North Carolina’s E. coli outbreak — mostly connected to the state fair — continued to expand Tuesday.

The North Carolina Division of Public Health said it is investigating nine confirmed and 18 suspected cases of E. coli O1257:H7 for a total of 27.

That’s three more cases than the public health division reported earlier in the week, when it adjusted its count downward to 24, from an earlier reported 26.

Officials say 24 is the number of illnesses they’ve definitely linked to the state fair.  All of the nine confirmed cases are connected to the fair.

However, the source of the contamination at the fair is still unknown.  Possible culprits include food vendors, animal exhibits and the petting zoo. 

Health officials are now questioning both people who became sick after attending the fair and those who attended but did not become sick.  They say four of the five people who remain hospitalized are children.

A breakdown of the state’s counties with cases follows:

– Wake County: 12 cases reported

– Cleveland: 1 confirmed case

– Durham: 1 reported case

– Johnston: 1 reported case

– Lenoir: 1 reported case

– Sampson: 7 reported cases

– Wilson: 2 reported cases

– Orange: 2 reported cases