At least 37 people have been sickened with E. coli in connection with Chipotle Mexican Grill restaurants. According to updated case counts released Tuesday, there are 12 victims in Oregon and 25 in Washington. In Washington, residents of Clark (11), Cowlitz (2), Island (2), King (6), and Skagit (4) counties have been reported as outbreak cases. Of the 25 cases, 23 reported having been at Chipotle restaurants before getting sick. Nine of the Washington residents were hospitalized. Cases range in age from 5 to 60. Oregon’s 12 cases — up from three cases reported Oct. 31 — are linked to eating at Chipotle restaurants in the Portland metro area. Chipotle has closed at least 14 of its restaurants in Oregon’s Multnomah, Clackamas and Washington counties to assist public health agencies with their investigation. The Oregon Health Authority, Washington State Department of Health, and the U.S. Food and Drug Administration and U.S. Centers for Disease Control and Prevention are working with local health departments in the Portland area and in other Oregon counties on the outbreak investigation. During a call with reporters on Tuesday to discuss the Centers for Disease Control and Prevention’s new Vital Signs issue on food safety, CDC Director Tom Frieden said there isn’t much new information to report on the E. coli outbreak because “the investigation is really just starting now.” “We don’t have much more to tell you about this outbreak,” Frieden said. “We don’t yet know of a vehicle — what food caused it,” or whether all of the reported infections are even related to each other. He added that “there’s no reason to believe that this is associated with prior outbreaks that have affected [Chipotle].” The fast casual restaurant chain has recently experienced three consecutive outbreaks involving three separate pathogens. It briefly closed a restaurant in Simi Valley, CA, in August after 82 customers and 17 employees were sickened by Norovirus. Then, in September, 22 Chipotle locations in the Minneapolis area were associated with a Salmonella Newport outbreak in which 64 people were sickened. Later in the Nov. 3 CDC briefing, in answer to a question regarding Chipotle’s decision to close 43 of its restaurants, Frieden said, “I think it’s always better to take a broad action and then narrow it down as we learn more … . They’re being very responsible in their actions in response to the cases that have been reported.” Most people infected with E. coli develop watery or bloody diarrhea and abdominal cramps within one to 10 days, with the average three to four days. Most illnesses resolve on their own within seven days. Most people recover within a week but, rarely, some develop a severe type of kidney failure which can begin as the diarrhea is improving and is most common in children younger than five years and the elderly. Health officials want people who have eaten at a Chipotle restaurant during October 2015 and become ill with vomiting and bloody diarrhea to see their health care provider and mention this outbreak. (To sign up for a free subscription to Food Safety News, click here.)