At least 13 people are sick from an outbreak of E. coli O157:H7in central Missouri, with a farm suspected as a possible source. Investigators at the Missouri Department of Health and Senior Services (DHSS) have not yet identified a definite source of the outbreak, though 6 of the 13 ill consumed raw milk products from the same farm in Howard County.

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According to DHSS spokeswoman Gena Terlizzi, the remaining seven individuals said they were not associated with that farm. Still, the farm is under investigation and has halted sales of its raw dairy products.

The Missouri State Public Health Laboratory has analyzed eight food samples from the farm, all of which tested negative for E. coli O157:H7.

On April 13, the DHSS released a health update on the outbreak, saying that 7 of the 13 cases had genetically matching O157 infections when tested. Tests results for another 3 cases were still pending at that time.

Five of the six ill who reported consuming raw milk products had matching O157 bacteria, while tests for the sixth are still pending.

Columbia-Boone County Health Department epidemiologist Sarah Rainey told Food Safety News that some of the 13 cases may turn out to come from separate sources, which would explain why some stool bacteria differ genetically.

Last week, Food Safety News reported that two of the victims — a 2-year-old and a 17-month-old — were hospitalized and had both developed hemolytic uremic syndrome (HUS), a kidney disease associated with severe E. coli infection. The 2-year-old’s infection matched those of the raw milk drinkers, while the 17-month-old’s did not.

The 2-year-old has also now been hospitalized for more than two weeks.

The 13 illnesses are spread across Boone, Camden, Clarke, Cooper, Howard and Jackson counties.