The U.S. Centers for Disease Control and Prevention (CDC) posted an update Friday, Dec. 4, on the E. coli outbreak associated with Chipotle Mexican Grill. The agency reported that, as of Dec. 2, 52 people from nine states have been sickened, 20 have been hospitalized, and there are no deaths. The seven additional E. coli cases have been reported from California (1), Illinois (1), Maryland (1), Ohio (2), Pennsylvania (1), and Washington (1) since the last update on Nov. 20, CDC noted. of these illnesses started in October, and five started in November 2015. The new states reporting cases are Illinois, Maryland and Pennsylvania. Of the three most recent illnesses reported in November, only one ill person, whose illness started on Nov. 10, reported eating at Chipotle Mexican Grill in the week before their illness began, CDC stated. The specific food item being linked to these illnesses has still not been determined, and the investigation is continuing, according to CDC. Previous coverage follows: According to the latest update posted Friday, Nov. 20, from the U.S. Centers for Disease Control and Prevention (CDC), there are now 45 people sickened in the E. coli outbreak linked to Chipotle Mexican Grill outlets in Washington and Oregon. That is an increase from 37 cases reported on Wednesday, Nov. 18. CDC noted that it is only reporting ill people who have been confirmed by PulseNet as being infected with the outbreak strain of Shiga toxin-producing Escherichia coli O26 (STEC O26). Forty-five people infected with the outbreak strain of STEC O26 have been reported from six states. The majority of illnesses have been reported from Washington and Oregon. The number of ill people reported from each state is as follows: California (2), Minnesota (2), New York (1), Ohio (1), Oregon (13), and Washington (26). Among people for whom information is available, illnesses started on dates ranging from Oct. 19, 2015, to Nov. 8, 2015. Ill people range in age from 2 years to 94, with a median age of 22. Fifty-eight percent of ill people are female. Sixteen (36 percent) people reported being hospitalized. There have been no reports of hemolytic uremic syndrome and no deaths. The epidemiologic evidence available to investigators at this time suggests that a meal item or ingredient served at Chipotle Mexican Grill restaurants at several states is a likely source of this outbreak. The investigation has not identified what specific food is linked to illness. Chipotle Mexican Grill is assisting public health officials with understanding the distribution of food items served at locations where ill people ate and this work is ongoing. State and local public health officials are interviewing ill people to obtain information about foods they might have eaten and other exposures in the week before their illness started. Forty-three (96 percent) of 45 people interviewed reported eating at a Chipotle Mexican Grill restaurant. The investigation is ongoing to identify common meal items or ingredients causing illness. This outbreak can be illustrated with a chart showing the number of people who became ill each day. This chart is called an epidemic curve or epi curve. Illnesses that occurred after Oct. 31, 2015, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of two to three weeks. Please see the Timeline for Reporting Cases of E. coli Infection for more details. CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill persons and to interview them. Investigators are also using whole genome sequencing, an advanced laboratory technique, to get more information about the DNA fingerprint of the STEC O26 bacteria causing illness. To date, whole genome sequencing has been performed on STEC O26 isolates from nine ill people in Washington and one ill person in Minnesota. All 10 isolates were highly related genetically to one another. This provides additional evidence that illnesses outside the Pacific Northwest are related to the illnesses in Oregon and Washington. Updates will be provided when more information is available. Previous coverage follows: On Nov. 12, 2015, the U.S. Centers for Disease Control and Prevention (CDC) reported there were 50 ill people from Washington (31) and Oregon (19) from Shiga toxin-producing Escherichia coli O26 (STEC O26) infections. Fourteen of them were hospitalized in Washington (10) and Oregon (4) in this outbreak linked to Chipotle restaurants in those two states. On Wednesday, Nov. 18, CDC reported that public health officials in Washington, Oregon, and Minnesota had announced that they are continuing the investigation of an outbreak of Shiga toxin-producing E. coli O26 (STEC O26) infections. CDC and the U.S. Food and Drug Administration (FDA) are assisting with the investigation. As of Nov. 17, 2015, 37 people infected with the outbreak strain of STEC O26 have been reported to CDC PulseNet from Washington (24) and Oregon (13), according to CDC. Thirteen of these people were hospitalized in Washington (9) and Oregon (4). Additional illnesses are under investigation in those two states and will be reported if they are confirmed to be infected with the outbreak strain of STEC O26. There have been no reported infections with the outbreak strain of STEC O26 in Washington or Oregon since the Chipotle Mexican Grill locations closed in the Pacific Northwest on Oct. 30, 2015, CDC noted. A search of the PulseNet database identified one person in Minnesota infected with STEC O26 that has the same DNA fingerprint as ill people in Washington and Oregon. This ill person did not eat at a Chipotle Mexican Grill in the week before illness onset. Minnesota’s investigation is ongoing. The illness does not appear to be linked to Chipotle Mexican Grill locations in Washington and Oregon, CDC stated. Washington and Oregon report that nearly all of the ill people ate at several locations of Chipotle Mexican Grill in those states before getting sick. The investigation is still ongoing to determine if the ill people ate a meal item or ingredient in common that was served at the Chipotle Mexican Grill locations. Chipotle Mexican Grill has reopened its restaurants in Washington and in the Portland, OR, area that had been closed in response to this outbreak investigation.

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