Health authorities are investigating a multistate E. coli outbreak potentially connected to raw-milk cheese.
Thirteen people have become ill and eight have required hospitalization after reportedly eating products linked to E. coli O26:H11. The strain produces Shiga toxins that can damage the intestinal lining, causing intense stomach cramps, watery or bloody diarrhea, fever and vomiting, according to the Food and Drug Administration and the Centers for Disease Control and Prevention.
Three patients have also developed hemolytic uremic syndrome, or HUS, a serious complication that can cause potentially fatal kidney failure.
Investigators are examining Sierra Nevada Graziers grass-fed raw milk cheese as the possible source of the outbreak.
After being notified about the illnesses, Sierra Nevada Cheese Company agreed to voluntarily recall its medium cheddar, sharp cheddar, Monterey Jack and jalapeño Jack cheeses.
Officials have not determined which individual products may have been contaminated. The FDA said its inquiry remains underway as authorities work to identify the source and determine whether other products are involved.
Cases have been identified in nine states: California, Colorado, Georgia, Kentucky, Michigan, Nevada, Oregon, Tennessee and Utah.
The recalled cheeses were produced using raw, or unpasteurized, milk.
Raw cheese products have been recalled over concerns they may contain E. coli bacteria
Pasteurization relies on heat to destroy dangerous germs, including E. coli. Products made without that process can therefore carry a greater risk of harmful bacteria.
The FDA advised consumers who bought the recalled cheese to return it to the retailer for a refund.
The products were sold at unspecified retail locations in 8-ounce and 16-ounce packages. They were also distributed to food-service businesses and wholesalers in 5-pound loaves, described as large rectangular blocks of cheese.
Public health officials are speaking with patients to learn which foods they consumed during the week before symptoms began.
All nine people interviewed by the CDC said they had eaten Sierra Nevada Graziers grass-fed raw milk cheese.
The reported illnesses occurred between July 7 and August 26.
RELATED: Senior military leaders promise strong support for Israel despite demonstrations – NewsFinale
The CDC cautioned that the outbreak may be larger than current figures suggest, since many people recover without seeking medical care or undergoing testing for E. coli.
More recent cases may also not have been counted yet because it can take three to four weeks to establish whether an illness is connected to an outbreak.
Oregon, Utah, Colorado, Michigan, Kentucky, Tennessee and Georgia have each recorded one case. California and Nevada have reported three cases apiece.
CDC data shows that patients range in age from 1 to 58, with a median age of five. More than half of those sickened are children aged five or younger.
E. coli infections are commonly associated with undercooked meat, unpasteurized dairy products and raw foods such as apples, cucumbers and sprouts.
Roughly 75,000 to 90,000 Americans are exposed to the bacteria each year and about 100 die annually. However, cases are vastly undercounted because most people recover without complications and do not get tested.
Sierra Nevada Cheese Company recalled these products after learning of the E. coli outbreak
The CDC’s map showing the number of E. coli cases linked to the outbreak per state
E. coli bacteria stop growing at temperatures below 45.5F (7.5C) but can survive being frozen and are able to withstand temperatures below -112F (-80C).
Once back in a warm environment, the bacteria are reactivated and start to grow – potentially causing an infection.
E. coli typically sickens people between two and eight days after exposure.
Most patients develop bloody diarrhea and vomiting, as well as stomach cramps, but recover within a week. In more severe cases, some develop HUS, a type of kidney failure most common in children under five, the elderly and people with compromised immune systems.
Symptoms include easy bruising, decreased urine and a pale appearance. A kidney transplant may be necessary in severe or life-threatening instances.
The CDC warned individuals who believe they have been sickened to seek medical care immediately if they experience diarrhea with a fever higher than 102F (39C), diarrhea that does not improve for more than two days, bloody diarrhea, vomiting to the point of being unable to keep down liquids or signs of dehydration such as not urinating often, dry mouth and throat and dizziness.
The agency advised against consuming raw dairy and suggested washing and sanitizing items and surfaces that may have come into contact with the recalled products.