CDC Issues Update on Search for Source of Midwestern E. coli Outbreak

A CDC investigation notice update regarding a multistate outbreak of E. coli O157 infections is now live:

Key points:

  • Since the last update on August 17, 2022, 8 more illnesses have been reported and 2 states have been added to the investigation (Indiana and Pennsylvania).
  • 37 people infected with the outbreak strain of coli O157 have been reported from 4 states: Indiana (1), Michigan (15), Ohio (19), and Pennsylvania (2).
  • 10 people have been hospitalized, including 3 people in Michigan who have a type of kidney failure called hemolytic uremic syndrome. No deaths have been reported.
  • A specific food has not yet been confirmed as the source of this outbreak, but most sick people reported eating sandwiches with romaine lettuce at Wendy’s restaurants before getting sick.
    • Among 26 people interviewed, 22 (86%) reported eating at a Wendy’s restaurant in the week before their illness started.
    • The Wendy’s restaurants where sick people ate are in Michigan, Ohio, and Pennsylvania. The sick person in Indiana has not been interviewed.
  • Based on the information collected so far, Wendy’s is taking the precautionary measure of removing the romaine lettuce being used in sandwiches from restaurants in that region. Wendy’s uses a different type of romaine lettuce for salads.
  • CDC is not advising that people avoid eating at Wendy’s restaurants or that people stop eating romaine lettuce.
    • At this time, there is no evidence to indicate that romaine lettuce sold in grocery stores, served in other restaurants, or in people’s homes is linked to this outbreak.
  • Investigators are working to confirm whether romaine lettuce is the source of this outbreak, and whether romaine lettuce served at Wendy’s restaurants was served or sold at other businesses.

What You Should Do:

  • Call your healthcare provider right away if you have severe coli symptoms, such as diarrhea that lasts for more than 3 days or diarrhea that is accompanied by a fever higher than 102˚F, bloody diarrhea, or so much vomiting that you cannot keep liquids down and are not peeing much.
  • If you have symptoms of coli, help us solve this outbreak:
    • Write down what you ate in the week before you got sick.
    • Report your illness to your local or state health department.
    • Answer public health officials’ questions about your illness.

About E. coli:

  • Symptoms of Shiga toxin-producing coli (STEC) infection vary for each person, 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).
  • Most people get better within 5 to 7 days. Some infections are very mild, but others are severe or even life-threatening.
  • Most people with a STEC infection start feeling sick 3 to 4 days after eating or drinking something that contains the bacteria. However, illnesses can start anywhere from 1 to 10 days after exposure.

If you have questions about cases in a particular state, please call that state’s health department.

Thank you,

CDC News Media Branch


CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.