On November 26, the Centers for Disease Control and Prevention updated its warning to consumers regarding tainted romaine lettuce. CDC continues to advise 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.
Currently, 52 people have been infected with E. coli in this outbreak, which was first announced in October. Illnesses have been reported in 15 states: California, Connecticut, Florida, Illinois, Louisiana, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, and Wisconsin.
Nineteen people have been hospitalized, including two who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.
The most common way to acquire an E. coli infection is by eating contaminated food, such as:
—Ground beef. When cattle are slaughtered and processed, E. coli bacteria in their intestines can get on the meat. Ground beef combines meat from many different animals, increasing the risk of contamination.
—Unpasteurized milk. E. coli bacteria on a cow’s udder or on milking equipment can get into raw milk.
—Fresh produce. Runoff from large-scale confined-animal farms, such as those that house cattle or pigs, can contaminate fields where fresh produce is grown. Certain vegetables, such as spinach and lettuce, are particularly vulnerable to this type of contamination.
—Contaminated water. Human and animal feces may pollute ground and surface water, including streams, rivers, lakes, and water used to irrigate crops.
—Personal contact. E. coli bacteria can easily spread from person to person, especially when infected adults and children don’t wash their hands properly. Family members of young children with E. coli infection are especially likely to acquire it themselves.
If you do not know where the romaine is from, do not eat it. Some romaine lettuce products are now being labeled with a harvest location by region. Consumers, restaurants, and retailers should check bags or boxes of romaine lettuce for a label indicating where the lettuce was harvested.
If the romaine lettuce is not labeled with a harvest growing region, do not buy, serve, sell, or eat it.
Romaine lettuce labeled with a harvest region outside of the Central Coast growing regions (Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, and Ventura counties) is not linked to the outbreak. Areas not linked to this outbreak include the desert growing region near Yuma, Ariz.; the California desert growing region near Imperial County and Riverside County; the state of Florida; and Mexico.
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.
Also necessary is to wash and sanitize drawers or shelves in refrigerators and on counters where romaine was stored or processed. To reiterate:
—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.
—Hydroponic or greenhouse-grown romaine lettuce has not been linked to this outbreak.
—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; and assist public health investigators by answering questions about your illness.
Signs and symptoms of an E. coli O157:H7 infection typically begin three or four days after exposure to the bacteria, though you may become ill as soon as one day after to more than a week later. Signs and symptoms include:
Diarrhea, which may range from mild and watery to severe and bloody;
Abdominal cramping, pain, or tenderness; and
Nausea and vomiting in some people.
Contact your doctor if your diarrhea is persistent, severe or bloody.