ST. LOUIS COUNTY, Mo. – An investigation into a recent outbreak of E. coli is nearly complete, the St. Louis County Department of Public Health said Tuesday. Whole genome sequencing links nearly a quarter of confirmed cases to a local caterer, while cases in six other states share the same genetic profile.

Last month, Rockwood School District students, staff, and parents began experiencing symptoms of E. coli after attending off-campus events catered or hosted by Andre’s Banquets and Catering.

As of Tuesday, Dec. 3, the county health department has identified 115 cases and 13 hospitalizations tied to this E. coli outbreak. Two people remain hospitalized. Three other people were diagnosed with hemolytic uremic syndrome (HUS), a severe complication of E. coli caused by toxins leaving the intestines and entering the bloodstream.

Genetic testing, according to the county health department, links 25 of the 115 cases to the caterer, making it the largest subcluster of the E. coli outbreak. However, whole genome sequencing (WGS) has found matches in cases in Illinois, Indiana, Kansas, North Dakota, Ohio, and South Dakota.

Leafy greens are believed to be the common source at the heart of these cases. However, the statement from the county health department does not identify a specific leafy green. Salad served at the events was believed to be the source of the illness. The Missouri State Public Health Laboratory tested lettuce samples from the salads, which turned up negative.

The caterer faces multiple lawsuits tied to the outbreak. Andre’s has denied responsibility, claiming some students were ill before the catered events and said it was irresponsible of the public health department to name them as a possible source.

On Tuesday, a spokesman for the caterer released a statement implying the discovery of similar genetic material in E. coli cases outside of Missouri should clear them of suspicion.

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 André’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.

Ed Rhode, spokesman for André’s Banquets and Catering