2020 E. coli Outbreak Linked to Clover Sprouts – Investigation Updates
Final Update
Posted on April 22, 2020 at 3:00 PM ET
This outbreak appears to be over. However, raw and lightly cooked sprouts are a known source of foodborne illness. CDC recommends that consumers, restaurants, and other retailers always follow food safety practices to avoid illness from eating sprouts.
March 19, 2020
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of E. coli O103 infections linked to clover sprouts.
As of March 17, 2020, 39 people infected with the outbreak strain of E. coli O103 have been reported from six states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.
Illnesses started on dates ranging from January 6, 2020, to March 2, 2020. Ill people range in age from 1 to 79 years, with a median age of 28. Fifty-three percent of ill people are female. Two people have been hospitalized. No deaths have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 3 to 4 weeks. Please see the Timeline for Reporting Cases of E. coli Infection for more details.
Investigation of the Outbreak
Epidemiologic, traceback, and laboratory evidence indicate that clover sprouts are the source of this outbreak.
State and local public health officials are interviewing ill people to determine what they ate and other exposures they had in the week before their illness started. Sixteen (59%) of 27 people interviewed reported eating sprouts. This percentage is significantly higher than results from a survey [PDF – 787 KB] of healthy people in which 8% reported eating sprouts in the week before they were interviewed. Fourteen (58%) of 24 people interviewed reported eating sprouts at a Jimmy John’s restaurant.
Jimmy John’s LLC reported that all of their restaurants stopped serving clover sprouts on February 24, 2020. Clover sprouts should no longer be available at Jimmy John’s restaurants.
FDA identified the outbreak strain of E. coli O103 in samples of Chicago Indoor Garden products that contain sprouts. On March 16, 2020, Chicago Indoor Garden recalled all products containing red clover sprouts.
FDA’s traceback investigation has shown that a common seed lot was used to grow the sprouts recalled by Chicago Indoor Garden and the sprouts that were served at Jimmy John’s locations where people sickened in the current outbreak reported eating. The same seed lot was also used to grow sprouts linked to an outbreak of the same strain of E. coli O103 infections in 2019.
This investigation is ongoing to determine where implicated sprouts and seeds have been distributed, and CDC will provide updates when more information is available.
February 26, 2020
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of E. coli O103 infections linked to clover sprouts served at Jimmy John’s restaurants.
Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on E. coli bacteria isolated from ill people by using a standardized laboratory and data analysis method called whole genome sequencing (WGS). CDC PulseNet manages a national database of these sequences that are used to identify possible outbreaks. WGS gives investigators detailed information about the bacteria causing illness. In this investigation, WGS showed that bacteria isolated from ill people are closely related genetically. This means that people in this outbreak are more likely to share a common source of infection. Additionally, WGS results showed that this strain of E. coli O103 is closely related genetically to the strain identified in a late 2019 outbreak of E. coli O103 infections linked to clover sprouts served at Jimmy John’s restaurants in Iowa.
As of February 25, 2020, 14 people infected with the outbreak strain of E. coli O103 have been reported from five states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page.
Illnesses started on dates ranging from January 6, 2020, to February 11, 2020. Ill people range in age from 1 to 79 years, with a median age of 28. Sixty-two percent of ill people are male. No hospitalizations and no deaths have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 3 to 4 weeks. Please see the Timeline for Reporting Cases of E. coli Infection for more details.
Investigation of the Outbreak
Epidemiologic evidence indicates that sprouts from Jimmy John’s restaurants are a likely source of this outbreak.
State and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before their illness started. Five of six people (83%) interviewed reported eating at a Jimmy John’s restaurant. Of the six people interviewed, four (67%) remembered eating sprouts on a sandwich from Jimmy John’s. This percentage is significantly higher than results from a survey [PDF – 787 KB] of healthy people in which 8% reported eating sprouts in the week before they were interviewed.
Jimmy John’s LLC reported that all of its restaurants stopped serving clover sprouts on February 24, 2020. Investigators are working to trace the source of the clover sprouts served at the Jimmy John’s restaurants where sick people ate, and to determine whether other restaurants or retailers received the same clover sprouts.
This investigation is ongoing, and CDC will provide updates when more information is available.
