Multi-state outbreak of E. coli shows up in Arizona daycares; linked to soynut butter

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Arizona health officials say four cases of E. coli infections involving children at Arizona child care centers appear to be linked to eating soynut butter.

The Arizona Department of Health Services is recommending that consumers avoid eating the SoyNut Butter Co.'s I.M. Healthy brand soynut butter.

The department says the four cases occurred in January in Coconino and Maricopa counties and involved children under age 5. All have recovered from the illness.

The company that produces the product has launched a voluntary recall for I.M. Healthy Original Creamy SoyNut Butter with the "Best By" date of Aug. 30 or 31 of 2018.

State health officials are working with federal and local partners to investigate the outbreak, which has affected more than a dozen people nationwide.

"Our disease detectives are working on the state and local level to rapidly identify the source of this outbreak," said Dr. Cara Christ, director of the Arizona Department of Health Services. “As we determine suspected food sources that may be linked to E. coli, our state lab will test those products to determine if there’s a match.” 

The ongoing investigation of at least four cases in Maricopa and Coconino counties is part of a larger multi-state investigation of 13 cases in five states.

Half of the Arizona cases have been hospitalized for this disease; each one of the reported cases have recovered from their illness. 

 "This strain of E. coli produces a toxin that can cause very severe symptoms including bloody diarrhea, fever, abdominal pain, nausea, vomiting, but then especially in young children and the elderly and those with health conditions that can make them more susceptible it can cause things like kidney failure," said Christ.  

Young children, the elderly, and the immuno-compromised are at risk of developing Hemolytic Uremic Syndrome (HUS), a potentially life-threatening illness that can cause kidney failure. 

“Illness from E. coli can be very serious especially for vulnerable people such as pregnant women, young children, older adults, and people with immune systems compromised by disease,” said Marie Peoples, chief health officer for the Coconino County Public Health Services District. “It’s important that everyone take appropriate precautions to protect against foodborne illness by thorough hand washing with soap and water prior to food preparation or consumption.” 

The I.M. Healthy soynut butter and soynut butter-containing products have been distributed to a range of stores and purveyors in Arizona and are also available for purchase online. Due to their long shelf life, consumers should check for these products and not eat these products until further notice.  
The Arizona State Public Health Laboratory has confirmed all four Arizona cases with the outbreak strain of STEC O157 bacteria. All of the persons became ill on or after January 16, 2017 and reported eating soynut butter-containing products. 

The Arizona State Public Health Laboratory will be testing samples to identify products involved in the outbreak. State and local health departments continue to interview confirmed cases to provide as much information as possible to CDC and FDA so that all products can be removed from the marketplace. 

The State should know by Monday if these samples are to blame.

The multi-state investigation shows most of the people affected are young children. The median age is 7, with cases ranging from age 2 to 48. About 43 percent of cases are female. At least six have been hospitalized and no deaths have been reported.

"We are only seeing those cases that got bad enough to go to their doctor and then actually return with a stool sample to get it tested at the state lab. So we are probably only seeing the tip of the iceberg," said Christ. 

The national investigation has also pointed to soynut butter-containing products as the source of this outbreak contamination that appears to be linked with soynut butter-containing products.
To prevent illness, avoid consumption of I.M. Healthy soynut butter and soynut butter-containing products until further notice. In addition, thorough hand washing with soap and water prior to food preparation or consumption and after using the toilet is recommended.

Wash fruits and vegetables before eating or cutting them up. E. coli can be killed by cooking beef steaks and roasts to an internal temperature of 145°F and ground beef to 160°F. Avoid cross-contamination of food during preparation by washing hands, cutting boards, utensils, and surfaces after they touch raw meat. 

The Centers for Disease Control has more information online.

The manufacturer released the following statement on its website:

The SoyNut Butter Co. has announced a voluntary recall of our of I.M. Healthy Original Creamy SoyNut Butter with the Best By date of 08-30-18 or 08-31-18. The voluntary recall is in response to the FDA alerting us of a possible link between our product and illnesses regarding E.coli. While we are taking the necessary investigative steps in getting the product in question and the supply chain tested, we decided to issue the recall for the sake of food safety. We take our products integrity seriously and will update all our customers as we receive more information.

Consumers who have purchased I.M. Healthy Original Creamy SoyNut Butter should not consume the product. The recall does noteffect any other I.M. Healthy products except for the I.M. Healthy Original Creamy with the Best By date of 08-30-18 or 08-31-18. For questions or concerns, please call our office at 800-288-1012.

Copyright 2017 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.

The Associated Press contributed to this report.

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