Investigation Details

Posted October 7, 2022

October 7, 2022

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 O121 infections.

Epidemiologic data show that Earth Grown brand frozen falafel sold at ALDI stores may be contaminated with E. coli O121 and may be making people sick.

Epidemiologic Data

As of October 7 2022, 20 people infected with the outbreak strain of E. coli O121 have been reported from 6 states (see map). Illnesses started on dates ranging from July 13, 2022, to September 13, 2022 (see timeline).

Sick people range in age from less than 1 to 71 years, with a median age of 31, and 79% are female. Of 14 people with information available, 5 have been hospitalized, including 1 who 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 higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because some 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.

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Among 18 people interviewed, 15 reported shopping at ALDI stores. Among these 15 ALDI shoppers, 6 reported eating Earth Grown brand frozen falafel purchased from ALDI in the week before getting sick.

Laboratory 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

On October 7, 2022, Cuisine Innovations of Lakewood, New Jersey, recalled Earth Grown Vegan Traditional Falafel and Garlic & Herb Falafel. According to ALDI, Cuisine Innovations is the sole supplier of Earth Grown brand frozen falafel sold in ALDI stores.

CDC is advising people to not eat, sell, or serve recalled frozen falafel.

Previous Updates

Investigators are continuing to collect different types of data to identify the food source of this multistate outbreak of E. coli O157:H7 infections. A specific food has not yet been confirmed as the source of this outbreak, but many sick people reported eating burgers and sandwiches with romaine lettuce at Wendy’s restaurants before getting sick.

Epidemiologic Data

Since the last update on August 19, 2022, 47 more illnesses have been reported to CDC. As of August 24, 2022, a total of 84 people infected with the outbreak strain of E. coli O157:H7 have been reported from 4 states (see map). Illnesses started on dates ranging from July 26, 2022, to August 9, 2022 (see timeline).

Sick people range in age from 5 to 94 years, with a median age of 24 years, and 52% are male. Of 73 people with information available, 38 have been hospitalized and 8 people in Michigan have developed a type of kidney failure called hemolytic uremic syndrome. No deaths have been reported.

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

State and local public health officials have been interviewing people about the foods they ate in the week before they got sick. Among 62 people who have been interviewed, 52 (84%) reported eating at a Wendy’s restaurant in the week before their illness started. The Wendy’s restaurants where sick people ate are in Indiana, Michigan, Ohio, and Pennsylvania. People reported eating a variety of menu items, including burgers and sandwiches. Of 17 people with detailed information about what they ate at Wendy’s, 15 (88%) reported eating romaine lettuce served on burgers and sandwiches. Investigators continue to analyze data at the ingredient level to determine if there are any other possible foods that could be the source of the outbreak.