State health officials are working with federal and local partners to investigate four cases of Shiga Toxin-Producing E. coli (STEC) O157 infections that appear to be linked to eating soynut butter-containing products from “The SoyNut Butter Company.” The Arizona Department of Health Services is recommending consumers avoid eating “I.M. Healthy” brand soynut butter and soynut butter-containing products.

I.M. Healthy“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 12 cases in five states. In Arizona, all cases are children under the age of 5 years old. Half of the Arizona cases have been hospitalized for this disease; each one of the reported cases have recovered from their illness.

E. coli infection ranges from mild to severe, with symptoms lasting about five to seven days in most people. Symptoms of E. coli include diarrhea (sometimes bloody), fever, and abdominal pain. 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.

“Individuals with symptoms such as nausea, diarrhea, and abdominal cramping should seek medical attention if they develop bloody diarrhea or cannot drink enough fluids to keep hydrated,” said Dr. Rebecca Sunenshine, medical director for Maricopa County Department of Public Health. “We are asking healthcare providers to get stool cultures if they suspect E. coli especially in young children.”

“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 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% of cases are female. At least six have been hospitalized and no deaths have been reported. 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.

STEC O157 infections in Arizona have fluctuated over the last decade, from as few as 68 to as many as 246.