UPDATE: 2 p.m. Eastern, March 3, 2017, — The CDC has posted outbreak details.

Victims of E. coli infection in three states report they ate I.M. Healthy brand “SoyNut Butter” before becoming ill, spurring state and federal public health officials to warn consumers nationwide not to eat the products until further notice.

I.M. Healthy SoyNut Butter labelsThe Maryland Department of Health and Mental Hygiene was the first government agency to go public with the possible source of the pathogen, posting a consumer warning about the I.M. Healthy brand soy nut butter Thursday. The state is working with other states, the federal Centers for Disease Control and the Food and Drug Administration to confirm the connection between the soy butter and illnesses.

The CDC had told Food Safety News on Wednesday that it was investigating foodborne sources for multiple E. coli illnesses across four states.

Following the lead of Maryland, on Thursday night the CDC posted a statement warning consumers about I.M. Healthy brand products. Officials from the Food and Drug Administration later told Food Safety News that they are working on the investigation, also.

“CDC, FDA, and several states are investigating an outbreak of 12 illnesses of Shiga toxin-producing E. coli (STEC) O157:H7 reported from several states. Epidemiologic information collected to date indicates that I.M. Healthy brand ‘SoyNut Butter’ products might be contaminated with this harmful bacteria and are a likely source of this outbreak,” according to CDC’s Thursday notice.

“CDC recommends that people not eat or serve these products. CDC will post additional details on its outbreak website on Friday, March 3.”

I.M. Healthy logoA spokeswoman for I.M. Healthy, which is based in Glenview, IL, who would only identify herself as “Marsha” told Food Safety News Thursday morning that the company had not been contacted by anyone from the CDC or any other agency about a possible problem with its products.

“We would be the first to know if there was a problem,” the I.M. Healthy spokeswoman said.

“The CDC would call us first.”

Advice for consumers nationwide
Anyone who has eaten I.M. Healthy brand “SoyNut Butter” products of anything containing the products and developed symptoms of E. coli infection should immediately seek medical attention and tell their doctors about the possible exposure to the bacteria.

“The symptoms of STEC infections vary but often include severe stomach cramps, diarrhea — often bloody — and vomiting,” according to the CDC notice.

“Most people get better within 5–7 days, but some infections are severe or even life-threatening. Hemolytic uremic syndrome (HUS), a type of kidney failure, is a potentially life-threatening complication of E. coli O157 infection. Very young children and the elderly are more likely to develop severe illness and HUS than others, but even healthy older children and young adults can become seriously ill.”

The CDC advises people to watch for diarrhea that lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

Public health officials are concerned that consumers may have the I.M. Healthy “SoyNut Butter” and other products containing it in their homes and are urging people nationwide to check their kitchens.

The products were “distributed to a range of stores in Maryland and are also available for purchase online,” the Maryland warning states. “Due to their long shelf life, consumers should check for these products and not eat these products until further notice.”

Children hit hard so far
At least two children who became ill in the past month with E. coli infections ate I.M. Healthy “SoyNut Butter” products before becoming ill, said Bill Marler, a Seattle attorney who specializes in foodborne illnesses cases.

“A week ago I was contacted by a woman who’s young son was hospitalized at Stanford Medical Center and was on dialysis,” Marler said Thursday night. “She said she has been interviewed by the California Department of Public Health and that they took I.M. Healthy SoyNut Butter from her for testing.”

Public health officials told the California mother that the E. coli infecting her son is a genetic match with E. coli that has infected about a dozen other children in multiple states, Marler said.

I.M. Healthy soy nut butterOfficials with the California Department of Public Health did not provide any details about the situation Thursday, neither confirming nor denying the state’s involvement in the investigation.

It is still unknown whether a child on dialysis in an intensive care unit in a Seattle hospital is infected with the same strain of E. coli as the California boy.

“Her mother said they are waiting on test results, but like the boy in California, the girl also ate I.M. Healthy SoyNut Butter before getting sick” Marler said. He said he had advised the mother to contact local public health officials so they could collect the unused product from her for testing.

The California boy became sick the second week of February and was in the hospital for about 10 days. The girl in Seattle became sick the last week of February.

“I think we could be seeing early signs of a larger, multi-state outbreak,” Marler said.

The consumer warning from Maryland health officials also suggested additional victims are possible.

“These infections are closely related genetically, indicating a likely common source, such as food. The investigation is ongoing, however, the Maryland patient consumed I.M. Healthy soy nut butter prior to becoming ill and cases in other states might also be associated with this product.”

Marler said outbreaks from contaminated nut butter products can be difficult to detect because pathogens can be unevenly dispersed through the products — both in individual containers and during production runs. By testing multiple samples of unused product that outbreak victims consumed and comparing date codes, outbreak investigators can begin to determine how much contaminated product is on the market.

Editor’s note: Bill Marler is publisher of Food Safety News.

(To sign up for a free subscription to Food Safety News, click here.)