Eleven more cases of E. coli O26 infection have been confirmed in the outbreak  linked to raw clover sprouts served at Jimmy John’s sandwich restaurants. The newly reported cases raise the outbreak toll to 25 in 8 states.

In an investigation update Thursday, the Centers for Disease Control and Prevention said nine cases have been reported in Michigan, five in Iowa, three each in Missouri and Ohio, two in Kansas and one each in Alabama, Arkansas and Wisconsin.

The 11 cases confirmed since the CDC’s last report, on February 24, were from Alabama, Michigan and Ohio.

Of the 24 ill people who provided information to outbreak investigators, 21 (87 percent) said they ate sprouts at Jimmy John’s restaurants during the week before they became ill. 

The ill people range in age from 9 to 53 years old (median age is 26) and 88 percent are female. Six were so ill they had to be hospitalized.  Onset of their illnesses ranged from Dec. 25, 2011 to Feb. 15, 2012.

“Results of the epidemiologic and traceback investigations indicate eating raw clover sprouts at Jimmy John’s restaurants is the likely cause of this outbreak,” the CDC has concluded.

There have been no recalls involved with this outbreak, and the CDC and Food and Drug Administration have not named the sprout supplier.

Raw sprouts, considered a high-risk food, have been associated with at least 40 foodborne illness outbreaks — mostly E. coli and Salmonella infections — since 1990. Raw sprouts served at Jimmy John’s restaurant franchises have been linked to five outbreaks in four years.

Sprout seeds are typically the problem. They can become contaminated with pathogens from animal feces, or from dirty growing or processing equipment. The bacteria then multiply to dangerous levels as the seeds germinate under humid conditions. Homegrown sprouts are not necessarily any safer than commercially grown sprouts.

Jimmy John’s recently indicated it would no longer serve raw sprouts with its sandwiches.

The CDC’s advice about sprouts:

– Children, older adults, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind (including alfalfa, clover, radish, and mung bean sprouts).

– Cook sprouts thoroughly to reduce the risk of illness. Cooking thoroughly kills the harmful bacteria.

– Request that raw sprouts not be added to your food. If you purchase a sandwich or salad at a restaurant or delicatessen, check to make sure that raw sprouts have not been added.

– Persons who think they might have become ill from eating potentially contaminated sprouts should consult their health care providers.

More information about illnesses associated with sprouts can be found at Sprouts: What You Should Know.

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CDC outbreak map

As far back as September 1998, the FDA issued a warning against sprouts urging:

children, pregnant women and the elderly

should not eat alfalfa sprouts until growers find a way to reduce the

risk of a potentially deadly bacteria that infects some sprouts, the

Food and Drug Administration said this week. The FDA, which is

investigating sprout industry practices, said children, the elderly and

people with weakened immune systems should avoid eating sprouts. The

agency’s statement, issued Monday, repeated similar but little-noticed

advice the U.S. Centers for Disease Control gave to doctors and

researchers a year ago.

Bill Marler, publisher of Food Safety News, has filed two lawsuits against Jimmy John’s in Iowa.