization, but no cases of hemolytic uremic syndrome or fatalities have been reported.

On March 28, 2019, the Kentucky Department for Public Health reported that 20 cases of E coli had been reported across the state, involving children and adults living in the central Kentucky area. In a statement, health officials reported that the origin of the outbreak was unknown, but food distribution was the likely mechanism of transmission.

Public health investigators are employing the PulseNet system to determine if other reported illnesses are linked to this outbreak. DNA fingerprinting is performed on bacteria isolated from the ill individuals through pulsed field gel electrophoresis and whole genome sequencing. The CDC has a collection of these fingerprints in a database that aides in identifying potential outbreaks.

Whole genome sequencing performed on isolates from the ill in this outbreak indicates that the strains are closely related genetically, suggesting that the sickened individuals likely to share a common source of infection.

The onset of illnesses ranges from March 2 through March 29, 2019. Ill individuals range in age from 1 to 74 years with a median age of 17. Fifty-five percent of the affected are female.

The CDC also reports that additional cases that may be linked to this outbreak are currently under investigation in several states.

On April 5, 2019, the CDC reported that the source of the infections has not yet been linked to a specific food item, grocery store, or restaurant chain. Therefore, there are no current recommendations to avoid consumption of a particular food or for retailers and restaurants to avoid serving or selling any particular food products.

Health officials are reminding clinicians that antibiotics are not recommended for patients with suspected E coli infections, as studies have shown that antibiotics increase the risk of developing hemolytic uremic syndrome. Therefore, antibiotics should not be administered until diagnostic testing can be performed to rule out E coli infections.

The CDC is labeling this outbreak a “rapidly evolving investigation,” and indicates that updates will be provided as more information is available. If a source is identified, guidance may be updated.

On April 23, 2019, the CDC reported that a total of 156 individuals were infected with the outbreak strain across 10 states. In total 20 hospitalizations have been reported.

The outbreak source has been preliminarily identified as ground beef and on the same day, K2D Foods of Carrolton, Georgia issued a recall for 113,424 pound of raw ground beef, potentially contaminated with E coli O103. However, the US Department of Agriculture said, "At this time, there is no definitive link between this positive product and the ongoing E. coli O103 outbreak. Further traceback and product analysis continues to determine if the recalled products are related to the E. coli O103 outbreak."

For affected states and case counts in this multistate E coli outbreak, check out the Contagion® Outbreak Monitor.