More than two dozen people have been infected by an E. coli O157:H7 outbreak that is being preliminarily blamed on cheese that was sold and offered in free samples by Costco.

A public health warning was issued late Thursday by the federal Centers for Disease Control and Prevention in Atlanta, the U.S. Food and Drug Administration (FDA) and the Issaquah, WA-based Costco Wholesale Corporation.  Consumers were told not to eat Bravo Farms Dutch Style Gouda cheese.

The cheese has been linked to an outbreak strain of E. coli O157:H7 that has sickened 25 people in five states since mid-October.  It was sold as Costco item 40654 and given to the public in free samples at multiple Costco outlets.

According to the Bravo Farms website, the cheese is “handmade in small wheels and hand dipped in red wax” and made from whole raw milk aged for 2 months.

Costco offered the Bravo Farms Dutch Style Gouda cheese for sale and also for in-store tasting at its stores in Arizona, Colorado, New Mexico, Nevada and the San Diego area in California.

Costco has voluntarily removed the cheese from its stores and used purchase records to notify consumers who may have purchased or sampled the cheese between Oct. 5 and Nov. 1.  Consumers are being told that they can return the product for a refund.

The FDA says consumers who purchased the Gouda cheese should return it in a closed plastic bag or place it in a sealed trash can to prevent its consumption by people or animals, including wild animals.

The number of ill persons identified in each state with this strain is as follows: AZ (11), CA (1), CO (8), NM (3) and NV (2). There have been 9 reported hospitalizations, one  possible case of hemolytic uremic syndrome (HUS), and no deaths.

E. coli O157:H7 symptoms include diarrhea and abdominal cramps.  Some illnesses may last longer and can be more severe.

Rarely, as symptoms of diarrhea improve, a type of kidney failure called hemolytic uremic syndrome (HUS) can occur; this can happen at any age but is most common in children under 5 years old and in older adults.

People with HUS should be hospitalized immediately, because their kidneys may stop working and they may be at risk for other serious health problems.