By: Candess Zona-Mendola

As of this afternoon, March 21, 2017, the Centers for Disease Control and Prevention (CDC) provided details that more cases have now been linked to the I. M. Healthy SoyNut Butter Outbreak. The investigation is still pending concerning this outbreak, but additional details have also been released about cases with additional complications, etc.

Additional Case Information

As of the time of this post, there are now 23 confirmed cases of a rare strain of E. coli O157:H7 linked to the outbreak. The CDC confirmed that laboratory testing results identified genetically similar bacteria related to the outbreak strain of E. coli O157:H7 linked to I.M. Healthy brand SoyNut Butter. The test results were collected from victims, the homes of ill people, and from retail locations throughout the United States. The majority of those who have fallen ill confirmed they ate The SoyNut Butter Company’s I.M. Healthy brand SoyNut Butter prior to becoming ill. Many were served the products at a daycare or childcare facility. Some became ill through apparent person-to-person transmission.

The CDC’s latest update includes the following information:

  • “Twenty-three people infected with the outbreak strains of STEC O157:H7 have been reported from nine states.”
  • “[E]ven more ill people have been reported since the last update on March 13, 2017. The most recent illness started on March 5, 2017.”
  • “Two more hospitalizations and two more ill people with hemolytic uremic syndrome, a type of kidney failure, have been reported.”
  • “Ten ill people have been hospitalized. Seven people developed hemolytic uremic syndrome, a type of kidney failure, and no deaths have been reported.” and
  • “Twenty (87%) of the 23 ill people in this outbreak are younger than 18 years.”

To review the CDC’s outbreak page and past updates, you can visit their website here.

The new case count factors in 4 additional Oregon cases, presumably from the Portland-based Montessori school. It is highly likely additional cases will be linked. Test results from others from the school are still pending with the Oregon Public Health Division.  The newly linked cases brings the state of Oregon case count to six – a set of siblings from Clackamas County and 4 people from Multnomah County. Three cases are still pending test results. According to the agency’s Deputy Health Officer Dr. Jennifer Vines, “We are working closely with families, staff, and school administrators to stop the spread of this infection and understand how this outbreak happened.”

One more case was found in California, as well.

No additional details apart from the case counts have been released at this time.

Finding New Cases, Linking Existing Cases

The CDC’s partner investigation with the Food and Drug Administration (FDA) is ongoing. In an effort to explain to the public about how the agencies find cases related to this outbreak, the CDC explains on its website:

“To find cases in an outbreak of Escherichia coli O157 (E. coli O157) infections, public health laboratories perform a kind of “DNA fingerprinting” on E. coli O157 laboratory samples. Investigators determine whether the “DNA fingerprint” pattern of E. coli O157 bacteria from one person is the same as that from other people in the outbreak and from the contaminated food, water, or infected animal. Bacteria with the same “DNA fingerprint” are likely to come from the same source. Public health officials conduct intensive investigations, including interviews with ill people, to determine if people whose infecting bacteria match by “DNA fingerprinting” are part of a common-source outbreak.”

As new cases are identified, the case timeline has expanded. The latest illness was found to have started on March 5, 2017, almost a month later than the latest illness identified in the previous update.

Test results and updated into the national database can take up to 2 to 3 weeks to finalize, according to previous agency reports.

No New Recalls of Products, Yet

The latest information from the CDC has not disclosed the name or origin of the processor(s) or supplier(s) of the soynut products. No company has come forward either. It is presumed that when this information is disclosed, there may be additional products linked to the outbreak and recalled. The SoyNut Butter Company has confirmed on its recall notice that a third party contract manufacturer made the products for them. The SoyNut Butter Company also has not commented on the name or whereabouts of the mystery third party contractor.

At this time, the current recalls in place include:

  • All products from the I.M. Healthy SoyNut Butter line, regardless of dates, packaging, flavor, or type. A listing of these products, their details, and pictures can be found here.
  • Any and all Dixie Diner’s Club brand Carb Not Beanit Butter products.
  • New Era Nutrition Inc.’s So Lo GI meal replacement bar products

No illnesses to date have been linked to the Dixie Diner’s Club brand Carb Not Beanit Butter or New Era Nutrition Inc.’s So Lo GI meal replacement bar products.

Prevention Tips

The CDC has provided many resources for the public, especially retailers and childcare providers, to help prevent the spread of illness related to this outbreak. The CDC especially provided a resource concerning diaper changing methods for childcares. It is recommended, and a law in some states, that anyone who is ill with an E. coli infection refrain from attending school or work. In childcares and daycares, person-to-person transmission is especially concerning, as young children are still developing their hygiene habits. To help avoid person-to-person transmission, the CDC has a handy page following a previous E. Coli outbreak here.

If you or someone in your family have eaten a recalled product related to this recall and become ill, urgent medical attention is recommended. E. coli symptoms can manifest anywhere from 1 to 9 days after eating a contaminated product. Typical symptoms can include: vomiting, watery diarrhea, abdominal pain, and sometimes, a low grade fever. Oftentimes, symptoms will become more severe and develop into bloody diarrhea. According to the FDA, “Most people get better within 5–7 days. Some infections are very mild, but others are severe or even life-threatening. Around 5–10 percent of those who are diagnosed with STEC infection develop a potentially life-threatening complication, known as hemolytic uremic syndrome (HUS).”

UnsafeFoods will continue to report on the details surrounding this outbreak and related recalls as they are forthcoming.