ST. LOUIS COUNTY, Mo. — The St. Louis County Department of Public Health announced Tuesday that it is finalizing its investigation into an E. coli outbreak linked to multiple events catered by Andre's Banquets and Catering.
According to the health department, there have been a total of 115 cases, including 13 hospitalizations. Two people remain hospitalized and three people have been diagnosed with Hemolytic Uremic Syndrome, or HUS, a rare but serious disease that can occur as a complication of an E. coli infection.
Genetic testing confirmed 25 cases linked to Andre's through Whole Genome Sequencing, the health department said in a press release. Additional cases with matching WGS profiles have been reported in several states, including Kansas, Illinois, North Dakota, South Dakota, Ohio and Indiana.
The health department said the genetic data and food histories suggest "leafy greens" as an exposure factor and have "consistently emerged as a key factor" across all states.
St. Louis County Health Department Senior Epidemiologist Amanda Brzozowski said they are still investigating exactly where the outbreak began.
"Nationally, those other states, they did not attend these same events. So that does suggest that it could be a food product, but we still don't know if it's at the farm, if it's storing, the processing, the distribution. And we also don't know why our attack rate here in St. Louis was so much higher than it is in other places," Brzozowski said.
On Nov. 22, tests run by the Missouri Department of Health and Senior Services detected no traces of E. coli in an unopened package of iceberg lettuce collected at Andre's. The health department said that "a negative test result for the lettuce does not conclusively rule out the salad as the source of the E. Coli outbreak."
Attorney Bill Marler is representing about a dozen people who got sick. He said he's seen in previous cases the contamination starts in the fields.
"They all link these things back to frankly, cattle, and it's cattle feces. It's near where they're growing the lettuce, too close to them," Marler said.
Jory Lange is another attorney representing several affected families.
"This has really wrecked people's lives. Some people have had acute kidney failure, HUS, which E. coli can cause, can lead to lifelong complications and problems. It's really a big deal and it's important for people to know that they're entitled to compensation for what they've gone through," Lange said.
Neither the state nor county health department have cleared Andre's of E. coli. Health officials said they still believe the outbreak came from Andre's salad.
“The depth of this investigation reflects the commitment of our team and the community to uncovering critical details and protecting public health,” said Dr. Kanika Cunningham, Director of the Saint Louis County Department of Public Health. “With 25 cases tied to one specific business and no significant increase in new cases expected, we are confident that we are nearing the conclusion of this outbreak investigation. We are immensely grateful for the cooperation of affected individuals and families, particularly those who participated in surveys. This data has been essential to our progress and confidence in these findings.”
The events under investigation include two Rockwood High School band events, two funerals, and a veterans event, all catered by Andre's Banquets and Catering between Nov. 6-9.
Event-specific surveys from the Rockwood School District Veterans Day Event and band banquet have provided valuable data, the release said.
In a statement, a spokesperson for Andre's again denied it was the source of the local outbreak:
"Two weeks ago, state investigators reported lettuce taken from our facility tested negative for E Coli. Nearly a month after its investigation began, St Louis County health officials are still working to find the cause of our local outbreak. Today, they confirmed genetic sequencing of local cases has now connected the outbreak with cases in at least six other states. We have said all along that it was unfair to name Andre's before the lettuce was tested and before the investigation was complete. We look forward to St Louis County finishing its work and finding the source of our local outbreak."
At least four lawsuits have been filed against Andre's in connection to the outbreak.
The health department did not give an exact day when the investigation would be complete.