Washington:

A King County child is currently hospitalized with an E.coli infection that is part of a national outbreak of Shiga toxin-producing E. coli (STEC) O157:H7 linked to I.M. Healthy brand SoyNut Butter.  As of March 7, the I.M. Healthy brand SoyNut Butter is believed to have made 16 people in nine states ill, including one confirmed case in a King County child whose parents reported the child ate this brand of soy nut butter. Fourteen of the 16 ill people in this outbreak are younger than 18 years old.

I.M. Healthy SoyNut Butter product recall

On March 7, 2017, the SoyNut Butter Company recalled all varieties of I.M. Healthy SoyNut Butters and all varieties of I.M. Healthy Granola products. The Centers for Disease Control and Prevention (CDC) advises that people not eat any variety or size of I.M. Healthy brand SoyNut Butter or I.M. Healthy brand granola coated with SoyNut Butter. Even if consumers ate this product and did not get sick, the remaining product should be thrown away. CDC recommends wrapping the product in a sealed bag before putting it in the trash so that children and pets can’t eat it.

Symptoms of STEC infections

Symptoms of STEC infections vary for each person but include severe stomach cramps and diarrhea (often bloody). Most people get better within a week. Some illnesses can be more severe, resulting in a type of kidney failure called hemolytic uremic syndrome (HUS). HUS can occur in people of any age but is most common in young children under 5 years, older adults, and people with weakened immune systems. Symptoms of HUS can include fever, abdominal pain, pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and decreased urination. People who experience these symptoms should seek emergency medical care immediately.

California:

California Department of Public Health (CDPH) Director and State Public Health Officer Dr. Karen Smith today warned consumers, especially children, not to eat I.M. Healthy brand SoyNut Butter or granola coated with SoyNut Butter. These products may be contaminated with Shiga toxin-producing Escherichia coli O157 (STEC O157).

CDPH, in coordination with local and state health departments, the U.S. Centers for Disease Control and Prevention (CDC), and the U.S. Food and Drug Administration (FDA), is investigating a multistate outbreak of STEC O157 infections.

As of March 2, 2017, 12 patients have been identified, including four from California. Most of the patients have been children, and several patients have been hospitalized with a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). The most severe cases of HUS can include kidney failure. All four California patients reported eating I.M. Healthy brand Creamy SoyNut Butter in the week before becoming ill.

“Consumers who purchased Creamy SoyNut Butter or coated granola should dispose of the product immediately, even if it was already eaten and didn’t cause illness,” said Dr. Smith.

While the investigation is ongoing, people should avoid eating any I.M. Healthy brand SoyNut Butter varieties and sizes, or granola coated with SoyNut Butter, until additional information, including the exact products and lot numbers, are confirmed. The products have a shelf life of two years.

Symptoms of illness caused by STEC O157 typically include stomach cramps and diarrhea, often with bloody stools. If there is fever, it usually is not very high. People typically become ill three to four days after exposure, but this period can range from one to eight days. Most people get better within a week. Young children and the elderly are at highest risk for HUS. People who develop symptoms of STEC infection should consult their health care provider.

Arizona:

Our disease detectives at the state and counties are at it again, investigating an outbreak of E. coli O157 . We are working with Arizona’s counties, other states, CDC, and regulatory agencies to determine the source of the outbreak.

E. coli O157 is a strain that causes diarrhea, often bloody, along with abdominal cramps, headache, and body aches. Most people recover on their own after getting sick with E. coli O157. But some people, especially young children, develop a serious complication affecting the kidneys, called hemolytic uremic syndrome, or HUS. HUS can be life threatening.

E. coli O157 is most often spread by contaminated food or drink. But people can also get sick after coming in contact with another infected person, or after contact with animals, like cattle and other livestock, who naturally carry E. coliO157 in their intestines. The germ has to be swallowed in order to get sick.

The current outbreak of E. coli was identified when the Arizona State Public Health Laboratory used molecular laboratory techniques to identify four children who had the same rare strain of E. coli. Because they had the same strain of bacteria, they likely got sick from the same source. Other people in four other states, mostly children, have also been identified with the same strain. In all, 12 people from 5 states have been identified so far, with illnesses starting in early January. More than half have been hospitalized and four children have developed HUS.

Once the laboratory link was identified, public health investigators interviewed parents and child care providers to identify all food, drinks, and other risk factors for each child during the week before they got sick. During these interviews, we discovered that several children had eaten products containing soynut butter. Further investigation identified that the child care locations for the sick children in Arizona served the same brand of products.

We still have some work to go to determine exactly what caused these children’s illnesses. But with the information we have so far, we are advising consumers to not eat I.M. Healthy Soynut Butter-containing products, including granola.

Anyone who is sick with symptoms of E. coli O157 infection should seek medical care.

Maryland:

The Maryland Department of Health and Mental Hygiene is warning consumers not to eat “I.M. Healthy” brand soy nut butter and soy nut butter-containing products from “The SoyNut Butter Company” until further notice because of possible contamination with E. coli O157 bacteria.  This strain of E. coli can cause disease by making a toxin called Shiga toxin. These bacteria are referred to as Shiga toxin-producing E. coli, or STEC.

Health and Mental Hygiene is working with other states, CDC, and the FDA to investigate a multistate cluster of E. coli O157 infections.  These infections are closely related genetically, indicating a likely common source, such as food.  The investigation is ongoing, however, the Maryland patient consumed “I. M. Healthy” soy nut butter prior to becoming ill and cases in other states might also be associated with this product.

Some types of STEC frequently cause severe disease, including bloody diarrhea and hemolytic uremic syndrome (HUS), which is a type of kidney failure. Sometimes infection causes non-bloody diarrhea or no symptoms. Symptoms typically begin within 3 to 4 days, but can range from 1 to 10 days, after exposure. Hemolytic uremic syndrome (HUS) is a serious complication that occurs in some infected people, particularly children under 5 and the elderly. In this syndrome, red blood cells are destroyed and kidney failure occurs.  Anyone suspecting STEC infection should contact their healthcare provider.

The I.M. Healthy soy nut butter and soy nut butter-containing products have been distributed to a range of stores in Maryland and are also available for purchase online. Due to their long shelf life, consumers should check for these products and not eat these products until further notice.