An outbreak of E. coli O111:NM infections in South Australia was associated with eating uncooked, semi-dry, fermented sausage that had been produced by a single manufacturer. E. coli O111:NM was isolated in the sausage and matched the strain that had been isolated from ill persons. The E. coli was PCR-positive for shiga-like toxin (SLT) genes and fermented sorbitol. This strain would not have been detected by sorbitol-MacConkey medium, which was the then recommended laboratory testing medium for E. coli O157:H7 screening. Screening by PCR assisted in this outbreak investigation, however this method was not typically available at the time.