The Knox County Health Department (KCHD) has concluded its investigation into a recent cluster of E. coli infections and attributes the outbreak to two different sources.

Fifteen confirmed cases of E. coli O157 were reported to KCHD recently. All cases were among children, nine were hospitalized and seven developed a complication of the infection called Hemolytic Uremic Syndrome (HUS).

The investigation determined that both consumption of raw, unpasteurized milk and contact with farm animals contributed to the outbreak.

Ten of the 15 children consumed raw milk from French Broad Farm, Knox County, Tenn., the only common link among all ten children. The only common link among the other five ill children was attending the same child care facility, Kids Place, Inc., Mascot, Tenn., where goats are present.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan. “The investigation revealed no definitive connections between the two sources or the two groups of ill children. And this is now supported by the state’s lab results confirming it was two different strains of E. coli O157.”

Of the children who were hospitalized, one remains in fair condition at East Tennessee Children’s Hospital. Lab results from the Tennessee Department of Health have confirmed two different strains of E. coli O157 caused the children to become ill. 

Both Kids Place, Inc. and French Broad Farm have fully cooperated throughout KCHD’s investigation, including sharing contact information of those who may be at risk, supporting sample collection and ceasing operations as requested. KCHD lifted the directive for Kids Place, Inc. on June 8, 2018, by following existing state and national procedures for infection control and mitigation at a permitted, regulated facility. KCHD lifted the health directive requesting French Broad Farm temporarily cease operations on June 14, 2018.

While the investigation thus far has revealed no specific problems with French Broad Farm, the risk in consuming raw milk cannot be mitigated. The E. coli outbreak appears to be over as KCHD is not seeing ongoing transmission.