On March 7, 2017, the CDC posted a press release, that SoyNut Butter Company recalled all varieties of I.M. Healthy SoyNut Butters and all varieties of I.M. Healthy Granola products, due to a recent multistate outbreak of E. coli.¹ This release comes after 4 additional cases were confirmed early last week. Consumers are advised not to eat, and childcare centers, schools, and other institutions not to serve, any variety of I.M. Healthy brand SoyNut Butter or I.M. Healthy brand granola coated with SoyNut Butter, regardless of the date of purchase or the date listed on the container.

STEC Infection Information

This recall occurred after 16 people have fallen ill from Shiga toxin-producing Escherichia coliO157:H7 (STEC O157:H7) infection, supposedly from eating the SoyNut Butter since January 4. Eight people have been hospitalized, and 5 have developed hemolytic uremic syndrome. No deaths have yet been reported. The outbreak seems to be targeting younger individuals, as 14 of the 16 people involved in this outbreak have been under the age of 18.  Epidemiologic evidence from the CDC indicates that I.M. Healthy SoyNut Butter is the likely source of the outbreak.

STEC Symptoms

Symptoms of STEC most commonly include a history of bloody diarrhea, a visibly bloody stool specimen, and a white blood cell count above 10,000/microL.² Fever is typically not reported.² Hospitalization is common, and required in between 23 and 47 percent of cases which present with acute diarrhea caused by STEC, with an average hospital stay of 6-14 days.³ The most concerning systemic complication of STEC infection is hemolytic-uremic syndrome (HUS). ⁴ HUS is characterized by a triad of symptoms: acute renal failure, microangiopathic hemolytic anemia, and non-immune thrombocytopenia; these symptoms typically follow 5-10 days after the onset of diarrhea.⁴

Sources:

1. CDC Press Release: Multistate Outbreak of Shiga toxin-producing Escherichia coli O157:H7 Infections Linked to I.M. Healthy Brand SoyNut Butter. March 7, 2017. https://www.cdc.gov/ecoli/2017/O157H7-03-17/index.html
2. Slutsker L, Ries AA, Greene KD, et al. Escherichia coli O157:H7 diarrhea in the United States: clinical and epidemiologic features. Ann Intern Med. 1997;126(7):505.
3. Su C, Brandt LJ. Escherichia coli O157:H7 infection in humans. Ann Intern Med. 1995;123(9):698.
4. Karmali MA, Petric M, Lim C, Fleming PC, et al.  The association between idiopathic hemolytic uremic syndrome and infection by verotoxin-producing Escherichia coli. J Infect Dis. 1985;151(5):775.

Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.