Officials with the Centers for Disease Control and Prevention are investigating a second outbreak of a rare strain of E. coli O26 that has sickened five people who ate at Chipotle restaurants in the Midwest.

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Federal food safety officials are investigating a second outbreak of a rare strain of E. coli linked to Chipotle restaurants, even as cases in an outbreak that started in Washington and Oregon continue to rise.

At least five people are sick with a new strain of Shiga toxin-producing E. coli O26, including three cases in Oklahoma and one each in Kansas and North Dakota, officials with the Centers for Disease Control and Prevention (CDC) reported Monday. Those illnesses were reported between Nov. 18 and Nov. 26 and all five people reported eating at a Chipotle Mexican Grill restaurant.

That outbreak is in addition to 53 people sickened in nine states by a separate strain of E. coli O26 tied to Chipotle since late October. That outbreak includes 27 people in Washington and 13 in Oregon, along with three each in California and Ohio, two in Pennsylvania and Minnesota and one each in Maryland and New York.

Dozens of Chipotle restaurants in Washington and Oregon were voluntarily closed after that outbreak.

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“Consumers should contact a health care provider if they recently became ill with diarrheal symptoms after eating at a Chipotle Mexican Grill restaurant,” CDC officials said in a statement.

The new E. coli outbreak comes within weeks after a norovirus outbreak linked to a Chipotle restaurant near Boston College sickened more than 140 people. The fast-food firm also faced an earlier norovirus outbreak in California last summer and an outbreak of salmonella that sickened at least 45 people at 17 restaurants in Minnesota.

In Seattle, a Chipotle restaurant in South Lake Union was closed for repeated food safety violations Dec. 10 and then reopened the next day.

Shiga toxin-producing E. coli infections can cause serious illness, even death, in young children and others with compromised immune systems.