In September 2017, an outbreak of E. coli O157:H7 associated with consumption of falafel occurred at a restaurant in Rochester, Minnesota. Eleven cases (8 confirmed and 3 probable) were identified. Four people were hospitalized. No one died. None developed hemolytic uremic syndrome (HUS). All of the cases had eaten at the restaurant between September 12 and September 30, 2017.

Consuming a falafel main dish was significantly associated with illness (4 of 6 cases vs. 6 of 28 controls; odds ratio [OR] 7.3; 95% confidence interval [CI] 1.1 to 50.2; p=0.048). Consuming any falafel was also significantly associated with illness (7 of 7 cases vs. 10 of 27controls; OR, undefined; p=0.007). No other food items were statistically significant.

Investigators learned that during the meat and vegetable prep, the same grinder was used for raw beef, raw lamb, and garbanzo beans used to make falafel. The cleaning process appeared to be effective, as there was no visible evidence of food residue in or on any of part of the grinder. The owner of the restaurant was instructed to use a second grinder for use prior.

The restaurant voluntarily closed on October 10 while the investigation was underway. On October 11, after public health interventions had been put in place, it reopened. It closed again on October 18 when it was discovered through stool sample testing that multiple employees were infected with Shiga Toxin E. coli (STEC). Five employees tested positive for E. coli O91:H14, suggesting that infected employees were not the source of the outbreak. Infected employees were required to submit 2 negative samples collected at least 24 hours apart.