A second child in Washington became seriously ill after eating a soy nut butter product included as part of a nationwide illness outbreak and food recall. The Washington State Department of Health is urging people in Washington to double-check their cupboards for I.M. Healthy SoyNut Butter and other products recalled after people who ate them became ill.

The Centers for Disease Control and Prevention (CDC), the federal Food and Drug Administration (FDA) and state health departments including Washington are investigating an ongoing outbreak of Shiga toxin-producing E. coli (STEC) O157:H7 reported from several states. CDC recommends that consumers do not eat, and childcare centers, schools, and other institutions do not serve, any variety or size of I.M. Healthy SoyNut Butter, I.M. Healthy Granola, or Dixie Diner’s Club Carb Not Beanit Butter, regardless of the date of purchase or the date listed on the container.

Health officials say that even if a portion of the products were eaten or served and no one became sick, the remaining product should be sealed in a bag and thrown in the trash so that children, pets, or other animals can’t eat it.

The symptoms of STEC infections vary but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Most people get better within 5–7 days, but some infections are severe or even life-threatening. Hemolytic uremic syndrome (HUS), a type of kidney failure, is a potentially life-threatening complication of E. coli O157 infection. Very young children and the elderly are more likely to develop severe illness and HUS than others, but even healthy older children and young adults can become seriously ill. The majority of the illnesses confirmed so far are in people younger than 18 years old, at least eight have been hospitalized.

Contact your healthcare provider if you have diarrhea that lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.