Investigation Details
Posted December 1, 2022
This outbreak is over. Learn what you can do to protect yourself from getting sick from E. coli.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of E. coli O121 infections.
Epidemiologic, laboratory, and traceback data showed that Earth Grown brand frozen falafel sold at ALDI stores made people sick.
As of December 1, 2022, this outbreak is over.
Epidemiologic Data
A total of 24 people infected with the outbreak strain of E. coli O121 were reported from 6 states (see map).
Illnesses started on dates ranging from July 13, 2022, to October 24, 2022 (see timeline). Sick people ranged in age from under 1 to 71 years, with a median age of 30, and 74% were female. Of 22 people with information available, 5 were hospitalized and 1 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 is likely much higher than the number reported, and this 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.
State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 18 people interviewed, 15 (83%) reported shopping at ALDI stores. Among these 15 ALDI shoppers, 14 (93%) reported eating Earth Grown brand frozen falafel purchased from ALDI in the week before getting sick.
Laboratory Data and Traceback Data
Public health investigators used the PulseNet system to identify illnesses that were 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 were closely related genetically. This suggests that people in this outbreak got sick from the same food.
On October 7, 2022, the Michigan Department of Agriculture and Rural Development collected Earth Grown frozen falafel for testing from a sick person’s home. WGS done at the Michigan Department of Health & Human Services showed that the E.coli in the falafel were closely related to bacteria from sick people. This means that people likely got sick from eating frozen falafel.
WGS analysis of bacteria from 24 people’s samples and one food sample did not predict resistance to any antibiotics. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently underway. These findings do not affect treatment guidance since antibiotics are not recommended for patients with E. coli O121 infections.
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 advises people to not eat, sell, or serve recalled frozen falafel.
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.
