The outbreak began with people who ate at a July 3 customer appreciation picnic for a lawn care business in Germantown, about 15 miles southwest of Dayton. A statement from the Montgomery County health department says the man who died was from the Germantown area.

At least 75 people have become ill and 14 have been hospitalized. A 4-year-old girl and a teenage boy remain in serious condition with a complication that can lead to kidney failure.

E. coli is spread through contaminated food but also can be spread from person to person. Investigators are looking at food preparation, storage and handling to help determine what caused the outbreak.

The illnesses were reported in Germantown, southwest of Dayton. The Montgomery County’s health department says 11 people have been hospitalized at some point. Updates on their conditions weren’t available.

Those who became ill were among attendees at a July 3 customer appreciation picnic for a lawn care business.

Health department spokesman Bill Wharton says officials are interviewing them about what they ate at the picnic to determine how the outbreak started.

The bacteria can cause diarrhea, dehydration and, in severe cases, kidney failure.