Outbreak of E. coli Infections Linked to Clover Sprouts

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Posted on March 19, 2020 at 3:30 PM ET

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of E. coli O103 infections linked to clover sprouts.

Recall and Advice to Consumers, Retailers, and Restaurants
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At A Glance

 

Photo of clover sprouts
Photo of clover sprouts.

Do not eat, serve, or sell recalled products containing sprouts from Chicago Indoor Garden. Regardless of where you buy sprouts, raw and lightly cooked sprouts are a known source of foodborne illness and outbreaks.

  • On March 16, 2020, Chicago Indoor Garden recalled all products containing red clover sprouts. Recalled products have a “Best By” date of March 12, 2020. To view a full list of recalled products click hereexternal icon. Products include:
    • Red Clover 4 oz. clamshell
    • Red Clover 2 lb. boxes
    • Sprout Salad 6 oz. clamshell
    • Mixed Greens 4 oz. clamshell
    • Spring Salad 6 oz. clamshell
  • Check your refrigerator for the recalled products. If you have any of them, do not eat, sell, or serve them. Throw them away.
  • Restaurants and retailers should check storage coolers for the recalled product. Do not sell or serve recalled products.

You can reduce your risk of getting sick from raw or lightly cooked sprouts.

  • Sprouts are a known source of foodborne illness.
  • The following groups of people should avoid eating raw or lightly cooked sprouts of any kind (including alfalfa, clover, radish, and mung bean sprouts): Children, older adults, pregnant women, and people whose immune systems are weakened by health conditions or medicine used to treat them, including people with diabetes, liver or kidney disease, HIV/AIDS, or cancer.
  • Cook sprouts thoroughly to reduce the risk of illness. Thoroughly cooking sprouts kills the harmful bacteria.
  • Ask that raw sprouts not be added to your food. If you buy a sandwich or salad at a restaurant or deli, check to make sure that raw sprouts have not been added.

Talk to your healthcare provider if you ate the recalled products and have symptoms of an E. coli infection.

Latest Outbreak Information
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  • Since the last update on February 26, 2020, a total of 25 additional people infected with the outbreak strain of E. coli O103 have been reported from two states.
    • Illnesses started on dates ranging from January 6, 2020, to March 2, 2020.
    • 2 hospitalizations have been reported, and no deaths have been reported.
  • Information gathered to date indicates that clover sprouts are the source of this outbreak.
  • Many ill people reported eating clover sprouts served at Jimmy John’s restaurants. Jimmy John’s LLC reported that all of its restaurants stopped serving clover sprouts on February 24, 2020.
  • On March 16, 2020, Chicago Indoor Garden recalledexternal icon all products containing red clover sprouts. More information is available on the FDA website.external icon
  • This investigation is ongoing, and CDC will provide updates when more information is available.
Symptoms of E. coli Infection
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  • People usually get sick from Shiga toxin-producing E. coli (STEC) 2 to 8 days (average of 3 to 4 days) after swallowing the germ.
  • Symptoms vary, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may have a fever, which usually is not very high (less than 101˚F/38.5˚C).
  • Some people with an STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS).
  • Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing HUS, and a benefit of treatment has not been clearly demonstrated.
  • For more information, see Symptoms of E. coli Infection.
Investigation Details

March 19, 2020

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of E. coli O103 infections linked to clover sprouts.

As of March 17, 2020, 39 people infected with the outbreak strain of E. coli O103 have been reported from six states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.

Illnesses started on dates ranging from January 6, 2020, to March 2, 2020. Ill people range in age from 1 to 79 years, with a median age of 28. Fifty-three percent of ill people are female. Two people have been hospitalized. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 3 to 4 weeks. Please see the Timeline for Reporting Cases of E. coli Infection for more details.

Investigation of the Outbreak

Epidemiologic, traceback, and laboratory evidence indicate that clover sprouts are the source of this outbreak.

State and local public health officials are interviewing ill people to determine what they ate and other exposures they had in the week before their illness started. Sixteen (59%) of 27 people interviewed reported eating sprouts. This percentage is significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy people in which 8% reported eating sprouts in the week before they were interviewed.  Fourteen (58%) of 24 people interviewed reported eating sprouts at a Jimmy John’s restaurant.

Jimmy John’s LLC reported that all of their restaurants stopped serving clover sprouts on February 24, 2020.  Clover sprouts should no longer be available at Jimmy John’s restaurants.

FDA identified the outbreak strain of E. coli O103 in samples of Chicago Indoor Garden products that contain sprouts. On March 16, 2020, Chicago Indoor Garden recalledexternal icon all products containing red clover sprouts.

FDA’s traceback investigationexternal icon has shown that a common seed lot was used to grow the sprouts recalled by Chicago Indoor Garden and the sprouts that were served at Jimmy John’s locations where people sickened in the current outbreak reported eating. The same seed lot was also used to grow sprouts linked to an outbreakexternal icon of the same strain of E. coli O103 infections in 2019.

This investigation is ongoing to determine where implicated sprouts and seeds have been distributed, and CDC will provide updates when more information is available.

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