More people have fallen ill, and at least one individual has developed a serious complication amid an ongoing outbreak linked to raw dairy products.

More cases of E. coli poisoning, a foodborne disease, have been traced back to Raw Farm-brand unpasteurized cheeses, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) said in a Thursday, March 26 update. Nine people in total have been confirmed ill across three states, more than half of whom are children under the age of 5, according to the agencies.

Three people have been hospitalized, and one developed a complication called hemolytic uremic syndrome, or HUS, which causes kidney damage and failure.

The affected cheeses have yet to be removed from the market as Raw Farm, which has been attached to multiple high-profile outbreaks, has declined the FDA’s request to recall its products, the agency said. The FDA is awaiting further sample testing to confirm the source of the outbreak.

Here’s what to know about the outbreak.

What Cheese Is Affected?

The outbreak has been traced back to cheddar cheese products sold by the brand Raw Farm. This includes:

• Original flavor Raw Farm cheddar cheese.
• All sizes of Raw Farm block and shredded cheese packages.
• Two people also reported getting sick in 2025 from Raw Farm-brand raw milk, but those products have already been removed from shelves, according to the CDC.

Which States Have E. Coli Cases?

As of March 26, nine people were sick, including two who were hospitalized, across three states. More than half of the cases involved children under 5 years old.

• California (seven cases)
• Florida (one case)
• Texas (one case)

What to Do With Impacted Cheddar Cheese

Raw Farm declined the FDA’s request to voluntarily recall its cheese products, a decision that drew criticism from the congressional Food Safety Caucus, which has called on the food safety agency to exercise its authority to force a recall.

While the investigation is ongoing, the FDA and CDC advise against eating any affected cheeses and throwing them away. Surfaces that may have touched the cheese should be washed and sanitized with hot, soapy water.

What Is Shiga Toxin-Producing E. Coli, or STEC?

The outbreak strain of E. coli linked to the cheese has been identified as Shiga toxin-producing E. coli, or STEC. This type of E. coli is known to cause a serious kidney condition called hemolytic uremic syndrome, or HUS, according to the FDA.

Children are more likely to suffer from HUS, which damages blood vessels, according to the Mayo Clinic. This causes red blood cells to break down, leading to anemia and clots in the blood vessels. These clots may damage the kidneys and other organs and cause kidney failure or even death.

One case of HUS has been reported to the FDA as of Thursday, March 26. No deaths have been recorded.

Symptoms of E. Coli Poisoning

According to the CDC, symptoms of E. Coli poisoning appear two to eight days after exposure and usually last about a week. These can include:

• Diarrhea and a fever higher than 102°F
• Diarrhea for more than three days
• Bloody diarrhea
• So much vomiting that you cannot keep liquids down
• Signs of dehydration, such as dry mouth, reduced urination and dizziness.
• Abdominal cramping, pain or bloating.

HUS has some additional symptoms, according to the Mayo Clinic, including:

• Pallor or loss of color in the skin.
• Extreme tiredness.
• Easy bruising.
• Unusual bleeding, such as bleeding from the nose and mouth.
• Decreased urination or blood in the urine.
• Swelling, called edema, of the legs, feet or ankles.
• Confusion, seizures or stroke.
• High blood pressure.

What to Know About Raw/Unpasteurized Dairy

Raw Farm, located in Fresno, California, is a seller of raw or unpasteurized dairy products, or dairy that has not been heated to kill harmful germs.

The process of pasteurization became routine in the commercial milk supply in the United States in the 1920s and was widespread by the 1950s. As a result, illnesses commonly spread via milk became less prevalent.

While misinformation about the process has led some to believe that pasteurized milk is less nutritious or better for people with lactose intolerance, pasteurization does not significantly compromise the nutritional value or content of milk. In some states, selling raw milk directly to a consumer is illegal.

Raw milk can carry a host of harmful bacteria, such as salmonella, E. coli, listeria and Staphylococcus aureus, among several others. These bacteria are known to cause a host of ailments, including listeriosis, typhoid fever, tuberculosis, diphtheria, Guillain-Barré syndrome, miscarriage, brucellosis, chronic inflammatory conditions, reactive arthritis and death.

US Reps Demand Recall of Raw Dairy Products

Members of the Food Safety Caucus issued a joint statement on March 20 from 10 members of the U.S. House of Representatives, demanding that the FDA intervene. Raw Farm, the largest commercial manufacturer of unpasteurized dairy products in the United States, has been the source of several outbreaks over the last two decades.

“The FDA recommended that Raw Farm voluntarily remove its raw cheese products from sale after they determined it was the likely source of an ongoing E. coli outbreak,” the committee said in a March 20 statement. “Raw Farm refused. We have one message for Raw Farm and FDA: get it off the shelves – now.”

Health and Human Services Secretary Robert F. Kennedy Jr. has historically been a proponent of raw dairy products and has known connections to Raw Farm, specifically. In June 2024, Raw Farm boasted that the RFK campaign had visited its farm, saying RFK “defended the interests of the American people The same month, Kennedy said publicly that he “only drinks raw milk.”

“Secretary Kennedy’s connection to Raw Farm and FDA’s lack of action here raise serious questions. At bare minimum, this is a potentially concerning conflict of interest. At worst, Secretary Kennedy is once again playing dangerous games with Americans’ health,” said the Food Safety Caucus’ statement.

USA TODAY contacted HHS and Raw Farm for comment on March 27, but has not received a response.

This article originally appeared on USA TODAY: E. Coli outbreak linked to cheeses grows. See affected states, items.

Reporting by Mary Walrath-Holdridge, USA TODAY / USA TODAY

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