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Louisiana has just confirmed a fourth case of E. coli O145 in a six-state outbreak whose source has not yet been identified.

All four Louisiana victims became ill during late April and early May 2012. A 21-month old child died as a result of her illness. The other three victims are adults living in the Greater New Orleans area, according to a report just released by the Louisiana Department of Health & Hospitals.

Associated Press reports that the outbreak now includes 14 victims in six states: Georgia (5), Louisiana (4), Alabama (2), Tennessee (1), Florida (1) and California (1). Three people were hospitalized.

There is, as yet, no indication of the source of the outbreak. Dr. Raoult Ratard, Louisiana’s State Epidemiologist told me that the little girl who died had visited a petting zoo, but that the other Louisiana victims had not. Investigators from the state visited the zoo, and determined that it follows all guidelines to safeguard its patrons from infection.

Outbreak victims in Louisiana – and, presumably, the other affected states – are now being interviewed with a standard questionnaire to try to identify a common element to this rash of illnesses.

CDC has been mumchance. In response to my email inquiry, I was told by CDC spokesperson Lola Russell that the federal agency is “not in the lead in this outbreak.” She advised me to “reach out” to the various states, but declined to name them. Nor did she indicate which state was coordinating the outbreak investigation.

This could turn out to be one of those frustrating outbreaks for which a source is never identified. The victims are widely scattered; even the five cases in Georgia are spread over four counties. Louisiana might be the best bet in the search for a common element, since that state’s three adult outbreak victims are all from the Greater New Orleans area.

Regardless of whether or not a source is identified, this outbreak is a reminder to all consumers and food handlers to intensify their food safety awareness in advance of the summer holiday season.

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