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Investigation of Outbreak of Human Infections Caused by E. coli O157:H7

Updated June 25, 2008

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Multistate Outbreak of E. coli O157:H7 infections – Michigan and Ohio

State departments of health and agriculture in Michigan and Ohio, CDC, and the United States Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) are investigating a multi-state outbreak of Escherichia coli O157:H7 infections.  Based on this investigation, as of 5pm EST, June 24, 2008, 32 confirmed cases have been linked both epidemiologically and by molecular fingerprinting to this outbreak, 15 in Michigan and 17 in Ohio.  Onset of illness in these patients occurred from 5/30/08 to 6/11/08.  Fourteen ill persons have been hospitalized.  One patient has developed a type of kidney failure called hemolytic-uremic syndrome (HUS).  No deaths linked to the outbreak have been reported.  Twenty (62%) of patients are female.  Patients range in age from 4 to 78 years with a median age of 21 years.

States with cases of E. coli 0157:H7 infections with the outbreak strain

US States with Outbreak-Associated Cases of E. coli O157, June 2008

CDC and public health agencies across the United States continue surveillance activities to detect additional cases related to this outbreak.

State health and agriculture departments have tested ground beef recovered from patient residences and purchased at Kroger® retail stores in Michigan and Ohio.  Molecular fingerprinting testing conducted by the Ohio and Michigan Departments of Health and Agriculture Laboratories, in collaboration with PulseNet, the national molecular subtyping network for foodborne disease surveillance, on E. coli O157 isolates isolated from ground beef samples have confirmed the isolates to be the outbreak strain of E. coli O157.

CDC’s OutbreakNet Team initiated a multi-state case-control study in collaboration with Ohio and Michigan Departments of health to epidemiologically determine an association between exposures related to E. coli O157 illness in patients.  Analysis of the case-control study data indicates a significant association between illness among case patients and eating ground beef purchased at  at one of several Kroger® Co. stores in Michigan and Ohio.  CDC has provided these results to the USDA-FSIS and public health agencies in Michigan and Ohio.

A recall has been announced for ground beef sold at Kroger® Co. Stores in Michigan and Ohio.  More information about this recall may be found at the United States Department of Agriculture, Food Safety and Inspection Service’s web site at Consumers with questions about the recall should contact the Kroger Consumer Hotline at (800) 632-6900.

Consumers with food safety questions can “Ask Karen,” the FSIS virtual representative available 24 hours a day at The toll-free USDA Meat and Poultry Hotline 1-888-MPHotline (1-888-674-6854) is available in English and Spanish and can be reached from l0 a.m. to 4 p.m. (Eastern Time) Monday through Friday. Recorded food safety messages are available 24 hours a day.

During an E. coli outbreak: Carefully follow instructions provided by public health officials on what foods to avoid in order to protect yourself and your family from infection.

Cook all ground beef thoroughly.  Cook ground beef to 160° F. Test the meat by putting a food thermometer in the thickest part of the meat. Do not eat ground beef that is still pink in the middle.

Vegetables should be boiled for at least 1 minute before serving.

Drink only pasteurized milk, juice, or cider. Frozen juice or juice sold in boxes and glass jars at room temperature has been pasteurized, although it may not say so on the label.

Drink water from safe sources like municipal water that has been treated with chlorine, wells that have been tested or bottled water.

Do not swallow lake or pool water while you are swimming.

Don’t spread bacteria in your kitchen. Keep raw meat away from other foods. Wash your hands, cutting board, counter, dishes, and knives and forks with hot soapy water after they touch raw meat, spinach, greens, or sprouts.

If a restaurant serves you an under-cooked hamburger, send it back for more cooking. Ask for a new bun and a clean plate, too.

Never put cooked hamburgers or meat on the plate they were on before cooking. Wash the meat thermometer after use.

See E. coli O157:H7 for more information.

Previous Updates on this Outbreak

Page last modified: June 25, 2008
Content source: National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)

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