epi-big-12-21-15Will the numbers go above 58?

Fifty-three people infected with the outbreak strain of STEC O26 have been reported from 9 states. The majority of illnesses have been reported from Washington and Oregon during October 2015. The number of ill people reported from each state is as follows: California (3), Illinois (1), Maryland (1), Minnesota (2), New York (1), Ohio (3), Oregon (13), Pennsylvania (2), and Washington (27).

Among people for whom information is available, illnesses started on dates ranging from October 19, 2015 to November 14, 2015. Ill people range in age from 1 year to 94, with a median age of 21. Fifty-nine percent of ill people are female. Twenty (38%) people reported being hospitalized. There have been no reports of hemolytic uremic syndrome and no deaths.

The most recent person reporting Chipotle exposure became ill on November 10, 2015. Reports to PulseNet of new illnesses in this outbreak have slowed substantially since the peak of the outbreak in October 2015. CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them.

State and local public health officials continue to interview ill people to obtain information about foods they might have eaten and other exposures in the week before their illness started. To date, 46 (88%) of 52 people interviewed reported eating at a Chipotle Mexican Grill restaurant. The investigation is still ongoing to identify common meal items or ingredients causing illness.

Investigators are also using whole genome sequencing (WGS) to get more information about the DNA fingerprint of the STEC O26 bacteria causing illness. WGS has been performed on STEC O26 isolates from 29 ill people in Washington (16), California (2), Maryland (1), Minnesota (2), New York (1), Ohio (3), Oregon (3), and Pennsylvania (1). All 29 isolates were highly related genetically to one another. This provides additional evidence that illnesses outside the Pacific Northwest are related to the illnesses in Oregon and Washington.

Additionally, 5 people infected with a different, rare DNA fingerprint of STEC O26 have been identified in Kansas (1), North Dakota (1), and Oklahoma (3) and appear to be linked to Chipotle Mexican Grill. The infections started on dates ranging from November 18, 2015 to November 26, 2015. All five (100%) reported eating at a Chipotle Mexican Grill in the week before illness started. All 3 Oklahoma ill people ate at a single Chipotle location in Oklahoma, and the North Dakota ill person traveled to Kansas during their exposure period and ate at the same Chipotle location as the Kansas ill person. It is not known if these infections are related to the larger outbreak of STEC O26 infections; this investigation is ongoing. WGS is being used to determine if this strain is genetically related to the STEC O26 causing the larger outbreak.

And, let’s not forget:

Seattle

When: July 2015

Sickened: 5 people

Culprit: E. coli O157:H7

Source: Unknown

Simi Valley, CA

When: August 2015

Sickened: At least 234

Culprit: Norovirus

Source: Ill worker

Minnesota

When: August and September 2015

Sickened: 64 people

Culprit: Salmonella Newport

Source: Tomatoes

Boston

When: December 2015

Sickened: At least 136 people

Culprit: Norovirus

Source: Ill worker