More patients are being identified by investigators working on an E. coli O157 outbreak that has been limited to Washington State. However, today Arizona officials confirmed there is a child in that state with an infection from the same strain of the pathogen.

There are 11 confirmed patients in Washington in the outbreak linked to locally produced organic yogurt sold by Pure Eire Dairy. Another three probable patients are from the Moses Lake area in Adams County, WA. Teresa McCallion of the Washington Department of Health said it is not unusual for counties and local health departments to know of probable cases before they are added to the state’s tally.

“We only report confirmed cases,” McCallion told Food Safety News on Wednesday evening. The Washington Health Department is working on a special outbreak information web page, which McCallion said should be available soon.

In Arizona, health officials are working to confirm a suspected link between a patient there and the Washington outbreak.

“We have a case of E. coli 0157 in a 2-year-old girl that matches by whole genome sequencing the cluster of cases in Washington linked to Pure Eire yogurt. It’s likely she was exposed by a relative who traveled from Washington state,” Steve Elliott of the department told Food Safety News.

In Washington, investigators from the state Department of Agriculture have collected 27 product samples of various types and 40 environmental samples, according to a department spokesman. Results of those tests are expected in the coming days.

“We are still working on assessing the yogurt production process and reviewing records as part of the investigation,” the spokesman told Food Safety News.

The dairy has shut down the production of all of its products, which include unpasteurized, raw milk.

Washington State officials report that the 11 confirmed cases include six children younger than 10 years old. Seven people have been so sick they had to be admitted to hospitals. Three people have developed hemolytic uremic syndrome (HUS), a serious complication that can lead to complete kidney failure and sometimes death. The sick people are spread across four counties.

Pure Eire Dairy recalled all of its organic PCC brand yogurts Friday, May 14, after outbreak patients reported eating it before becoming sick. All flavors and best-by dates of the 8-ounce and 16-ounce yogurt sold under the PCC brand have been recalled.

About E. coli infections
Anyone who has eaten any of the implicated products and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which are often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

Disclosure:  William Marler, of Marler Clark, is the publisher of Food Safety News and represents five of the reported victims.

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