The Centers for Disease Control and Prevention (CDC) is investigating whether ground beef from a Carrolton, Georgia, producer is responsible for an outbreak of E.coli infections that have sickened at least 156 people across 10 states.

The patients were infected with E.coli O103, the same strain of bacterium that was found in raw ground beef products produced by K2D Foods, a Georgia company doing business as Colorado Premium Foods. The company has issued a recall of approximately 113,424 pounds of raw beef products produced on March 26, March 29, April 5, April 10, and April 12, 2019, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced.

The recall affects two 24-pound vacuum-packed packages in cardboard boxes containing raw “GROUND BEEF PUCK” with “Use Thru” dates of 4/14/19, 4/17/19, 4/20/19, 4/23/19, 4/28/19 and 4/30/19. Affected products were shipped to distributors in Ft. Orange, Florida, and Norcross, Georgia, for further distribution to restaurants. Restaurants are advised to check their refrigerators and freezers for any ground beef products that may be affected by the recall.

An ongoing investigation conducted by the FSIS, its public health partners, the CDC, and the Tennessee Department of Health closed in on unopened, intact ground beef collected from a restaurant where multiple case-patients reported dining tested positive for E.coli O103. “At this time, there is no definitive link between this positive product and the ongoing E.coli O103 outbreak,” FSIS said in a news release. “Further traceback and product analysis continues to determine if the recalled products are related to the E.coli O103 outbreak.”

Many clinical laboratories do not test for this particular strain of E.coli because it is harder to identify than other strains. With this strain, most people become ill within two to eight days after being exposed to the organism, and recover within a week. Rarely, some infected people develop more a severe infection called hemoplytic uremic syndrome (HUS), a type of kidney failure. HUS can occur in people of all ages but is most common in children younger than 5 years of age, older adults, and people with weakened immune systems. Symptoms of HUS include easy bruising, pallor and decreased urine output. Anyone who experiences these symptoms should seek medical attention immediately.

Illnesses have been reported in the following states: Florida (3), Georgia (33), Illinois (1), Indiana (1), Kentucky (65), Minnesota (1), Mississippi (1), Ohio (8), Tennessee (41), and Virginia (2). Of the 156 people infected, 20 required hospitalization. There have been no deaths associated with this outbreak at this time.

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