While acknowledging they have as many as four more cases of toxin-producing E. coli, health official in Northeast Tennessee are telling parents not to panic over stomach flu that is also showing up in the region.

Northeast Tennessee’s eight counties added one confirmed E. coli case for a total of 11 in the current outbreak. There are three more suspected cases waiting for laboratory confirmation.

But there’s also a nasty stomach bug going around in the area and health officials are telling parents not to panic if their child develops a fever or vomiting. However, they are warning parents to take children with bloody diarrhea to the doctor immediately.

Dr. Demetrio Macariola, a pediatric infectious disease specialist at Eastern Tennessee State University, said bloody diarrhea is a “red flag” symptom of a more serious E. coli infection.

In addition to to Tennessee’s cluster of E. coli cases, there were also two cases across the border in Southwest Virginia, where the foodborne illness was blamed for the death of a two-year-old girl.

The source of the current outbreak has not been determined, but Tennessee health officials are conducting field interviews.

Health officials say the Tennessee E. coli cases are not related to the outbreak in Germany, and the strain of E. coli for these cases is not O157: H7.

The two illnesses in Southwest Virginia were confirmed as O157:H7 cases.  The brother of the little girl who died has recovered.