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Romaine outbreak illnesses rise above 100

Illustration by Pamela Riemenschneider

From the Food and Drug Administration December 4, 2019:

Recommendation
FDA, CDC, and state health authorities are investigating an outbreak of illnesses caused by E. coli O157:H7 in the United States. Epidemiologic, laboratory, and traceback evidence indicates that romaine lettuce from the Salinas, California growing region is a likely source of this outbreak. According to CDC, there have been 102 cases reported in 23 states. The latest date that one of these patients reports becoming ill was on November 18, 2019.

Consumers: Consumers should not eat romaine lettuce harvested from Salinas, California. Additionally, consumers should not eat products identified in the recall announced by the USDA on November 21, 2019.

Romaine lettuce may be voluntarily labeled with a harvest region. If this voluntary label indicates that the romaine lettuce was grown in “Salinas” (whether alone or with the name of another location) do not eat it. Throw it away or return it to the place of purchase. If romaine lettuce does not have information about harvest region or does not indicate that it has been grown indoors (i.e., hydroponically- and greenhouse-grown), throw it away or return it to the place of purchase. Consumers ordering salad containing romaine at a restaurant or at a salad bar should ask the staff whether the romaine came from Salinas. If it did, or they do not know, do not eat it.

At this time, romaine lettuce that was harvested outside of the Salinas region has not been implicated in this outbreak investigation.

Hydroponically- and greenhouse-grown romaine, which is voluntarily labeled as “indoor grown,” from any region does not appear to be related to the current outbreak. There is no recommendation for consumers to avoid using romaine harvested from these other sources.

Restaurants and Retailers: Restaurants and retailers should not serve or sell romaine harvested from Salinas, California. If you do not know the source of your romaine lettuce, and if you cannot obtain that information from your supplier, you should not serve, nor sell it.

Suppliers and Distributors: Suppliers, distributors and others in the supply chain should not ship or sell romaine harvested in Salinas, California. If the source of the romaine lettuce is unknown, you should not ship, nor sell the product.

For Restaurants, Retailers, Suppliers and Distributors: Currently, the FDA does not have enough traceback information to identify the specific source of the contamination that would allow us to request a targeted recall from specific growers.

FDA requested that industry voluntarily withdraw romaine grown in Salinas from the market and is requesting that industry withhold distribution of Salinas romaine for the remainder of the growing season in Salinas. Without more specific traceback information, this was the most efficient way to ensure that contaminated romaine was off the market.

At this time, romaine lettuce that was harvested outside of the Salinas region has not been implicated in this outbreak investigation. Hydroponically- and greenhouse-grown romaine, which is voluntarily labeled as “indoor grown,” from any region does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these other sources.
Update

According to the CDC, as of December 2, 2019, 102 people infected with the outbreak strain of E. coli O157:H7 have been reported from 23 states. The case patients report that illnesses started on dates ranging from September 24, 2019 to November 18, 2019. Illness onset dates reported to date are prior to the public warning issued on November 22.

Based on available traceback data, FDA requested that industry voluntarily withdraw romaine grown in Salinas from the market and is requesting that industry withhold distribution of Salinas romaine for the remainder of the growing season in Salinas. This was the most efficient way to ensure that contaminated romaine was off the market.

Products that were part of the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced recall related to this outbreak investigation had a “Best By” of Nov. 1 or earlier, more than one month ago, and should no longer be on the market.

FDA continues to actively investigate the cause of this outbreak. FDA, with the assistance of staff from the California Department of Public Health and the California Department of Food and Agriculture, immediately deployed investigators to three farms in the Salinas area that were identified based on the traceback investigation. On the farms, investigators sampled soil and animal droppings, compost, water, and other potential environmental sources.
The samples and information collected during the farm investigations are currently being analyzed. Investigators are attempting to identify any factors that could have led to contamination. Additionally, state partners are testing romaine lettuce samples for E. coli that they have collected from stores and from case patients’ homes.

The FDA and state partners are conducting a traceback investigation to determine whether a common supplier or source of contamination can be identified. This investigation involves collecting and analyzing potentially hundreds of distribution records to trace the romaine that may have been available at points of exposure reported by ill people to their source. We are continuing to collect these records.

This remains an evolving and fluid situation. Information about our findings will be forthcoming as the investigation proceeds.

The Salinas region as defined by the United Fresh Produce Association and the Produce Marketing Association Romaine Taskforce Report includes: Santa Cruz, Santa Clara, San Benito, and Monterey counties in California.

Case Counts
Total Illnesses: 102
Hospitalizations: 58
Deaths: 0
Last illness onset: November 18, 2019
States with Cases: AZ (3), CA (4), CO (6), FL (1), IA (1), ID (3), IL (1), MD (4), MI (1), MN (3), MT (1), NE (1), NJ (7), NC (1), NM (2), OH (12), OR (1), PA (8), SD (1), TX (4), VA (4), WA (2), WI (31)