E. coli outbreak linked to peanut butter substitute

Current epidemiologic evidence indicates I.M. Healthy brand SoyNut Butter is the likely source.

SoyNut Butter is a nut-free substitute for peanut butter and has a shelf life of two years.

The company has recalled I.M. Healthy Original Creamy SoyNut Butter 15 oz plastic jars with Best By dates July 5, 2018, August 30 and 31, 2018; individual portion cups with date August 8, 2018; and 4lb plastic tubs with dates of November 16, 2018 and July 25, 2018.

Demographics drilldown and new to PulseNet​

Six people have been hospitalized and four developed hemolytic uremic syndrome (HUS), a type of kidney failure. Illness dates range from January 6 to February 15.

Ill people range in age from two to 48 years, with a median age of eight. Eleven (92%) of the 12 sick people are younger than 18, said the Centers for Disease Control and Prevention (CDC).

Affected states are California and Arizona (four illnesses each), Oregon (two) and New Jersey and Maryland (one illness each).

“Consumers who purchased Creamy SoyNut Butter or coated granola should dispose of the product immediately, even if it was already eaten and didn’t cause illness​,” said Dr Karen Smith, California Department of Public Health director and state public health officer.

The DNA fingerprint of the outbreak strain has never been seen before in the PulseNet database.

PulseNet, coordinated by CDC, is the national subtyping network of public health and food regulatory agency labs.

It performs DNA fingerprinting on STEC bacteria isolated from ill people by using pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS).

Illnesses after February 8 might not yet be known as it takes an average of two to three weeks between when a person becomes ill and when the illness is reported.

Interviews help investigation​

All nine people interviewed ate either I.M. Healthy brand SoyNut Butter at home (five) in the week before they became ill or attending a childcare center that served it or I.M. Healthy brand granola coated with SoyNut Butter (four).

CDC said this proportion is higher than expected when compared to the 6% of ill people interviewed during past outbreaks who ate a ground nut butter or spread other than peanut butter.

Multiple varieties and sizes of I.M. Healthy brand SoyNut butter and I.M. Healthy granola coated with SoyNut Butter are sold nationwide in stores, online and to institutions.

The company is headquartered in Illinois but no cases have been reported there. 

“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,”​ said the firm.

The US Food and Drug Administration’s (FDA) investigation of the firm and production methods is ongoing including product testing.

Meanwhile, a Canadian investigation into an outbreak due to a different strain of E. coli has been updated to include additional cases.

There are now 20 illnesses due to E. coli O121, said the Public Health Agency of Canada (PHAC).

Investigations to find the source are continuing, added the agency.

British Columbia (8), Saskatchewan (4), Alberta (3) and Newfoundland and Labrador (5) have reported illnesses with onset dates ranging from November 2016 to January 2017.