The rapidly evolving investigation into the outbreak of rare E. coli O103 is looking beyond the two previously announced ground beef recalls into additional sources for the contamination, the federal Centers for Disease Control and Prevention has disclosed.

“Ill people in this outbreak ate ground beef from many sources,” the CDC warned this afternoon. The agency says investigators continue to trace other sources for ground beef. More products contaminated with E. coli O103 may be recalled.

Meanwhile, the CDC is reporting the E. coli O103 outbreak continues to grow with 21 additional victims. It brings the total number of people infected with the outbreak strain to 177 across 10 states. Twenty-one people have been admitted to hospitals. No cases of hemolytic uremic syndrome, a type of kidney failure associated with E. coli infections, have been reported. No deaths have been confirmed.

Grant Park Packing in Franklin Park, IL, and K2D Foods, doing business as Colorado Premium Foods in Carrollton, GA, earlier this week recalled raw ground beef because of likely E. coli O103 contamination.

The CDC reported laboratory testing found the outbreak strain of E. coli O103 in samples from the recalling companies. Testing is ongoing on another sample from one of the companies to determine if it contains the outbreak strain.

But, the CDC is looking beyond those two companies.

“Some ill people in this outbreak ate ground beef from other sources other than the products currently recall,” CDC’s late Friday update says. “Investigators continue to race other sources for ground beef, and more products may be recalled.”

The Colorado Premium Foods recall was for 113,434 pounds of raw ground beef on April 23, and the next day Illinois’s Grant Park Packing recalled 53,200 of raw ground beef.

So far, its people are known to have become ill from March 1, 2019, to April 14, 2019.

The multistate investigation into the outbreak of the rare E. coli O103 strain has been underway since March 28, 2019, when state public health officials in Kentucky and Georgia notified CDC.  Epidemiologic and laboratory evidence indicates that ground beef is the likely source of this outbreak.

CDC reports that In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of the 125 people interviewed, 100, representing 80 percent, reported eating ground beef.

“This percentage is significantly higher than results from a survey of healthy people,” CDC’s update says Ill people bought or ate ground beef from several different grocery stores and restaurants. Many ill people bought large trays or chubs of ground beef from grocery stores and used the meat to make dishes like spaghetti sauce and sloppy joe.”

The U.S. Department of Agriculture’s Food Safety and Investigation Service (FSiS) in Kentucky, and in Tennessee collected ground beef from a restaurant and an institution where ill people reported eating.

Laboratory testing identified the outbreak strain of E. coli O103 in the ground beef collected in Tennessee. E. coli O103 was identified in the ground beef collected in Kentucky, but laboratory results are pending to determine if it is closely related to the E. coli O103 identified in ill people.

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