A sprout outbreak has spread to 15 states carrying two different bacteria at once

A multistate outbreak tied to alfalfa sprouts has grown to 55 confirmed illnesses across 15 states, and federal investigators say two separate pathogens are behind the cases at the same time. Four patients have been hospitalized, and two people tested positive for both Shiga toxin-producing E. coli and Salmonella simultaneously, an overlap that has added complexity to the response. No deaths have been reported, and the investigation remains open as officials continue tracing the contamination back through the supply chain of a single sprout grower.

A Recall That Widened Twice in a Week

The outbreak traces to Everything Sprouts, LLC, which on August 22 recalled specific lots of alfalfa sprouts sold under its own Everything Sprouts brand and the Calco label at retailers and grocery stores. Six days later, the company expanded the recall to cover certain lots of Robust Radish Sprout Mix, citing the risk that the radish product had been cross-contaminated during handling of the recalled alfalfa sprouts. Health officials list the investigation status as open, meaning additional lots or products could still be added as tracing continues and as more illnesses are reported to state and local health departments.

Two Pathogens Sharing One Outbreak

Investigators have identified multiple strains of Shiga toxin-producing E. coli, including serotypes O26:H11, O103:H25 and O168:H8, circulating alongside one strain of Salmonella. Officials flagged the situation as an urgent notice specifically because two people were infected with both organisms at once, a pattern that is uncommon in produce-linked outbreaks. That overlap suggests the contamination reached the product through more than one route, or that both organisms were already present together somewhere in the growing or processing environment before the sprouts reached store shelves. Whole genome sequencing run through the CDC’s PulseNet system found that bacteria pulled from sick people’s samples were closely related genetically, evidence that points investigators toward a single shared source rather than several unconnected contamination events. The sequencing also flagged a narrower concern: Salmonella isolated from nine patients was predicted to carry resistance to three or more antibiotics, including fosfomycin, streptomycin, sulfisoxazole and tetracycline, though officials say that finding is unlikely to change treatment, since most Salmonella infections resolve without antibiotics and the E. coli strains showed no predicted resistance across the 46 samples analyzed. Illnesses in the outbreak began as early as May 31 and as recently as August 8, a roughly ten-week span that traceback investigators used alongside restaurant and grocery purchase records in Minnesota and Wisconsin, the two states that account for the bulk of cases, to confirm Everything Sprouts alfalfa sprouts as the shared source, a link the Food and Drug Administration cited when it expanded the recall to the radish product on August 28.

Why Sprouts Keep Turning Up in Outbreak Investigations

Sprouts have long been treated as a higher-risk category by food-safety regulators because of how they are grown. Seeds germinate in warm, humid conditions and are typically soaked in shared water baths, an environment that favors the growth of any bacteria already present on the seed coat and is difficult to fully sanitize once sprouting begins. Unlike many other vegetables, sprouts are usually eaten raw, which removes the cooking step that would otherwise kill off Salmonella or E. coli before the product reaches a plate. That combination of warm, moist growing conditions and no kill step is why sprout-related illnesses tend to resurface even when growers follow standard sanitation practices.

Fifteen States and an Investigation Still in Progress

Cases have now been confirmed in 15 states, according to the latest update from the Centers for Disease Control and Prevention, which reviewed and republished its outbreak page on September 1. The agency’s fast-facts summary lists 55 total cases, four hospitalizations and zero deaths as of that update. Officials caution that outbreak figures like these are provisional and typically continue to shift, sometimes upward, as additional illnesses are confirmed through laboratory testing or ruled out during interviews with sick patients. Patients in the outbreak range in age from 12 to 94, with a median age of 34, and skew heavily toward women, who make up 73 percent of reported cases. Food-history interviews add further weight to the sprout link: of 34 patients reached in detail, 26, or about 76 percent, reported eating alfalfa sprouts in the week before falling ill, compared with roughly 9 percent of respondents who report eating any type of sprout in the CDC’s broader FoodNet population survey, a gap investigators say points squarely at the sprouts rather than another shared food.

Recognizing Severe E. coli and Salmonella Symptoms

Most people infected with Shiga toxin-producing E. coli develop severe stomach cramps, diarrhea that is often bloody, and vomiting. A smaller share go on to develop hemolytic uremic syndrome, a serious kidney complication that can require hospitalization, particularly in young children and older adults. Salmonella infections more commonly cause diarrhea, fever and stomach cramps, though children under 5, adults 65 and older, and people with weakened immune systems face a higher risk of illness severe enough to need medical treatment. Health officials are urging anyone with a fever above 102 degrees Fahrenheit, diarrhea lasting more than two days, bloody stools, or signs of dehydration such as reduced urination or dizziness upon standing to contact a healthcare provider promptly.

Clearing Recalled Alfalfa and Radish Sprouts From the Kitchen

Anyone holding recalled alfalfa sprouts or Robust Radish Sprout Mix is advised to discard the product or return it to the store of purchase rather than attempt to rinse or cook around the contamination. The FDA’s recall notice also calls for washing any surfaces, containers or utensils that may have touched the sprouts with hot, soapy water or in a dishwasher. Retailers and food-service businesses that received the affected lots are instructed not to sell or serve them and to sanitize any equipment that came into contact with the product before resuming normal operations. Because the investigation remains open, additional retailers or product lines could still be named as health departments continue interviewing patients and tracing distribution records back toward the source.

This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.

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