UPDATE: Jan. 15, 2020: The FDA identified a common grower in the outbreak and declared it is over. There were three outbreaks identified by FDA. One sickened 167 people in 27 states. One linked to Fresh Express salad kits sickened 10 people in five states. The third was in Washington and sickened 11 people. No source of contamination or root cause has been identified, and the common grower was not named. Traceback technology found a different strain of E. coli that is unrelated to any illnesses in a buffer zone between harvesting and cattle grazing areas, which the agency said is a clue to discovering the cause.
UPDATE: Dec. 19, 2019: The CDC updated its numbers again, finding that a total of 138 people have been infected with the outbreak strain from 25 states. There have been 72 hospitalizations as a result with 13 developing hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.
UPDATE: Dec. 5. 2019: The CDC says 102 people from 23 states have been infected from this outbreak strain. A total of 58 hospitalizations have been reported, with 10 developing hemolytic uremic syndrome, a type of kidney failure.
UPDATE: Nov. 27, 2019: The FDA is warning consumers against eating any romaine lettuce harvested from Salinas, California. The CDC is now reporting 67 people infected with the outbreak strain from 19 states, hospitalizing 39 of them.
- Another E. coli outbreak linked to lettuce has sickened 17 people in eight states, hospitalizing seven of them, according to a Nov. 21 Investigation Notice from the U.S. Centers for Disease Control and Prevention.
- The CDC said Maryland Department of Health officials found E. coli O157 in an unopened package of Ready Pac Foods Bistro Chicken Caesar Salad taken from a sick person’s home. Some of the sickened people in Maryland reported eating that product, while those in other states have not, the agency said.
- On Nov. 21, Missa Bay, LLC, of Swedesboro, New Jersey, recalled 75,233 pounds of salad products sold under various brand names due to possible E. coli O157:H7 contamination. The CDC said the recalled products, which have "Use By" dates ranging from Oct. 29, 2019, to Nov. 1, 2019, contained lettuce from the same lot used to make the contaminated salad found in Maryland.
The CDC announced this latest outbreak more quickly than the last major incident — an E. coli outbreak associated with romaine lettuce that sickened 23 people in 12 states between July 12 and Sept. 8. Illnesses were reported from Sept. 24 to Nov. 8, the CDC said, and the agency's announcement came Oct. 31.
The FDA posted its own announcement of the most recent outbreak Nov. 21, noting it was tracing back the supply of romaine lettuce in the Caesar salad product and had identified possible farm sources in Salinas, California. The agency also said it was sending investigators to determine the source and extent of contamination and would provide more information as it is uncovered.
Most of the recalled salad products were made with romaine, but a few also contained iceberg lettuce. The contaminated Ready Pac Foods Bistro Chicken Caesar Salad in Maryland only contained romaine. The CDC said Maryland health officials are using whole-genome sequencing to determine whether the pathogen they found is closely related genetically to the one that has sickened people.
Bonduelle Fresh Americas, which owns the Ready Pac brand, said in a Nov. 21 statement posted on its website the recalled salad products are already significantly past their use-by dates, and the company is working with retailers to make sure they're no longer on store shelves. Bonduelle also said it had taken immediate action to trace the origin of the problem.
"We test all of our leafy greens (including romaine) in the fields prior to harvest, including screening for E. coli O157:H7. During the relevant time frame, we did not have any positive test results for E. coli O157:H7," the company said.
As federal and state health officials conduct this outbreak investigation, they would be wise to keep the public fully and quickly informed. Romaine lettuce has now been linked to five E. coli outbreaks in the past two years, including this latest one and the one announced in late October. If regulators and producers don't get a handle on the problem soon, romaine could become an unwanted commodity. The industry has already been hit by decreased sales following previous outbreaks, so this development is likely to bring further scrutiny to their operations.
The FDA recently said it will start sampling romaine for E. coli and salmonella bacteria this month in the California and Arizona growing regions and during the next year. Since the agency said contaminated lettuce in the most recent outbreak could have come from farms in the Salinas, California, area, that region could see additional sampling and testing as the investigation proceeds.
Previous romaine testing by the FDA — which collected 118 samples starting last December in the Yuma area and tested them for E. coli and salmonella — found a non-pathogenic type of E. coli in one, but no salmonella, the agency reported.
The leafy greens industry has recently taken steps to improve production processes. Producers have tightened up grower requirements and recently embarked on a multi-year food safety initiative involving government, academia and industry to better understand the impact of pathogens on leafy greens in areas including Yuma County, Arizona, and the Imperial Valley in California.
While these steps may help narrow down the problem's source, they clearly haven't been enough to keep E. coli outbreaks linked to lettuce from happening. Until that occurs, consumers are likely to avoid romaine — and possibly other lettuce types — in stores or restaurants until they can be sure the product is safe.