*Updated on 3/24/2017 at 2:07 PM EST
The Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) have teamed up to investigate a multistate outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections. The likely source of the outbreak is the SoyNut Butter Company’s I.M. Healthy Original Creamy Soynut Butter product.
Investigators are currently identifying illnesses that may potentially be a part of this outbreak through the CDC’s PulseNet system, which is a “national subtyping network” consisting of “public health and food regulatory agency laboratories.” The system uses pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) techniques to produce a DNA fingerprint for STEC bacteria taken from those who have fallen ill. The strain involved in this outbreak was defined by PFGE, what the CDC refers to as the “current ‘gold standard’ fingerprinting method.” According to the CDC, the outbreak strain’s DNA fingerprint “has never been seen before in the PulseNet database.”
As of March 24, 2017, the CDC has reported that a total of 23 individuals from nine different states (Arizona: 4, California: 4, Maryland: 1, Missouri: 1, New Jersey: 1, Oregon: 2, Virginia: 1, Washington: 1, and Wisconsin: 1), have been infected with the outbreak strain (STEC O157:H7). “Illnesses started” between January 4, 2017 and February 21, 2017. The ages of those infected range from 2 to 48 years of age, “with a median age of 10.” Twenty of the 23 infected individuals (87%) are under the age of 18. The CDC reports that 10 of the infected individuals have been hospitalized and seven of them have developed a type of kidney failure called hemolytic uremic syndrome (HUS), which is potentially life-threatening. No related deaths have been reported thus far.
The CDC reminds the public that since it takes an average of 2 to 3 weeks to fall ill, any illnesses that had occurred after February 13, 2017, may not yet be reported.
According to the CDC, epidemiologic evidence suggests that the aforementioned SoyNut Butter product is “a likely source of the outbreak.” Investigators have conducted interviews with those infected or their family members, and asked questions pertaining to the foods consumed prior to the week they fell ill. Nine of the individuals who were interviewed reported consuming SoyNut butter products (I.M. Healthy brand SoyNut Butter or I.M. Healthy granola that was coated in SoyNut Butter) either at home or at a childcare. According to the CDC, “This proportion is significantly higher than expected when compared to the approximately 6% of ill individuals interviewed during past outbreak investigations who reported eating a ground nut butter or spread other than peanut butter.”
The CDC warns the public to avoid consuming any I.M. Healthy brand SoyNut Butter “varieties or sizes or I.M. Healthy brand granola coated with SoyNut Butter.” They also caution any childcare centers or schools to avoid dispensing the aforementioned products.
As a result of the outbreak and potential connection, the SoyNut Butter Company announced a voluntary recall on March 4, 2017. According to their official statement on their website, “The voluntary recall is in response to the FDA alerting us of a possible link between our product and illnesses regarding E. coli. While we are taking the necessary investigative steps in getting the product in question and the supply chain tested, we decided to issue the recall for the sake of food safety. We take our products’ integrity seriously and will update all our customers as we receive more information.” On March 10, 2017, the company expanded its recall to include Dixie Diner's Club brand Carb Not Beanit Butter.
According to the CDC, the symptoms associated with STEC infections vary from person-to-person but they can include “severe stomach cramps, diarrhea (often bloody), and vomiting.” Although the majority of individuals should feel better within 5 to 7 days, some infections can have severe complications, such as HUS.
The CDC recommends that anyone who suffers from diarrhea that lasts over 3 days and is coupled with high fever, bloody stool, or excessive vomiting to which liquids cannot be kept down and little urine is passed, should contact his/her healthcare provider immediately.
The CDC will provide the public with updates as they arise in this ongoing investigation.
Feature Picture Source: Mike Mozart / flickr / Creative Commons.