'Fast-moving' E. coli outbreak in multiple Ohio counties prompts CDC investigation

• At least 29 people fell ill due to an E. coli outbreak in Michigan and Ohio.
• The CDC is investigating the outbreak, but no cause has been determined.
• Health officials advise people practice safe food handling as the outbreak could easily spread.

This story has been updated to include new cases found in Pennsylvania and Indiana and that many people who fell ill reported eating sandwiches containing romaine lettuce at Wendy's.

Dozens of people in Ohio and Michigan — including around the Columbus, Cincinnati and Akron areas — have fallen ill to a "fast-moving" E. coli outbreak, and the Centers for Disease Control and Prevention has not found a cause. 

There have been 37 reported cases of E. coli illness in the four states since July 26, with 19 in Ohio, 15 in Michigan, two in Pennsylvania and one in Indiana, according to CDC data. At least 10 people have been hospitalized.

According to the Ohio Department of Health, 14 cases of the Ohio cases are located in the following counties: Wood (5), Lucas (2), Mahoning (2), Clermont (1), Cuyahoga (1), Franklin (1), Lorain (1) and Summit (1). The individuals range in age from 11 to 72 years old and are nine males and five females.

At least four people have been hospitalized, but no deaths had been reported as of Friday morning, said the state health department.

However, officials believe the number of sick people is "likely higher," and the bacteria could be outside of the four states, since it usually takes up to four weeks to determine if an illness is part of an outbreak, and sometimes people don't require medical attention.

Capri Sun recall: Capri Sun cherry flavor recalled by Kraft Heinz over cleaning solution contamination

Metal in pizza? Illinois-based frozen pizza brand issues recall over possible contamination

Cause of outbreak unknown, CDC says

E. coli typically gets transmitted to humans through contaminated foods, but the CDC has yet to find the cause of the current outbreak. 

Early findings from the investigation "showed that bacteria from sick people’s samples are closely related genetically. This suggests that people in this outbreak got sick from the same food."

In a notice issued Friday afternoon, the CDC said while it hasn't confirmed a specific food as the source, "many people reported eating sandwiches with romaine lettuce at Wendy’s restaurants in Michigan, Ohio and Pennsylvania before getting sick." As a result, Wendy's is removing the lettuce from sandwiches in that region as a precaution, according to the CDC. The restaurant chain uses different lettuce for its salads.

The outbreak comes as the Michigan Department of Health and Human Services announced on Tuesday it was investigating 98 cases of E. coli illness, including ones not part of the CDC investigation. In comparison, there were only 20 cases in the same time period in 2021. 

"While reports of E.coli illness typically increase during the warmer summer months, this significant jump in cases is alarming," said Dr. Natasha Bagdasarian, MDHHS chief medical executive, in a statement.

The Ohio Department of Health says it is assisting the CDC, local health departments and other state and federal agencies in the investigation of this outbreak.

E. coli symptoms 

Symptoms of E. coli vary, but common ones include a fever, diarrhea, stomach cramps and signs of dehydration, the CDC says.

Symptoms often start 3 to 4 days after swallowing the bacteria, per the CDC.

If you or someone you knows appears to have an E. coli infection, the CDC recommends writing down what the person ate in the week prior, and reporting it to state health officials. 

E. coli prevention tips

In the meantime, the CDC says prevention tips for E. coli include proper hand hygiene and food handling practices. That includes washing hands with water and soap before and after handling food, using the bathroom and having contact with animals and their environments. 

Officials also advise not letting raw meat, poultry and eggs or cooked food sit at room temperature for more than two hours, to not place cooked food on a plate that was holding raw meat or poultry, cooking meat thoroughly and rinsing fruits and vegetables.

Contributing: Mitchell Boatman, The Holland Sentinel, and Nathaniel Shuda, The Columbus Dispatch.

Titus Wu is a reporter for the USA TODAY Network Ohio Bureau, which serves The Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.