E. coli:  Seattle Public Health is investigating an outbreak of E. coli potentially associated with four Evergreens restaurants in Seattle. Thirteen people who became ill during November 10–15, 2019, ate dishes containing raw vegetables, including leafy greens, from Evergreens restaurants during November 5 to 11.

Genetic testing on isolates from the people identified the same strain of E. coli, suggesting they have a common source of infection.

This strain of E. coli is different from the strain currently causing a national outbreak associated with romaine lettuce grown in Salinas, California, which the CDC announced on November 22.

Many of the people who became ill after eating at Evergreens also reported eating raw vegetables, including leafy greens, from sources other than Evergreens in the days prior to their illness, meaning they could share a separate source for their illness, unrelated to Evergreens.

E. coli:  As of December 2, 102 people infected with E. coliO157:H7 have been reported from 23 states. There have been over 50 hospitalizations, with at least 10 with acute kidney failure. Illnesses started on dates ranging from September 24 to November 18.

As of December 6, the Public Health Agency of Canada has reported two illnesses related to the U.S. outbreak.

Based on available traceback data, the FDA requested that industry voluntarily withdraw romaine lettuce grown in Salinas, California from the market and is requesting that the industry withhold distribution of romaine for the remainder of the growing season in Salinas.

Consumers are still advised to not eat, and retailers and food service establishments to not sell or serve, any romaine lettuce harvested from the Salinas growing region.

This is the fifth E. coli outbreak linked to romaine lettuce affecting U.S. and Canadian consumers in the last two years. Laboratory analysis indicates that the illnesses are genetically related to previous E. coli outbreaks that occurred in 2017 and 2018 that were linked to romaine lettuce. This suggests that there may be a reoccurring source of contamination.

Hepatitis A:   As of December 2, 2019, a total of 16 outbreak-associated cases of hepatitis A were reported from 6 states.

Illnesses started on dates ranging from October 8, 2019, to November 15, 2019. Ill people range in age from 14 to 73 years, with a median age of 50. Seventy-five percent of ill people are female. Of 15 people with available information, 9 (60%) were hospitalized. No deaths have been reported.

In interviews, ill people answered questions about the foods they ate and other exposures in the 2 to 7 weeks before they became ill. Of people who were interviewed, 15/15 (100%) reported eating fresh blackberries; of 13 people with known fresh blackberry purchase location information, 13/13 (100%) purchased fresh blackberries from Fresh Thyme Farmers Market. This proportion was significantly higher than results from a survey of healthy people in which 7% reported eating fresh blackberries in the week before they were interviewed.

Salmonella:   The Pennsylvania Department of Health reports that it is investigating 31 laboratory-confirmed illnesses of Salmonella at four healthcare facilities in southeast Pennsylvania. Salmonella has been identified among cases at three of four facilities.

The FDA and the Pennsylvania Department of Health are investigating an outbreak of illnesses caused by Salmonella in Pennsylvania. Epidemiologic and traceback evidence indicate that fruit mix with cantaloupe, honeydew, pineapple, and grapes from Tailor Cut Produce of North Brunswick, New Jersey, are a potential source of this outbreak.

Food service and institutional food operators should not sell or serve the fruit mix with cantaloupe, honeydew, pineapple, and grapes prepared by Tailor Cut Produce.

Tailor Cut Produce reports that their products may be found in restaurants, banquet facilities, hotels, schools and institutional food service establishments in New Jersey, New York, and Pennsylvania.

Because this fruit mix may have been distributed to nursing homes, schools, hospitals and other facilities that cater to vulnerable populations, it is important that these facilities do not sell or serve this fruit medley.