E. coli Infection Outbreak

chopped romaine

E. coli Infection Outbreak Related to Romaine Lettuce


(updated 11/28/2018)

CDC, public health and regulatory officials in several states, Canada, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (E. coli O157:H7) infections linked to romaine lettuce from the Central Coastal growing regions in northern and central California.

Based on new information, CDC is narrowing its warning to consumers. CDC is advising that U.S. consumers not eat and retailers and restaurants not serve or sell any romaine lettuce harvested from the Central Coastal growing regions of northern and central California. If you do not know where the romaine is from, do not eat it.

The specific California counties FDA is including in this region are:

Monterey
San Benito
San Luis Obispo
Santa Barbara
Santa Cruz
Ventura


Additional counties may be added as the FDA traceback develops. At this time, no common grower, supplier, distributor, or brand of romaine lettuce has been identified.

Romaine harvested from locations outside of the California regions identified by the traceback investigation does not appear to be related to the current outbreak.


Genetic analysis of the E. coli O157:H7 strains tested to date from patients in this current outbreak are similar to strains of E. coli O157:H7 associated with a previous outbreak from the Fall of 2017 that also affected consumers in both Canada and the U.S. The 2017 outbreak of E. coli O157:H7 was associated with leafy greens in the U.S. and romaine in Canada. This year, romaine lettuce is the suspected vehicle for both the U.S. and Canadian outbreaks. There is no genetic link between the current outbreak and the E.coli O157:H7 outbreak linked to romaine that occurred in the Spring of 2018.

The most recent illness onset in the U.S. in the current outbreak was October 31, 2018. For this outbreak investigation, the average interval between when a person becomes ill and when the illness is reported to CDC is 20 days.


 

Advice to Consumers

CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any romaine lettuce harvested from the Central Coastal growing regions of northern and central California. If you do not know where the romaine is from, do not eat it.

  • > Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick.
    • - This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.
    • - If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.
    • - Wash and sanitize drawers or shelves in refrigerators where romaine was stored. Follow these five steps to clean your refrigerator.
  • > Restaurants and retailers should check the label on bags or boxes of romaine lettuce, or ask their suppliers about the source of their romaine lettuce.
  • > Do not sell or serve any romaine lettuce harvested from the Central Coastal growing regions of northern and central California.
  • > If you do not know where your romaine lettuce was harvested, do not sell or serve it.
  • > Take action if you have symptoms of an E. coli infection:
    • - Talk to your healthcare provider.
    • - Write down what you ate in the week before you started to get sick.
    • - Report your illness to the health department.
    • - Assist public health investigators by answering questions about your illness.

 

Impacts in Idaho

> As of 11/30/2018, no Idaho residents have been associated with this multi-state E. coli outbreak.

For state-by-state case information click HERE.

What is E. coli?

E. coli O157:H7 is a type of bacteria that can cause bloody diarrhea, severe abdominal cramps, vomiting and low-grade fever.E. coli infection is usually diagnosed by testing a stool sample.

- People usually get sick from Shiga toxin-producing E. coli 2-8 days (average of 3-4 days) after swallowing the germ.

- Most people infected with E. coli develop diarrhea (often bloody), severe stomach cramps and vomiting.

- Most people recover within one week.

- Some illnesses last longer and can be more severe, resulting in a type of kidney failure called hemolytic uremic syndrome (HUS)

- HUS can occur in people of any age but is most common in young children under 5 years, older adults, and people with weakened immune systems.

- Symptoms of HUS can include fever, abdominal pain, pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and decreased urination.

- People who experience these symptoms should seek emergency medical care immediately.

Resources

CDC E. coli Outbreak Information (link to CDC website)

FDA E. coli Outbreak Information (link to FDA website)

CDHD Online Food Illness Report

CDHD Epidemiology Department | 208-327-8625

CDHD Food Inspectors | 208-327-7499