The Centers for Disease Control and Prevention (CDC) announced today that 27 E. coli cases have now been confirmed in connection with an E. coli O121 outbreak that has been traced to Farm Rich brand frozen foods. According to the CDC, residents of 15 states have been confirmed ill with E. coli O121 infections since December 30, 2012. Three states reported the confirmation of one new case each in this latest outbreak update: Illinois, Michigan and New York. Other states reporting illness are Alabama, Arkansas, Indiana, Mississippi, Ohio, Pennsylvania, South Dakota, Texas, Utah, Virginia, Washington and Wisconsin. The number of outbreak victims who developed hemolytic uremic syndrome, a complication of E. coli infection that can lead to kidney failure and central nervous system impairment, increased from one to two in this latest update. Rich Products Corporation expanded its recall of Farm Rich frozen mini meals and snack foods yesterday to include over 10 million pounds of frozen pizzas, quesadillas, mozzarella bites, sandwiches and other foods. Both the U.S. Department of Agriculture and U.S. Food and Drug Administration are working with the company, which said yesterday its recall includes all products produced at the Rich Products Waycross, Georgia plant between July 1, 2011 and March 29, 2013. Investigations are ongoing to determine the specific types and sources of frozen food that might be linked with illness, as well as to determine which particular ingredients or components of these products may be contaminated. In its latest outbreak update the CDC stated:

Testing conducted by the Outbreaks Section of the USDA-FSIS Eastern Laboratory identified the outbreak strain of STEC O121 from individually wrapped Farm Rich brand frozen mini pizza slices from an opened package collected from an ill person’s home in Texas. The frozen mini pizza slices were included in the products that were recalled on March 28, 2013. Testing conducted by the Outbreaks Section of the USDA-FSIS Eastern Laboratory identified the outbreak strain of E. coli O121 from individually wrapped Farm Rich brand frozen mini pizza slices from an opened package collected from an ill person’s home in Texas. The frozen mini pizza slices were included in the products that were recalled on March 28, 2013.

E. coli O121 was previously isolated from a frozen quesadilla taken from a New York resident’s home. E. coli O121 E. coli O121 is a Shiga toxin-producing strain of E. coli (STEC) that causes severe disease, including bloody diarrhea and hemolytic uremic syndrome. STEC bacteria are divided into serogroups (e.g., O157 or O121). E. coli O157 is the STEC serogroup found most commonly in U.S. patients. Other E. coli serogroups in the STEC group, including O121, are sometimes called “non-O157 STECs.” Because clinical laboratories typically cannot directly identify non-O157 STEC serogroups, they must first test stool samples for the presence of Shiga toxins. Then, the positive samples must be sent to public health laboratories to look for non-O157 STEC. In recent years, the number of clinical laboratories that test for Shiga toxin has increased greatly, but some laboratories still do not perform these tests. Because of these complexities, many non-O157 STEC infections are probably not identified. Anyone who has consumed the recalled products and is experiencing symptoms of E. coli infection should contact a healthcare provider or public health agency and request that their stool is tested for the presence of E. coli O121. According to the CDC, the “genetic fingerprint” of the E. coli O121 bacteria isolated from case-patients and food samples in this outbreak is rare.