Investigation Update: E. coli and Salmonella Outbreak, August 2026

August 21, 2026

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 3 strains of E. coli infections and 1 strain of Salmonella infections: E. coli O26:H11, O103:H25, and O168:H8 and Salmonella Agona.

Epidemiologic and traceback data show that alfalfa sprouts distributed by Everything Sprouts may be contaminated with multiple pathogens and may be making people sick.

Epidemiologic data

Cases

Illnesses started on dates ranging from May 31, 2026, to August 8, 2026. The true number of sick people in this outbreak is likely much higher than the number reported, and this 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 Salmonella or 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.

Demographics

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).

Food exposure

State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 34 people interviewed, 26 (76%) reported eating alfalfa sprouts.

This percentage is significantly higher than the 8.7% of respondents who reported eating any sprouts (including alfalfa, bean, or clover) 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 alfalfa sprouts.

Some ill people were also identified as part of illness clusters. An illness cluster is defined as two or more people who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming sick. Investigating illness clusters can provide critical clues about the source of an outbreak. If several unrelated sick people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there.

At least 2 illness clusters were identified in Minnesota and Wisconsin. The most commonly reported food item was alfalfa sprouts.

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.

Based on WGS analysis, Salmonella bacteria from 9 people's samples were predicted to be resistant to three or more of the following antibiotics: fosfomycin, streptomycin, sulfisoxazole, and tetracycline. Most people with Salmonella illness recover without antibiotics. However, if antibiotics are needed, this resistance is unlikely to affect the choice of antibiotic used to treat most people.

Based on WGS analysis, Shiga toxin-producing E. coli bacteria from 46 people's samples had no predicted antimicrobial resistance. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site. These findings do not affect treatment guidance since antibiotics are not recommended for patients with Shiga toxin-producing E. coli infections.

Traceback information from Minnesota and Wisconsin restaurants identified alfalfa sprouts distributed by Everything Sprouts as a source of illness in this outbreak. FDA is working to determine if there are additional sources of contaminated sprouts and if there is a common seed supplier.