The Centers for Disease Control and Prevention (CDC) reported the Indiana, Kentucky, and New York cases yesterday and the Georgia case today. With the four latest illnesses, the outbreak stands at 45 cases, including 20 in Michigan and 21 in Ohio, according to the CDC. The outbreak has been linked by epidemiologic studies and molecular fingerprinting to ground beef sold at Kroger Co. stores, the CDC has said. The cases led to a ground-beef recall by Kroger stores in Michigan and Ohio on Jun 25; on Jul 3 this was expanded to several other states. The outbreak also prompted a Jun 30 recall of 531,000 pounds of ground-beef components by Omaha-based Nebraska Beef Ltd. The company expanded the recall to 5.3 million pounds on Jul 3.

A CDC investigator said the Kentucky patient lives near the Ohio line, but the New York and Indiana patients did not travel to either Ohio or Michigan, according to a Jul 15 Associated Press report.

The US Department of Agriculture has confirmed that none of the affected products are still for sale in stores, but consumers should check their refrigerators and discard any involved products or return them for a refund, the CDC said.

Illnesses in the outbreak began between May 27 and Jun 24, according to the CDC. Twenty-three patients were hospitalized. There have been no deaths, but one patient suffered hemolytic-uremic syndrome, a potentially fatal type of kidney failure. (Cidrap)