With the CDC and FDA reported on a Listeria outbreak over the weekend and others still being investigated, what do consumers need know.

Listeria is a gram-positive, rod-shaped bacterium that is ubiquitous and can grow under either anaerobic (without oxygen) or aerobic (with oxygen) conditions. 

A.        The Prevalence of Listeria in Food and the Environment

Listeriosis is one of the most important bacterial infections worldwide that arises mainly from the consumption of contaminated food.[1] The disease is caused by Listeria monocytogenes, which is considered an opportunistic pathogen that affects mainly those with underlying immune conditions, such as pregnant women, neonates, and elders, resulting in septicemia, meningitis, and/or meningoencephalitis. Of the six species of Listeria, only L. monocytogenes causes disease in humans. It thrives between bacteria 86-98.6oF (30-37oC), but Listeria can grow at temperatures as low as −0.4°C and survive in freezing conditions down to −18°C.[2] This unique quality allows thermal characteristics to be used as a means of differentiating Listeria from other possibly-contaminating bacteria. 

Listeria monocytogenes is omnipresent in nature; it is found widely in such places as water, soil, infected animals, human and animal feces, raw and treated sewage, leafy vegetables, effluent from poultry and meat processing facilities, decaying corn and soybeans, improperly fermented silage, and raw (unpasteurized) milk.[3]

Foodborne listeriosis is relatively rare but is a serious disease with high fatality rates (20%–30%) compared with other foodborne microbial pathogens. Severe L. monocytogenes infections are responsible for high hospitalization rates (91%) among the most common foodborne pathogens, may cause sporadic cases or large outbreaks, and can persist in food-processing environments and multiply at refrigeration temperatures, making L. monocytogenes a significant public health concern.[4]

Ready-to-eat foods are a notable and consistent source of Listeria. For example, a research study done by the Listeria Study Group found that L. monocytogenes grew from at least one food specimen in the refrigerators of 64% of persons with a confirmed Listeria infection (79 of 123 patients), and in 11% of more than 2,000 food specimens collected in the study. Moreover, 33% of refrigerators (26 of 79) contained foods that grew the same strain with which the individual had been infected, a frequency much higher than would be expected by chance. The danger posed by the risk of Listeria in ready-to-eat meats prompted the USDA to declare the bacterium an adulterant in these kinds of meat products and, as a result, to adopt a zero-tolerance policy for the presence of this deadly pathogen. The Code of Federal Regulations includes requirements for the post-lethality control of Listeria in meat and poultry products. This regulation is referred to as “The Listeria Rule” and was enacted in 2003. The rule outlines prevention and control measures that must be taken in processing facilities to reduce the risk of contamination of ready-to-eat products.[5]

B.        Transmission of and Infection with Listeria

Listeria typically spreads to people through contaminated food or water but can also be transmitted from mother to fetus.

Except for the transmission of mother to fetus, human-to-human transmission of Listeria is not known to occur. Infection is caused almost exclusively by the ingestion of the bacteria, most often through the consumption of contaminated food. The most widely accepted estimate of foodborne transmission is 85-95% of all Listeria cases. 

The infective dose—that is, the number of bacteria that must be ingested to cause illness—is not known but is suspected to vary based on the strain. In an otherwise healthy person, an extremely large number of Listeria bacteria must be ingested to cause illness—estimated to be somewhere between 10-100 million viable bacteria (or colony forming units “CFU”) in healthy individuals, and only 0.1-10 million CFU in people at high risk of infection. Even with such a dose, a healthy individual will suffer only a fever, diarrhea, and related gastrointestinal symptoms.

The amount of time from infection to the onset of symptoms—typically referred to as the incubation period—can vary to a significant degree.[6]

According to the CDC, symptoms of Listeria infection can develop at any time from the same day of exposure to 70 days after eating contaminated food. According to the FDA, gastroenteritis (or non-invasive illness) has an onset time of a few hours to 3 days, while invasive illness can have an onset varying from 3 days to 3 months. According to one authoritative text:

The incubation period for invasive illness is not well established, but evidence from a few cases related to specific ingestions points to 11 to 70 days, with a mean of 31 days. In one report, two pregnant women whose only common exposure was attendance at a party developed Listeria bacteremia with the same uncommon enzyme type; incubation periods for illness were 19 and 23 days.

Adults can get listeriosis by eating food contaminated with Listeria, but babies can be born with listeriosis if their mothers eat contaminated food during pregnancy. The mode of transmission of Listeria to the fetus is either transplacental via the maternal bloodstream or ascending from a colonized genital tract. Infections during pregnancy can cause premature delivery, miscarriage, stillbirth, or serious health problems for the newborn. Pregnant women make up around 30% of all infection cases while accounting for 60% of cases involving the 10- to 40-year age group.

C.        Who is most susceptible to Listeria monocytogenes infection?

Several segments of the population are at increased risk and need to be informed so that proper precautions can be taken. The body’s defense against Listeria is called “cell-mediated immunity” because the success of defending against infection depends on our cells (as opposed to our antibodies), especially lymphocytes, otherwise known as “T-cells.” Therefore, individuals whose cell-mediated immunity is suppressed are more susceptible to the devastating effects of listeriosis, including HIV-infected individuals, who have been found to have Listeria-related mortality of 29%. The incidence of Listeria infection in HIV-positive individuals is higher than in the general population. One study found that:

The estimated incidence of listeriosis among HIV-infected patients in metropolitan Atlanta was 52 cases per 100,000 patients per year, and among patients with AIDS it was 115 cases per 100,000 patients per year, rates 65-145 times higher than those among the general population. HIV-associated cases occurred in adults who were 29-62 years of age and in postnatal infants who were 2 and 6 months of age. 

Pregnant women naturally have a depressed cell-mediated immune system. While other systemic bacterial infections may result in adverse pregnancy outcomes at comparable frequencies, L. monocytogenes have notoriety because fetal complications largely occur in the absence of overt illness in the mother, delaying medical intervention. In addition, the immune systems of fetuses and newborns are very immature and are extremely susceptible to these types of infections. 

Other adults, especially transplant recipients and lymphoma patients, are given necessary therapies with the specific intent of depressing T-cells, and these individuals become especially susceptible to Listeria as well. Other adults, especially transplant recipients and lymphoma patients, are given necessary therapies with the specific intent of depressing T-cells, and these individuals become especially susceptible to Listeria as well.

According to the FDA, CDC, and other public health organizations, individuals at increased risk for being infected and becoming seriously ill with Listeria include the following groups:

  • Pregnant women: They are about 10-20 times more likely than other healthy adults to get listeriosis. About one-third of listeriosis cases happen during pregnancy. Fetuses are also highly susceptible to infection and severe complications.
  • Newborns: Newborns can develop life-threatening diseases from perinatal and neonatal infections 
  • Persons with weakened immune systems 
  • Persons with cancer, diabetes, kidney, or gastrointestinal disease 
  • Persons with HIV/AIDS: Individuals with HIV/AIDS are almost 300 times more likely to get listeriosis than people with healthy immune systems. 
  • Persons who take glucocorticosteroid medications (such as cortisone) 
  • Persons of advanced age: One risk assessment showed people over 60 years old were 2.6 times more likely to develop listeriosis than the general population. And in 2011, the median age of diagnosed cases in people who were not pregnant was 71 years old. 

D.        Symptoms of Listeriosis

Only a small percentage of persons who ingest Listeria fall ill or develop symptoms. For those who do develop symptoms because of their infection, the resulting illness is either mild or quite severe, in what is sometimes referred to as a “bimodal distribution of severity.”[7] Listeria can cause two different types of disease syndromes with differing severity. Non-invasive Listeria infection causes gastroenteritis with symptoms such as diarrhea, nausea, and vomiting that resolve on their own. Healthy adults without any immunocompromising conditions typically experience this milder version of the disease. The more severe type of disease caused by Listeria monocytogenes is called listeriosis and is referred to as an invasive illness. 

On the mild end of the spectrum, listeriosis usually consists of the sudden onset of fever, chills, severe headache, vomiting, and other influenza-type symptoms. Along these same lines, the CDC notes that infected individuals may develop fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. When present, the diarrhea usually lasts 1-4 days (with 42 hours being average), with 12 bowel movements per day at its worst.

The more severe form of the illness occurs when the bacteria infect parts of the body that are typically sterile, such as the blood, brain, liver, and cerebral spinal fluid. The presence of the bacteria in these areas triggers the immune response and can lead to those more severe symptoms. L. monocytogenes has a specific affinity for the central nervous system (CNS), especially in cell-mediated immunodeficient individuals.[8]

As already noted, when pregnant, women have a mildly impaired immune system that makes them susceptible to Listeria infection. If infected, the illness appears as acute fever, muscle pain, backache, and headache. The illness usually occurs in the third trimester, which is when immunity is at its lowest. Infection during pregnancy can lead to premature labor, miscarriage, infection of the newborn, or even stillbirth. Around twenty percent of such infections result in stillbirth or neonatal death. 

Newborns may present clinically with early-onset (less than 7 days) or late-onset forms of infection (7 or more days). Those with the early-onset form are often diagnosed in the first 24 hours of life with septicemia, meningitis, or respiratory distress and have a higher mortality rate. Early-onset listeriosis is most often acquired through trans-placental transmission. Late-onset neonatal listeriosis is less common and less severe than the early-onset form. Clinical symptoms may be subtle and include irritability, fever, poor feeding, and meningitis. The mode of acquisition of late onset listeriosis is poorly understood. 

E.        Complications of Listeria Infection

For those persons who suffer a Listeria infection that does not resolve on its own, the complications can be numerous and possibly severe. The most common complication is septicemia (bacterial infection in the blood), with meningitis being the second most common. Other complications can include inflammation of the brain or brain stem (encephalitis), brain abscess, inflammation of the heart-membrane (endocarditis), septic arthritis, osteomyelitis (infection in the bone), and localized infection, either internally or of the skin. 

Death is the most severe consequence of listeriosis, and it is tragically common. The CDC has estimated that L. monocytogenes is the third leading cause of death from foodborne illness, with approximately 260 of 1,600 people diagnosed dying from their infections. For example, based on 2018 FoodNet surveillance data, 96% of 126 Listeria cases ended up in the hospital, the highest hospitalization rate for pathogenic bacterial infection. This data showed a fatality rate of 21%. According to the FDA, the case-fatality rate increases substantially based on complications, possibly reaching rates of 70% in cases with listeria meningitis, 50% in septicemia cases, and over 80% for perinatal/neonatal infections. In one US study, L. monocytogenes was reportedly the cause of nearly 4% of all cases of bacterial meningitis.

[1]           Reda, W. W., Abdel-Moein, K., Hegazi, A., Mohamed, Y., & Abdel-Razik, K. (2016). Listeria monocytogenes: An emerging food-borne pathogen and its public health implications. The Journal of Infection in Developing Countries, 10(02), 149-154. https://doi.org/10.3855/jidc.6616

[2]           Santos, T., Viala, D., Chambon, C., Esbelin, J., & Hébraud, M. (2019, May 24). Listeria monocytogenes Biofilm Adaptation to Different Temperatures Seen Through Shotgun Proteomics. https://www.frontiersin.org/articles/10.3389/fnut.2019.00089/full. 

[3]           Manning, A. (2019). Microbial Food Spoilage and Food Borne Diseases. In Food microbiology and food processing (pp. 125–130). Chapter 2. ED-TECH PRESS. 

[4]           Arslan, F., Meynet, E., Sunbul, M. et al. The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: a multinational study. Eur J Clin Microbiol Infect Dis 34,1213–1221 (2015). https://doi.org/10.1007/s10096-015-2346-5

[5]           USDA Staff. (2014, January 1). Controlling Listeria monocytogenes in Post-lethality Exposed Ready-to-Eat Meat and Poultry Products. https://www.fsis.usda.gov/wps/portal/fsis/topics/regulatory-compliance/guidelines/2014-0001.

[6]           Goulet V, King LA, Vaillant V, de Valk H. What is the incubation period for listeriosis? BMC Infect Dis. 2013; 13:11. Published 2013 Jan 10. doi:10.1186/1471-2334-13-11

[7]           Waldron, C. M. (2017, September 15). The Recovery and Transfer of Aerosolized Listeria Innocua. https://vtechworks.lib.vt.edu/handle/10919/78907. 

[8]           Arslan, F., Meynet, E., Sunbul, M., Sipahi, O. R., Kurtaran, B., Kaya, S., … Mert, A. (2015, June). The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: a multinational study. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology. https://www.ncbi.nlm.nih.gov/pubmed/25698311.

Sandwiches sold in California, Arizona, Nevada and Washington.

As of May 9, 2025, a total of 10 people infected with the outbreak strain of Listeria have been reported from two states. Sick people’s samples were collected on dates ranging from December 3, 2023, to September 9, 2024. Of 10 people with information available, all 10 have been hospitalized. No deaths have been reported.

The true number of sick people in this outbreak is likely higher than the number reported, and this outbreak may not have been limited to the states with known illnesses. This is because some people recover without medical care and are not tested for Listeria. Currently, there have been no illnesses identified in 2025. However, a recent environmental isolate was collected at Fresh & Ready Foods LLC and illnesses may not yet be reported.

CDC investigated this outbreak in 2024. Epidemiologic evidence in previous investigations identified that sick people were in healthcare settings such as hospitals prior to becoming sick, and the likely source was a food served in those types of institutions, but there was not enough information to identify a specific food. CDC reopened the investigation in April 2025 after the outbreak strain was found in environmental samples from Fresh & Ready Foods LLC.

State and local public health officials are interviewing people about the foods they ate in the month before they got sick. Of the six people with information, all six (100%) were hospitalized before becoming sick. Records reviewed from facilities indicated that ready-to-eat foods made by Fresh & Ready Foods LLC were served in at least three of the facilities.

On March 31, 2025, FDA collected environmental samples for testing at Fresh & Ready Foods, LLC. WGS showed that the Listeria in the environmental isolates were closely related to bacteria from sick people. This means that people likely got sick from eating ready-to-eat foods made by Fresh & Ready Foods LLC.

Records reviewed from facilities indicated that ready-to-eat foods made by Fresh & Ready Foods LLC were served in three facilities.

On May 10, 2025, Fresh & Ready Foods LLC recalled select ready-to-eat products, like sandwiches and protein snacks. 

  • Sold to retail stores, hospitals, hotels, airports and airlines in Arizona, California, Nevada, and Washington.
  • Best by dates from April 22, 2025 to May 19, 2025.
  • Brand names include Fresh & Ready Foods, City Point Market Fresh Food to Go and Fresh Take Crave Away
  • See the recall notice for the package labels, brand, and best by date details for each food item.

To date, the County has recorded 37 probable and confirmed cases of people who have gotten sick with Salmonella after dining at the Aladdin Mediterranean Café in the Clairemont San Diego area between April 25 to May 1. 

The restaurant voluntarily closed on May 1. Operators have since been working closely with the County’s Environmental Health and Quality Department (DEHQ) along with Public Health Services on the investigation into the outbreak.  

The ages of those impacted range from 1 to 90 years old, with nine people hospitalized. The source of the Salmonella outbreak has not been identified and the investigation is ongoing. 

The County continues to work closely with the restaurant operator. The restaurant will remain closed until it is safe to operate, and when its management is ready to reopen. 

Salmonella causes an infection called Salmonellosis. Symptoms include nausea, vomiting, diarrhea that might have blood or mucous, abdominal cramps and fever. Symptoms generally begin 12 to 72 hours after eating contaminated food. Illness from salmonella can last 4 to 7 days. Most people recover without treatment.  

People who dined at Aladdin Mediterranean Café between April 25 and May 1, 2025 and feel ill with any of the symptoms listed should contact a healthcare provider as needed.   

People who are still ill or have recovered after dining at Aladdin Mediterranean Café can report their illness to DEHQ by calling (858) 505-6814 or through this form if on a desktop or laptop device and by emailing it to fhdepi@sdcounty.ca.gov. 

I turned 68 yesterday. I must admit most of the time I do not feel it. I still have much to do, but clearly a little less time in which to do it.

A good friend of mine sent me the below article from the Pullman Herald. In the Fall of 1977, at the age of 19, I became the youngest elected person in the state of Washington. Given that 18 year olds only received the right to vote a few years earlier, not a bad accomplishment.

San Diego County public health officials are investigating an outbreak of salmonella linked to dining at Aladdin Mediterranean Café in the Clairemont area of San Diego. 

County epidemiologists have identified 14 confirmed and probable cases associated with this outbreak ranging between 18 and 79 years of age. Five people have been hospitalized.  

People who reported getting sick ate food from Aladdin Mediterranean Cafe between April 25 and April 26, 2025.

The County’s Environmental Health and Quality Department is investigating along with Public Health Services. No source of the outbreak has been determined, however once the investigation is complete and it is determined there is no ongoing risk, the restaurant will be cleared to resume operation.  

Aladdin Mediterranean Café voluntarily closed when notified of the situation to allow health officials to do more testing and interview staff and continues to work closely with the County. 

Salmonella causes an infection called Salmonellosis. Symptoms include nausea, vomiting, diarrhea that might have blood or mucous, abdominal cramps and fever. Symptoms generally begin 12 to 72 hours after eating contaminated food. Illness from salmonella can last 4 to 7 days. Most people recover without treatment. 

People who are at higher risk for serious illnesses from salmonella include: 
• Children younger than 5 years 
• Adults older than 65 years 
• Pregnant women 
• People with weakened immune systems 

People who dined at Aladdin Mediterranean Café in the Clairemont area April 25 –26, 2025, and feel ill with any of the symptoms listed should consider contacting a healthcare provider as needed.  

As of April 28, the County has identified 184 cases of Salmonellosis in 2025 across the region. In 2024, there were 753 cases identified, compared with 685 in 2023 and 683 in 2022.

Consumer Reports criticizes withdrawal given recent developments that undermine USDA’s ability to protect the public from foodborne illness 

WASHINGTON DC – The USDA’s decision to withdraw its proposed regulatory framework to reduce salmonella illness from poultry is just the latest development at the agency that weakens its ability to respond to foodborne illness outbreaks, according to Consumer Reports. Earlier this year, CR released an analysis detailing the large number of poultry plants with high levels of Salmonella contamination and urged the USDA to strengthen its proposed framework, which sought to keep poultry contaminated with Salmonella above a certain level off the market and subject to recall.

“The USDA’s decision is disappointing and troubling given the large number of poultry plants that have been found to pose a higher risk of triggering a Salmonella outbreak,” said Brian Ronholm, director of food policy at Consumer Reports. “Combined with recent staff and budget cuts, the delay in the implementation of the food traceability rule, and the elimination of critical food safety advisory committees, the administration is sending the message that consumers will be on their own when it comes to protecting their families from foodborne illness.”

Ronholm continued, “Salmonella infections from poultry have increased steadily over the past decade and sicken hundreds of thousands of Americans every year. Consumers deserve better safeguards against Salmonella and other threats to our food supply.”

The USDA’s proposed regulatory framework would have declared any chicken or turkey product as adulterated if they contain any type of Salmonella at or above 10 colony forming units (CFUs)/per millimeter or gram (10 cfu/mL(g)) and if they are contaminated with Salmonella strains of particular health concern for that commodity.

For any chicken product to be considered of public health concern under the proposed standard, it would have to be at or above 10 CFU for any Salmonellaand have detectable levels of the three serotypes: Enteritidis, Typhimurium, and I, 4 [5], 12:i-. For ground turkey to be considered of public health concern, it would have to be above 10 CFU for any Salmonella and have detectable levels of the following three serotypes: Typhimurium, Hadar, and Muenchen.

In its comment letter to the USDA, CR characterized that standard as too lax and urged the USDA to adopt an enforceable product standard for these poultry products that contain any type of Salmonella at 1 cfu/mL(g) as they did for not-ready-to-eat breaded stuffed chicken products.

While Salmonella can be spread through many foods, poultry is a leading source. Chicken alone accounts for more Salmonella infections than any other food category and has been steadily increasing over the past ten years. An estimated 195,634 illnesses are caused by Salmonella contaminated chicken, costing Americans $2.8 billion per year. According to the Centers for Disease Control and Prevention, the incidence of Salmonella illnesses in people increased between 1996 and 2022, going from 14.5 illnesses per 100,000 population in 1996 to 16.3 illnesses in 2022. Typical Salmonella infection symptoms include nausea, vomiting, severe stomach cramps, diarrhea and low-grade fever.

Salmonella contamination is widespread in chicken in part because of the often crowded and filthy conditions in which they are raised. A 2022 CR investigation, for example, found almost one-third of ground chicken samples tested contained Salmonella. Of those, 91 percent were contaminated with one of the three strains that pose the biggest threat to human health: Infantis, Typhimurium, and Enteritidis.

Media contact: Michael McCauley, michael.mccauley@consumer.org

Since the start of the Trump Administration, the CDC and FDA have withheld from the public details about a Romaine Lettuce E. coli O157:H7 outbreak that sickened 89 in 15 states with 36 hospitalized, 7 with kidney failure – hemolytic uremic syndrome –  and 1 death.

(Bainbridge Island, WA – April 21, 2025)  “It is disappointing, but with 20,000 employees at Health and Human Services (HHS) being fired, investigating, and reporting on outbreaks and alerting the public to the cause is clearly not a priority for this administration.  If the gutted CDC and FDA can no longer do the job, we will step up to inform and protect the public – so much for ‘Make America Healthy Again (MAHA),’” said William “Bill” Marler.  See,Marler Blog post: “CDC and FDA ‘Romaine’ Silent.”

In November 2024, the CDC and FDA began an investigation into an outbreak of E. coli O157:H7. By the time the CDC and FDA closed the investigation in January 2025, and reported it February 5, 20205, the outbreak included 89 people across 15 states: AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50)[1], MT (1), ND (2), NE (3), OH (8), PA (1), SD (1), TN (1), WI (2). Onset dates ranged from November 4, 2024, to November 30, 2024. Ages ranged from 4 to 90 years, with a median age of 24. Outcome information was available for 74 cases, of which 36 (49%) were hospitalized. There were 7 reported cases of HUS, and 1 death attributed to the outbreak. All cases were linked by whole genome sequencing (WGS) to each other.[2] See NCBI WGS Tree of Outbreak Cases.

According to documents reviewed, 7 subclusters of illnesses were identified across the multistate outbreak. These included 3 MO catered events, an OH secondary school, an IN restaurant, an IL restaurant, and an IL event catered by a different MO-based caterer. Salads were the common link across all 7 subclusters, and cases in all subclusters ate a romaine lettuce blend. At the time, based on information available at the points of service (POS), the traceback focused on romaine lettuce.

The CDC and FDA investigation consisted of three traceback legs representing twenty-eight cases and five POS. The three traceback legs identified four distribution centers, one broker, two processors, one grower, and one ranch – all names redacted in the documents. The traceback investigation determined that a sole processer sourced romaine lettuce from a single grower that would have been available at all points of service during the timeframe of interest. Additionally, romaine lettuce supplied to four of the five POS were traced back to the common ranch and lot. Through analysis of records, four lots of romaine lettuce were implicated, resulting in confirmation of romaine lettuce as the outbreak vehicle. Epidemiologic and traceback data supported the conclusion that romaine lettuce was the source of illnesses in the outbreak. The CDC and FDA closed the investigation on January 15, 2025, with the confirmed vehicle being romaine lettuce, without alerting the public who was the source of the outbreak. See, CDC Report and FDA Report.

“Because we represent people and families from several states that were WGS matches to each other, it was not long until our on-staff Epidemiologist determined that there was a common link to romaine lettuce in the outbreak period.  Had the CDC and FDA been allowed to do their jobs they would have publicized the conclusion,” said Marler.

William “Bill” Marler has been a food safety lawyer and advocate since the 1993 Jack-in-the-Box E. coli O157:H7 Outbreak which was chronicled in the book “Poisoned” and in the recent Emmy Award winning Netflix documentary by the same name. Bill’s work has been profiled in the New Yorker, “A Bug in the System;” the Seattle Times, “30 years after the deadly E. coli outbreak, A Seattle attorney still fights for food safety;” the Washington Post, “He helped make burgers safer, Now he is fighting food poisoning again;” and several others. 

Dozens of times a year Bill speaks to industry and government throughout the United States, Canada, Europe, Africa, China, and Australia on why it is important to prevent foodborne illnesses.  He is a frequent commentator on food litigation and food safety on Marler Blog. Bill is also the publisher of Food Safety News.

To contact Bill, reach out to Julie Dueck at jdueck@marlerclark.com or 1-206-930-4220.

[1] According to the St. Louis Health Department, there were a total of 115 cases, including 13 hospitalizations with two with HUS.

[2] “What is whole genome sequencing (WGS) and why is it pivotal in foodborne illness investigations?”

Since the start of the Trump Administration, the CDC and FDA have withheld from the public details about a Romaine Lettuce E. coli O157:H7 outbreak that sickened 89 in 15 states with 36 hospitalized, 7 with kidney failure and 1 death.

(Bainbridge Island, WA – April 17, 2025) Today, Marler Clark, Inc., PS, The Food Safety Law Firm, filed two Indiana and one Missouri Federal E. coli O157:H7 lawsuits against Taylor Farms on behalf of two children and one adult woman who all suffered hemolytic uremic syndrome (HUS) – acute kidney failure – due to E. coli O157:H7.  In addition, Marler Clark amended five previously filed E. coli O157:H7 lawsuits to include Taylor Farms as being linked to salads catered at a high school in St. Louis, Missouri that sickened over 50. 

“It is disappointing, but with 20,000 employees at Health and Human Services (HHS) being fired, investigating, and reporting on outbreaks and alerting the public to the cause is clearly not a priority for this administration.  If the gutted CDC and FDA can no longer do the job, we will step up to inform and protect the public – so much for ‘Make America Healthy Again (MAHA),’” said William “Bill” Marler.  See, Marler Blog post: “CDC and FDA ‘Romaine’ Silent.”

In November 2024, the CDC and FDA began an investigation into an outbreak of E. coli O157:H7. By the time the CDC and FDA closed the investigation in January 2025, the outbreak included 89 people across 15 states: AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50)[1], MT (1), ND (2), NE (3), OH (8), PA (1), SD (1), TN (1), WI (2). Onset dates ranged from November 4, 2024, to November 30, 2024. Ages ranged from 4 to 90 years, with a median age of 24. Outcome information was available for 74 cases, of which 36 (49%) were hospitalized. There were 7 reported cases of HUS, and 1 death attributed to the outbreak. All cases were linked by whole genome sequencing (WGS) to each other.[2] See NCBI WGS Tree of Outbreak Cases.

According to documents reviewed, 7 subclusters of illnesses were identified across the multistate outbreak. These included 3 MO catered events, an OH secondary school, an IN restaurant, an IL restaurant, and an IL event catered by a different MO-based caterer. Salads were the common link across all 7 subclusters, and cases in all subclusters ate a romaine lettuce blend. At the time, based on information available at the points of service (POS), the traceback focused on romaine lettuce.

The CDC and FDA investigation consisted of three traceback legs representing twenty-eight cases and five POS. The three traceback legs identified four distribution centers, one broker, two processors, one grower, and one ranch – all names redacted in the documents. The traceback investigation determined that a sole processer sourced romaine lettuce from a single grower that would have been available at all points of service during the timeframe of interest. Additionally, romaine lettuce supplied to four of the five POS were traced back to the common ranch and lot. Through analysis of records, four lots of romaine lettuce were implicated, resulting in confirmation of romaine lettuce as the outbreak vehicle. Epidemiologic and traceback data supported the conclusion that romaine lettuce was the source of illnesses in the outbreak. The CDC and FDA closed the investigation on January 15, 2025, with the confirmed vehicle being romaine lettuce, without alerting the public that Taylor Farms[3] was the source of the outbreak. See, CDC Report and FDA Report.

“Because we represent people and families from several states that were WGS matches to each other, it was not long until our on-staff Epidemiologist determined that the common link was that all clients consumed Taylor Farms romaine lettuce in the outbreak period.  Had the CDC and FDA been allowed to do their jobs they would have publicized the same conclusion,” said Marler.

See, complaints: Carnaghi, Graham, Mujkanovic, Swearington, Everding, George, Hasenour and Hefling.

William “Bill” Marler has been a food safety lawyer and advocate since the 1993 Jack-in-the-Box E. coli O157:H7 Outbreak which was chronicled in the book “Poisoned” and in the recent Emmy Award winning Netflix documentary by the same name. Bill’s work has been profiled in the New Yorker, “A Bug in the System;” the Seattle Times, “30 years after the deadly E. coli outbreak, A Seattle attorney still fights for food safety;” the Washington Post, “He helped make burgers safer, Now he is fighting food poisoning again;” and several others. 

Dozens of times a year Bill speaks to industry and government throughout the United States, Canada, Europe, Africa, China, and Australia on why it is important to prevent foodborne illnesses.  He is a frequent commentator on food litigation and food safety on Marler Blog. Bill is also the publisher of Food Safety News.

To contact Bill, reach out to Julie Dueck at jdueck@marlerclark.com or 1-206-930-4220.

[1] According to the St. Louis Health Department, there were a total of 115 cases, including 13 hospitalizations with two with HUS.

[2] “What is whole genome sequencing (WGS) and why is it pivotal in foodborne illness investigations?”

[3] Taylor Farms was also the source of an onion E. coli O157:H7 outbreak in 2024 that caused 104 illnesses, 34 hospitalizations and 1 death. See, Outbreak Investigation of E. coli O157:H7: Onions (October 2024).