Fifty-nine people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 have been reported from 15 states and the District of Columbia. Since the last CDC update on December 6, an additional 7 ill people have been included in this investigation – California 12, Connecticut 1, District of Columbia 1, Florida 1, Illinois 2, Louisiana 1, Massachusetts 1, Maryland 1, Michigan 7, New Hampshire 6, New Jersey 12, New York 7, Ohio 1, Pennsylvania 4, Rhode Island 1, Wisconsin 1.

Illnesses started on dates ranging from October 5, 2018 to November 16, 2018.

Twenty-three people have been hospitalized, including two people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

FDA Update.

The Public Health Agency of Canada has identified ill people infected with the same DNA fingerprint of E. coli O157:H7 bacteria in Canada. In Canada, as of December 6, 2018, there have been 27 confirmed cases of E. coli illness investigated in Ontario (4), Quebec (19), New Brunswick (1), and British Columbia (3). The illnesses in British Columbia were related to travel to Quebec, Ontario and the United States. Individuals became sick between mid-October and early November 2018. Nine individuals have been hospitalized, and two individuals suffered from hemolytic-uremic syndrome (HUS), which is a severe complication that can result from an E. coli infection. No deaths have been reported. Individuals who became ill are between 2 and 93 years of age. The majority of cases (52%) are male.

The FDA, along with CDC and state partners, is investigating farms and cooling facilities in California that were identified in traceback. CDC identified the outbreak strain of E. coli O157:H7 in sediment collected within an agricultural water reservoir on Adam Bros. Farming, Inc. farm, which was identified in traceback.

CDC is advising that consumers not eat any romaine lettuce harvested from Monterey, San Benito, and Santa Barbara counties in the Central Coastal growing regions of northern and central California. FDA continues its investigation of farms identified in traceback.

Laboratory analysis indicates that the illnesses reported in this outbreak are genetically related to illnesses reported in a previous E. coli outbreak from December 2017 that affected consumers in both Canada and the U.S. This tells us that the same strain of E. coli is causing illness in Canada and the US as was seen in 2017 and it suggests there may be a reoccurring source of contamination. Investigators are using evidence collected in both outbreaks to help identify the possible cause of the contamination in these events.  Twenty-five people infected with the outbreak strain of STEC O157:H7 were reported from 15 states. Illnesses started on dates ranging from November 5, 2017 to December 12, 2017. Nine people were hospitalized, including two people who developed hemolytic uremic syndrome, a type of kidney failure. One death was reported from California.

In December 2017, the Public Health Agency of Canada (PHAC) investigated an outbreak of STEC O157:H7 infections in several provinces linked to romaine lettuce. In total, there were 42 cases of E. coli O157 illness reported in five eastern provinces: Ontario (8), Quebec (15), New Brunswick (5), Nova Scotia (1), and Newfoundland and Labrador (13). Individuals became sick in November and early December 2017. Seventeen individuals were hospitalized. One individual died. Individuals who became ill were between the ages of 3 and 85 years of age. The majority of cases (74%) were female.