An ongoing E. coli outbreak affecting 16 people in 12 states has been linked to cake mix.

The Centers for Disease Control and Prevention (CDC), public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating the multistate outbreak of E. coli O121 infections from cake mix.

All those sick are female and illness dates range from Feb. 26 to June 21.

Sick people range in age from 2 to 73 years old, with a median of 13. Seventy-five percent are children under the age of 18. Children are more likely to have a severe E. coli infection.

Of 16 people with information available, seven have been hospitalized. One person has developed a type of kidney failure called hemolytic uremic syndrome (HUS) but no deaths have been reported.

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Of the eight people interviewed, six reported tasting or eating raw batter made with a cake mix. People said they bought different varieties and brands.

Illinois, Iowa, Nebraska and Ohio have two patients while Indiana, Massachusetts, Michigan, Oregon, South Carolina, Utah, Virginia, and Washington all have one.

Whole genome sequencing showed that bacteria from sick people’s samples are closely related genetically. This means patients in this outbreak likely got sick from the same food.

FDA is doing a traceback investigation using purchase records from locations wher sick people bought cake mix to try to determine a common brand or production facility.

The CDC is advising people not to taste or eat raw cake batter, whether made from a mix or homemade. Eating raw cake batter can make you sick as it can contain harmful bacteria. Bacteria are killed only when raw batter is baked or cooked.

The agency also told the public not to make milkshakes with products that contain raw foods such as cake mix, flour, or eggs, to keep raw foods such as cake mix, flour, or eggs separate from ready-to-eat foods and to follow the recipe or package directions for cooking or baking.

about E. coli infections
Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

about 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.