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  5. Outbreak Investigation of E. coli O103: Clover Sprouts (February 2020)
  1. Outbreaks of Foodborne Illness

Outbreak Investigation of E. coli O103: Clover Sprouts (February 2020)

Consumers should not eat Chicago Indoor Garden’s recalled products. CDC reports additional cases in this outbreak.

March 19, 2020

Recommendation

Chicago Indoor Garden is recalling all products containing Red Clover sprouts. FDA is recommending that consumers not eat the following recalled items with “Best By” dates between 12/1/2019 and 3/12/2020 that were distributed to Whole Foods throughout the Midwest, Coosemans Chicago Inc., Battaglia Distributing, and Living Waters Farms:

  • Red Clover 4oz. clamshell
  • Red Clover 2lb. boxes
  • Sprout Salad 6oz. clamshell
  • Mixed Greens 4oz. clamshell
  • Spring Salad 6oz. clamshell
Chicago Clover Sprouts

(PDF: 849 KB)

Generally, it is recommended that children, the elderly, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind.

Background

FDA, along with CDC and state and local partners, are investigating an outbreak of 39 illnesses caused by E. coli O103 in Florida, Iowa, Illinois, Missouri, Texas and Utah linked to clover sprouts..

The FDA's analysis of a sample of Chicago Indoor Garden’s sprouts identified the presence of E. coli O103. Whole Genome Sequencing of this bacteria showed that it matches the current outbreak strain. The sample also matches the outbreak strain from the November-December 2019 outbreak in Iowa, which was associated with sprouts from various Jimmy John’s restaurants.

CDC reported on February 26, 2020 that the epidemiologic evidence indicates that clover sprouts from Jimmy John’s restaurants are a likely source of the illnesses that have occurred since January 2020.

On February 24, 2020, Jimmy John’s had reported to FDA that they had removed sprouts from all of their restaurants.

Subsequently, an FDA traceback investigation has shown that a common seed lot was used to grow the sprouts recalled by Chicago Indoor Garden and sprouts served at some Jimmy John’s locations during this outbreak and the outbreak in 2019.

As the outbreak investigation progresses, the FDA will continue in its traceback investigation to determine where implicated sprouts and seeds have been distributed. FDA and CDC will continue monitoring for additional illnesses associated with this outbreak.

Case Counts

Total Illnesses: 39
Hospitalizations: 2
Deaths: 0
Last illness onset: March 2, 2020
States with Cases: FL (1), IA (3), IL (6), MO (1), TX (1) UT (27)


What is E. coli?

E. coli are mostly harmless bacteria that live in the intestines of people and animals and contribute to intestinal health. However, eating or drinking food or water contaminated with certain types of E. coli can cause mild to severe gastrointestinal illness. Some types of pathogenic (illness-causing) E. coli, such as Shiga toxin-producing E. coli (STEC), can be life-threatening.

People infected with pathogenic E. coli can start to notice symptoms anywhere from a few days after consuming contaminated food or as much as nine days later. Generally, the symptoms include severe stomach cramps, diarrhea, fever, nausea, and/or vomiting.

The severity or presence of certain symptoms may depend on the type of pathogenic E. coli causing the infection. Some infections can cause severe bloody diarrhea and lead to life-threatening conditions, such as a type of kidney failure called hemolytic uremic syndrome (HUS), or the development of high blood pressure, chronic kidney disease, and neurologic problems. Other infections may have no symptoms or may resolve without medical treatment within five to seven days.

Due to the range in severity of illness, people should consult their health care provider if they suspect that they have developed symptoms that resemble a(n) E. coli infection., including HUS, but even healthy older children and young adults can become seriously ill.

People of any age can become infected with pathogenic E. coli. Children under the age of 5 years, adults older than 65, and people with weakened immune systems are more likely to develop severe illness as a result of an E. coli infection. However, even healthy older children and young adults can become seriously ill.

General Food Safety Tips for Retailers

Restaurants and retailers should always practice safe food handling and preparation measures. It is recommended that employees wash hands, utensils, and surfaces with hot, soapy water before and after handling food.

  • Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.
  • Wash and sanitize display cases and refrigerators regularly.
  • Wash and sanitize cutting boards, surfaces, and utensils used to prepare, serve, or store food.
  • Wash hands with hot water and soap following the cleaning and sanitation process. 

General Food Safety Tips for Consumers

People should consult their healthcare provider if they suspect that they have developed symptoms that resemble a E. coli infection.

Consumers should follow these steps for preventing foodborne illness:

  • Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.
  • Wash and sanitize surfaces used to serve or store potentially contaminated products.
  • Wash hands with warm water and soap following the cleaning and sanitation process.

Consumers can also submit a voluntarily report, a complaint, or adverse event (illness or serious allergic reaction) related to a food product.

Children, the elderly, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind.

Previous Updates

March 13, 2020

FDA, along with CDC and state and local partners, are investigating an outbreak of 14 illnesses caused by E. coli O103 in Iowa, Illinois, Missouri, Texas and Utah likely linked to clover sprouts.

The FDA's analysis of a sample of Chicago Indoor Garden’s product identified the presence of E. coli O103. Whole Genome Sequencing of this bacteria showed that it matches the outbreak strain.

As the outbreak investigation progresses, the FDA will continue in its traceback investigation to determine where implicated sprouts have been distributed and will continue monitoring for additional illnesses associated with this outbreak.

February 26, 2020

FDA, along with CDC and state and local partners, are investigating an outbreak of 14 illnesses caused by E. coli O103 in Iowa, Illinois, Missouri, Texas and Utah. CDC reported on February 26 that the epidemiologic evidence indicates that clover sprouts from Jimmy John’s restaurants are a likely source of this outbreak. 

On February 21, 2020, the FDA issued a warning letter to Jimmy John’s Franchise LLC for engaging in a pattern of receiving and offering for sale adulterated fresh produce, specifically clover sprouts and cucumbers. On February 24, 2020, Jimmy John’s reported to FDA that they had removed sprouts from all of their restaurants.

The warning letter lays out evidence from five outbreaks, including recent outbreaks in the state of Iowa during November and December 2019, of human infections with Escherichia coli O103, a Shiga toxin producing Escherichia coli (STEC) linked to sprouts.

These 14 illnesses are new and are not associated with the outbreaks mentioned in the Jimmy Johns warning letter. FDA will continue its investigation and provide updates as more information becomes available.


Who to Contact

Consumers who have symptoms should contact their health care provider to report their symptoms and receive care.

To report a complaint or adverse event (illness or serious allergic reaction), you can

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