Investigation Details

Posted March 26, 2024

This outbreak is over. Learn what you can do to protect yourself from getting sick from E. coli.

March 26, 2024

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA), collected different types of data to investigate a multistate outbreak of E. coli O157:H7 infections.

Epidemiologic data showed that Raw Farm brand raw cheddar cheese made people sick in this outbreak.

Epidemiologic Data

A total of 11 people infected with the outbreak strain of E. coli were reported from 5 states (see map). Illnesses started on dates ranging from October 18, 2023, to February 5, 2024 (see timeline). Of 11 people with information available, 5 were hospitalized and 2 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths were reported.

The true number of sick people in this outbreak was likely much higher than the number reported, and the outbreak may not have been limited to the states with known illnesses. This is because many people recover without medical care and are not tested for E. coli.

Public health officials collected many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provided clues to help investigators identify the source of the outbreak.

The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).

Demographics Information
Table of demographic information (n is the number of people with information available)
Age
(n=11)
Range from 2 to 75 years
Median age of 25 years
Sex
(n=11)
36% female
64% male
Race
(n=10)
90% White
10% Asian
Ethnicity
(n=10)
100% non-Hispanic
0% Hispanic

State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 10 people interviewed, 7 (70%) specifically reported eating Raw Farm brand raw cheddar cheese. This percentage was significantly higher than the 4.9% of respondents who reported eating any raw milk cheese in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggested that people in this outbreak got sick from eating Raw Farm brand raw cheddar cheese.

Laboratory and Traceback Data

Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from all sick people’s samples were closely related genetically. This suggested that people in this outbreak got sick from the same food.

WGS analysis of bacteria from 11 people’s samples did not predict resistance to any antibiotics. Testing of one person’s sample using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) confirmed these results. These findings do not affect treatment guidance since antibiotics are not recommended for patients with Shiga toxin-producing E. coli infections.

Officials in California, Colorado, and Utah collected various Raw Farm products for testing including raw milk, raw butter, raw cheddar cheese, and raw kefir. No product samples detected E. coli.

Public Health Actions

To reduce your risk of foodborne illness, choose pasteurized dairy products.

Previous Updates

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA), are collecting different types of data to investigate a multistate outbreak of E. coli O157:H7 infections.

Epidemiologic data show that Raw Farm brand raw cheddar cheese is making people in this outbreak sick.

Epidemiologic Data

Since the last update, one new illness and one new state were reported. One sick person in New Jersey reported eating raw cheddar cheese during travel to Colorado in the week before they got sick. As of February 28, 2024, a total of 11 people infected with the outbreak strain of E. coli have been reported from 5 states (see map). Illnesses started on dates ranging from October 18, 2023, to February 5, 2024 (see timeline). Of 11 people with information available, 5 have been hospitalized and 2 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for E. coli. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.

The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).

Demographics Information
Table of demographic information (n is the number of people with information available)
Age
(n=11)
Range from 2 to 75 years
Median age of 25 years
Sex
(n=11)
36% female
64% male
Race
(n=10)
90% White
10% Asian
Ethnicity
(n=10)
100% non-Hispanic
0% Hispanic

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 9 people interviewed, 7 (78%) specifically reported eating Raw Farm brand raw cheddar cheese. This percentage was significantly higher than the 4.9% of respondents who reported eating any raw milk cheese in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggests that people in this outbreak got sick from eating Raw Farm brand raw cheddar cheese.

Laboratory and Traceback Data

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from all sick people’s samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

Officials in California, Colorado, and Utah collected various Raw Farm products for testing including raw milk, raw butter, raw cheddar cheese, and raw kefir. So far, no samples have detected E. coli. Additional testing is ongoing.

Public Health Actions

On February 26, 2024, Raw Farm brand withdrew their recall. However, CDC continues to advise people not to eat, sell, or serve Raw Farm brand raw cheddar cheese while the investigation is ongoing.

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are collecting different types of data to investigate a multistate outbreak of E. coli O157:H7 infections.

Epidemiologic data show that RAW FARM brand raw cheddar cheese is making people in this outbreak sick.

Epidemiologic Data

As of February 16, 2024, a total of 10 people infected with the outbreak strain of E. coli have been reported from four states (see map). Illnesses started on dates ranging from October 18, 2023, to January 29, 2024 (see timeline). Of 9 people with information available, 4 have been hospitalized and 1 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. No deaths have been reported.

The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for E. coli. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak.

The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).

Demographics Information
Table of demographic information (n is the number of people with information available)
Age
(n=10)
Range from 2 to 58 years
Median age of 24 years
Sex
(n=10)
30% female
70% male
Race
(n=7)
86% White
14% Asian
Ethnicity
(n=7)
100% non-Hispanic
0% Hispanic

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 8 people interviewed, 6 (75%) reported eating RAW FARM brand raw cheddar cheese. This percentage was significantly higher than the 4.9% of respondents who reported eating any raw milk cheese in the FoodNet Population Survey—a survey that helps estimate how often people eat various foods linked to diarrheal illness. This difference suggests that people in this outbreak got sick from eating RAW FARM brand raw cheddar cheese.

Laboratory and Traceback Data

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).

WGS showed that bacteria from sick people’s samples are closely related genetically. This suggests that people in this outbreak got sick from the same food.

Public Health Actions

CDC advises people not to eat, sell, or serve RAW FARM brand raw cheddar cheese while the investigation is ongoing.