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One Dead and 23 More Sickened by E. coli Outbreak Linked to Romaine Lettuce

One Dead and 23 More Sickened by E. coli Outbreak Linked to Romaine Lettuce


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The national E. coli outbreak linked to romaine lettuce has claimed the life of one person in California and now affects nearly half of U.S. states.

  • The first death has been reported following a national E. coli outbreak stemming from contaminated romaine lettuce. The person who died first contracted the sickness in California.
  • 23 new cases have sprung up since national agencies last updated consumers on the E. coli outbreak, bringing the total to 121. Of those who have fallen ill, 63 percent are female and the median age is 29 years old.
  • 52 of those affected by the outbreak have been hospitalized, and 14 people have developed a serious and rare form of kidney failure called hemolytic uremic syndrome.
  • A total of 24 states have now been implicated in the E. coli outbreak. The newest states added to the list are Kentucky, Utah, and Massachusetts.
  • National agencies are still asking consumers to refrain from eating all kinds of romaine lettuce.
  • The FDA and CDC have yet to pinpoint the source of the national outbreak beyond the growing region: Yuma, Arizona.

More than three weeks since the initial announcement of the outbreak, tainted romaine lettuce has claimed a life in California, and the Centers for Disease Control and Prevention have reported the first death linked to the widespread E. coli outbreak currently rocking the nation. Since the last announcement made on Friday, another 23 cases have been added to the CDC's growing list, and three new states have been added, for a total of 24 states affected.

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The outbreak, which initially began with 35 cases in 11 states, has spread to 121 people in the following areas: Alaska, Arizona, California, Colorado, Connecticut, Georgia, Idaho, Illinois, Kentucky, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, Montana, New Jersey, New York, Ohio, Pennsylvania, South Dakota, Tennessee, Virginia, Washington, and Wisconsin.

The CDC reported a few more details about the outbreak with its latest update: Those who have contracted sickness from the contaminated lettuce range in age from 1 to 88 years old, and the median age is 29. More than half (63 percent) of those sick are female. And 14 people who have been hospitalized have also developed hemolytic uremic syndrome, a rare condition where the kidney fails.

Despite the magnitude of the outbreak and the severity of cases, the CDC and FDA have yet to pinpoint where exactly the outbreak has began. One producer in the Yuma region, Harrison Farms, has been linked to the romaine lettuce that caused eight cases in a correctional facility in Alaska. But many critics are openly criticizing national agencies and pushing for systemic reform after weeks of investigation have failed to turn up any leads.

The first case was reported on March 13, 2018, to federal health officials—but those sickened by the outbreak after April 11, 2018, might not be reported just yet as it takes up to three weeks for local officials to notify national agencies.

Many have wondered why national agencies haven't issued a recall yet—unfortunately, romaine lettuce isn't packaged or sold with clear identification of where it came from, and many grocery stores re-brand the lettuce they purchase from third-party growers and producers. The CDC has asked Americans to stop eating romaine lettuce. Grocery stores have followed suit and many national retail outlets have pulled the product from shelves—but not all of them.

At Cooking Light, we've asked one of our writers to investigate how supermarkets and grocery retailers have responded to the outbreak, and we'll update this article with that information (and a link) as soon as possible.

Things have taken a turn for the worse with the first reported death during one of the country's worst E. coli outbreaks in over a decade. We'll update this article with more information as it becomes available, but you can keep up to date on this romaine lettuce E. coli outbreak by following Cooking Light on Facebook and Twitter, and signing up for our newsletters here.


CDC says 12 sickened in new E. coli outbreak possibly linked to romaine lettuce

Twelve individuals have been reported sick and five hospitalized in the latest outbreak of E. coli infections potentially linked to romaine lettuce, the US C.

Twelve individuals have been reported sick and five hospitalized in the latest outbreak of E. coli infections potentially linked to romaine lettuce, the US Centers for Disease Control and Prevention announced on Tuesday.

The outbreak strain has been reported in six states and was identified in a sample of Tanimaura & Antle romaine lettuce in a single-head package. No deaths have been reported.

"Tanimura & Antle recalled its packaged single-head romaine lettuce after officials in Michigan identified E. coli 0157:H7 in the romaine lettuce during routine sampling," the CDC said in a statement.

It was shown, through whole genome sequencing, that the sample of romaine was the same as the strain identified in sick people associated with the outbreak. But information available is not enough to prove a link in the outbreak, according to the CDC.

"People usually get sick from Shiga toxin-producing E. coli (STEC) two to eight days (average of three to four days) after swallowing the germ," according to the CDC.

Symptoms typically include severe stomach cramps, diarrhea (often bloody), and vomiting. Fever may occur in some individuals, usually not very high (less than 101ËšF/38.5ËšC)." Due to the time it takes between when a person becomes sick and when the illness is reported, which is an average of two to four weeks, infections may have not been reported yet.

The CDC's investigation is ongoing to determine if infected individuals became sick from eating recalled Tanimura & Antle packaged single head romaine lettuce. The agency says it will give updates when there is more information available and advises consumers and retailers not to eat, sell or serve the recalled romaine lettuce at this time.

Two additional, unrelated outbreaks of E. coli infections are also currently being investigated by the CDC -- one that has sickened at least 23 people in 12 states and another that's caused 21 illnesses and one death in eight states. The CDC has been unable to trace the sources of the other two outbreaks.


Multistate Outbreak of E. coli O157:H7 Infections Linked to Fresh Spinach (FINAL UPDATE)

NOTICE: This outbreak is over. The information on this page has been archived for historical purposes only and will not be updated.

Outbreak Summary

As of 1 PM (ET) October 6, 2006, Friday, 199 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 26 states.

Among the ill persons, 102 (51%) were hospitalized and 31 (16%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS). One hundred forty-one (71%) were female and 22 (11%) were children under 5 years old. The proportion of persons who developed HUS was 29% in children (<18 years old), 8% in persons 18 to 59 years old, and 14% in persons 60 years old or older. Among ill persons who provided the date when their illnesses began, 80% became ill between August 19 and September 5. The peak time when illnesses began was August 30 to September 1- 31% of persons with the outbreak strain became ill on one of those 3 days.

Three deaths in confirmed cases have been associated with the outbreak. One was in an elderly woman from Wisconsin. Yesterday, Idaho confirmed that stool samples from a 2-year-old child with HUS who died on September 20 contained E. coli O157 with a &ldquoDNA fingerprint&rdquo pattern that matches the outbreak strain. Today, Nebraska reported the death of an elderly woman with an illness compatible with E. coli O157 infection who consumed raw spinach E. coli O157 with the outbreak strain &ldquoDNA fingerprint&rdquo was detected in the remaining spinach.
Maryland is investigating a suspect case in an elderly woman who died on September 13 and had recently consumed fresh spinach. E. coli O157 was cultured from her stool, but &ldquoDNA fingerprinting&rdquo has not been possible.

E. coli O157 was isolated from 13 packages of spinach supplied by patients living in 10 states. Eleven of the packages had lot codes consistent with a single manufacturing facility on a particular day. Two packages did not have lot codes available but had the same brand name as the other packages. The &ldquoDNA fingerprints&rdquo of all 13 of these E. coli match that of the outbreak strain.


1 dead, dozens sickened after romaine lettuce E. coli outbreak in U.S.

The Center for Disease Control is investigating an E. coli outbreak in romaine lettuce that has sickened at least 58 people in the U.S. and Canada.

People in 13 states, including New York and Connecticut, have been infected. So far, five people have been hospitalized in the U.S.

Officials said one person has died in the U.S. and another in Canada.

Here's a list of all 13 states where people have been infected: California, Connecticut, Illinois, Indiana, Michigan, Nebraska, New Hampshire, New York, Ohio, Pennsylvania, Virginia, Vermont, and Washington states.

Consumer Reports says people should stop eating romaine lettuce until the cause of the outbreak is identified and the tainted product is removed from store shelves.


5 dead and nearly 200 sickened in romaine lettuce outbreak

Four more deaths have been linked to a national food poisoning outbreak blamed on tainted romaine lettuce, bringing the total to five.

Health officials have tied the E. coli outbreak to romaine lettuce grown in Yuma, Ariz. The growing season there ended six weeks ago, and given romaine’s short shelf life, it’s unlikely any tainted lettuce is still in stores or people’s homes.

1:45 PM, Jun. 01, 2018 An earlier version of this article said the four newly announced cases were in California, Arkansas, Minnesota and New York. In fact, there were two in Minnesota, one each in Arkansas and New York and no newly announced deaths in California.

There can be a lag in reporting illnesses and deaths, though, and the reports have continued to come in.

In an update Friday on the nation’s largest E. coli outbreak in a decade, health officials said 25 more cases raised the total to 197 illnesses in 35 states. At least 89 people were hospitalized.

Previously one death had been reported, in California. On Friday, health officials said they have learned of four more: two in Minnesota and one each in Arkansas and New York.

The first illnesses occurred in March, and the most recent began May 12, according to the Centers for Disease Control and Prevention.

Many of the newly reported cases were people who became ill two to three weeks ago, when contaminated lettuce was still being sold. Some said they did not eat romaine lettuce but were in close contact with someone who got sick after eating it.

Most E. coli bacteria are not harmful, but some produce toxins that can cause severe illness. People who get sick from toxin-producing E. coli come down with symptoms about three to four days after swallowing the germ, with many suffering bloody diarrhea, severe stomach cramps and vomiting.

Most people recover within a week, but some illnesses can last longer and be more severe.


More California salad contaminated by E. coli bacteria, CDC says

California’s Salinas Valley is grappling with a new outbreak of E. coli contamination linked to packaged salads.

The U.S. Centers for Disease Control and Prevention said Monday that the latest multistate outbreak, which sickened eight people in upper-Midwest states and 16 in Canada, involves a different E. coli strain than the one involved in a previous set of illnesses announced before Thanksgiving.

The outbreaks, however, share a common geographical origin: lettuce harvested in California’s Salinas Valley, according to the CDC.

This time, Fresh Express Sunflower Crisp salads were the “likely source” of contamination, the agency said. Although those packaged salads include romaine lettuce, the agency said it had not narrowed the outbreak to a specific ingredient. Consumers are advised to throw away salad mixes with a “best-before” date of Dec. 7 and a UPC number “0 71279 30906 4" and Lot Code “Z” in the top right corner, the agency said. No recall has been issued.

In a recorded consumer hotline message, Fresh Express said the company had halted its Salinas Valley romaine harvesting after a November outbreak that had sickened more than 100 people. A separate romaine outbreak over the summer sickened 23 people in 12 states.

Last year, a series of outbreaks linked to California romaine lettuce sickened more than 250 people.

The culprit in each of those previous outbreaks has been identified as a strain of E. coli known as 0157:H7 that produces a potent toxin that causes symptoms including diarrhea, vomiting and kidney failure. The bacteria are commonly found among stockyard animals such as cows.

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Source Still Not Traced

The Food and Drug Administration, which is also investigating this outbreak, announced this week that it hasn't made much headway in learning how or where the romaine was contaminated.

“[T]here isn’t a simple or obvious explanation for how this outbreak occurred within the supply chain,” wrote FDA Commissioner Scott Gottlieb in a FDA blog post Thursday. Only one farm, Harrison Farms, has been directly connected to the outbreak lettuce from Harrison sickened eight people (out of 197 total victims).

Last week, Consumer Reports and eight other organizations sent a letter to the FDA demanding better traceability for leafy greens. The letter notes that provisions of the Food Safety and Modernization Act, passed in 2011, require the agency to establish record-keeping within two years that would keep track of “high risk” foods at every step from harvest to consumption. This kind of precision could help investigators contain future outbreaks, and potentially save lives, say food-safety experts.

“Current technology makes it possible for retailers to track and trace products with extraordinary speed and accuracy,” wrote the groups in the letter. “Given these advances, it is no longer acceptable that the FDA has no means to swiftly determine where a bag of lettuce was grown or packaged."

Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services, and does not accept advertising. Copyright © 2018, Consumer Reports, Inc.


When Do Consumers Get Notified?

When romaine lettuce was identified as the likely source of the outbreak, available data, including a lack of new cases, indicated that the outbreak was not ongoing and that the romaine eaten by sick people was no longer for sale, said Brian Katzowitz, M.S., health communications specialist at the CDC. The CDC generally posts outbreak warnings when there’s something actionable for consumers to do, Katzowitz said.

The FDA said this notification was actually made more quickly than it would be in many cases. The FDA said that when there’s not an immediate public health threat, this information would often not be released until it was announced in a more traditional scientific publication.

“In this case, while there was no actionable consumer information and the outbreak was over prior to the determination of a vehicle, given the noteworthy nature of this outbreak and an interest in accelerating awareness, we chose to communicate through an FDA statement in the short term in order to ensure full awareness by the public,” an FDA representative told CR.


E. coli cases from romaine lettuce grown in California more than double, kidney failure reported

article

Romaine lettuce grows in the Salinas Valley. (Grower-Shipper Association of Central California,)

SALINAS, Calif. - At least 67 people - about double the number from last week - have now been sickened with E. coli linked to romaine lettuce likely grown in Salinas, Calif. and about 9 percent of those patients have shown signs of kidney failure, the Centers for Disease Control and Prevention reported.

The outbreak has now affected people in 19 states and romaine lettuce eaters in Wisconsin and Ohio have reported the most illnesses, with 21 and 12 caess respectively, the CDC reported on Tuesday. In California, where federal officials believe the source of the outbreak originated on Sept. 24, only four people have gotten sick. 

Of the total number of cases, the򠳜 said that 39 people have been hospitalizedਊnd six people have developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

The bulk of the romaine sold in the United States comes from the Salinas Valleyਊnd the Yuma, Ariz., growing region that includes the Imperial and Coachella valleys of Southern California. Chris Valadez, president of the Grower-Shipper Association of Central California, said that a customer in Maryland had a box of lettuce in her refrigerator and some of the romaine was grown in Salinas. 

As for how it got tainted? "We just don&apost know," he said. "We don&apost know what farmers are being investigated. We don&apost know what could have happened."

Valadez stressed that his 300 members want to work with federal health investigators to determine the cause as quickly as they can

"This is unacceptable," he said on Wednesday. "We should not be on the defensive. We need to turn over every stone."

He said he couldn&apost put a dollar figure on the lost romaine at this point, but he said that farmers were simply mowing the lettuce back into the field and shippers were helping yank romaine off the shelves. At Berkeley Bowl, for example, there was nary a head of romaine in sight this week. 

Federal authorities said that all the epidemiologic, laboratory, and traceback evidence collected so far indicate that romaine lettuce from the Salinas growing region may be contaminated with E. coli O157:H7. This outbreak is caused by the same strain of E. coli  that caused outbreaks linked to leafy greens in 2017 and to romaine lettuce in 2018, the CDC said. 

“No one is more frustrated than the producers of leafy greens that outbreaks continue to be associated with our products,” Scott Horsfall, CEO of the California Leafy Greens Marketing Agreement, said in a statement last week.

Farmer Dan Sutton, a farmer in Oceano, Calif. said the toll is both personal and financial.

“The situation is heartbreaking,” Sutton said. “I have a very young family and the products we grow go to my family’s dinner table. My children consume the very same products we are sending out to consumers across the nation. That’s something I think about every day.”

The Los Angeles Times noted that in 2002, Ethan Solomon and his colleagues at Rutgers University showed that E. coli in irrigation water travels through the roots of lettuce plants and into the lettuce leaves. Even after the outer surface of the leaves is chemically disinfected, E. coli cells are still in the plant tissue, meaning that tainted irrigation water means tainted greens.

And indeed, contaminated agricultural water is a prime suspect in these outbreaks, the Washington Post reported. The Trump administration delayed implementation of new agricultural water testing rules, developed during the Obama administration, that were set to take effect last year. The rules would require farmers to test four times per growing season for generic E. coli in agricultural water. Some farmers pushed back against the new rule, calling it confusing and unwieldy, the Post reported. The FDA decided to delay implementation. Now, large farms will be required to meet the requirements in January 2022, with small farms following in 2023 and very small farms in 2024.

But leafy greens industry officials told the Post that the delay in the rule isn’t to blame for the romaine lettuce outbreak, because the industry already performs the water tests on a monthly basis. And Valadez told KTVU that the farmers in the Salinas region had already adopted and were practicing proper water standards, so਋laming the water in this case is "very premature." 

Romaine lettuce package label from Salinas, Calif. (CDC)

But the growers association did acknowledge that some in their industry could move more quickly. 

"We said that many have worked hard to improve, and this is true – we have strengthened our food safety practices which are verified through mandatory government audits and new studies are now underway to advance new science and solutions at the Center for Produce Safety," the association stated. "This diligent work should not be diminished but we must do more and we must do it faster."

There are other seasonal factors that could be contributing to the problem. Michele Jay-Russell, a microbiologist and manager of the Western Center for Food Safety at the University of California at Davis, told the Post thatꃊttle, deer, goats and feral pigs carry E. coli O157:H7. Valadez said he thought this could be possible, too. 

The FDA said consumers can still safely eat romaine from outside four Salinas-area counties — Monterey, Santa Clara, Santa Cruz and San Benito — as well as hydroponically grown lettuce.


5 dead, nearly 200 sickened in romaine lettuce E. coli outbreak

NEW YORK (AP) - Four more deaths have been linked to a national food poisoning outbreak blamed on tainted Arizona-grown romaine lettuce, bringing the total to five.

The Arizona growing season is long over and it&aposs unlikely any tainted lettuce is still in stores or people&aposs homes. But there can be a lag in reporting, and reports of illnesses have continued to come in.

In an update Friday, health officials said 25 more cases raised the total to 197 illnesses in 35 states. At least 89 were hospitalized.

Previously one death had been reported, in California. On Friday, health officials said they have learned of four more - two in Minnesota and one each in Arkansas and New York.

Health officials have tied the E. coli outbreak to romaine lettuce grown in Yuma, Arizona.

According to the Mayo Clinic, O157 E.coli symptoms include diarrhea, which could be bloody, as well as abdominal cramping or pain, and in some people, nausea. Young children and adults have a greater risk of developing a form of kidney failure called hemolytic uremic syndrome, which is life-threatening.

H7 Infections Linked to Chopped Romaine Lettuce:
www.cdc.gov/ecoli/2018/o157h7-04-18/index.html

Mayo Clinic information on E.coli
https://mayocl.in/2xBwn20

CDC MAP: People infected with the outbreak strain of E. coli O157:H7, by state of residence, as of May 30, 2018 (n=197)


Watch the video: CDC: E. Coli Outbreak from Romaine Lettuce Grows (May 2022).


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