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Three had salmonella, and one of them also had a strain of E. coli bacteria called STEC O168:H8. Seven other people were sickened with a different version of E. coli, called STEC O103:H25. Thirteen more had yet another strain, STEC O26:H11.

Wisconsin investigators have identified another 18 cases of illness tied to alfalfa sprouts, Minnesota officials said.

The illnesses are being linked to alfalfa sprouts produced by Everything Sprouts, a Minnesota grower, and sold under the Calco and Everything Sprouts brands to restaurants and grocery stores, Minnesota officials said.

Minnesota investigators say they are working with Wisconsin and federal health officials to pinpoint the source and scope of contamination.

Food poisoning outbreaks tend to be defined by one type of germ.

“It's very unusual to have two bugs,” said Bill Marler, a Seattle lawyer who has worked on food safety cases for decades.

But it's not surprising that alfalfa sprouts might be the culprit, he added. It's easy for the seeds to harbor contaminants, it's difficult to clean them, and it's easy for contaminants to spread when they are grown in warm water, Marler said.

Shiga toxin-producing E. coli — or STEC — can cause stomach cramps and bloody diarrhea. Infections can lead to hemolytic uremic syndrome, a severe complication that involves acute kidney failure and other severe problems.

Salmonella poisoning can cause diarrhea, fever, severe vomiting, dehydration and stomach cramps.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.