According to Dan Flynn at Food Safety News, Tennessee is being assisted by the Centers for Disease Control and Prevention (CDC) in investigating a total of 11 cases of E. coli infection that involve E. coli O103, E. coli O169 and E. coli O157:H7. Virginia has seen two E. coli O157:H7 cases, including the death of one two-year-old girl.

Mac McLean of the Bristol Herald Courier adds a great time line to this outbreak or outbreaks.

Between May 11 and June 2, 11 Northeast Tennessee residents – including one from Sullivan County – developed symptoms that suggested they suffered from an E. coli infection. Lab test results, which the office received from June 2 to June 7, confirmed those suspicions. The tests were positive for the presence of an STEC bacterium.

Two Dryden, Virginia children – a 2-year-old girl and her 5-year-old brother – also started showing symptoms of a possible E. coli infection and were rushed to the Johnson City Medical Center’s Pediatric Intensive Care Unit on June 5. The girl died in the hospital’s emergency room, according to a report from the Washington County Tennessee Sheriff’s Office, while her brother spent four days undergoing treatment at the Vanderbilt University Medical Center in Knoxville, Tenn., before being released Wednesday.

Three of the 11 cases from Northeast Tennessee tested positive for the presence of E. coli O157:H7 – the same bacterial strain that was found in the two children from Dryden. The remaining eight Northeast Tennessee test results came back positive for the presence of a non-O157:H7 strain. Even more frustrating was the fact that a series of DNA fingerprint tests his office performed on the non-O157:H7 bacteria showed that each sample had its own distinct genetic make-up, E. coli O103, E. coli O169.

It will be interesting to see if this is one outbreak with multiple strains or separate outbreaks.