Since the initial investigation notice, 23 additional ill people have been reported. As of November 21, 2019, a total of 40 people infected with the outbreak strain of E. coli O157:H7 have been reported from 16 states.

Illnesses started on dates ranging from September 24, 2019, to November 10, 2019. Ill people range in age from 3 to 89 years, with a median age of 22. Sixty-five percent of ill people are female. Of 39 ill people with information available, 28 hospitalizations have been reported, including 5 people who developed hemolytic uremic syndrome (HUS), a type of kidney failure. No deaths have been reported.

Epidemiologic, laboratory, and traceback evidence indicate that romaine lettuce from the Salinas, California growing region is a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Eight (80%) of 10 people interviewed reported eating romaine lettuce. This percentage is significantly higher than results from a survey of healthy people in which 47% reported eating romaine lettuce in the week before they were interviewed. Ill people in Maryland reported eating Ready Pac Foods Bistro® Chicken Caesar Salad. To date, ill people in other states have not reported eating this particular salad, which contained romaine lettuce from the Salinas, California growing region.

As reported on November 20, 2019, the Maryland Department of Health identified E. coli O157 in romaine lettuce from an unopened package of Ready Pac Foods Bistro® Chicken Caesar Salad collected from a sick person’s home in Maryland. Whole genome sequencing has been completed and shows that the E. coli strain in the romaine lettuce is closely related genetically to the E. coli found in sick people in this outbreak. This provides additional evidence that people in this outbreak got sick from eating romaine lettuce.

On November 21, 2019, Missa Bay, LLC,  salad products due to possible E. coli contamination.

Do not eat or sell any of the recalled salad products, which were sold under many different brand names.

  • The recalled salad products have “Use By” dates ranging from October 29, 2019, to November 1, 2019.
  • The recalled products have establishment number “EST. 18502B” inside the USDA mark of inspection.

This recall includes salad products that contained contaminated romaine lettuce. The romaine lettuce was tested by the Maryland Department of Health as part of a foodborne illness outbreak in Maryland.

FDA and states are tracing the source of the romaine lettuce eaten by ill people. Preliminary information indicates that some of the ill people ate lettuce grown in Salinas, California. No common grower, supplier, distributor, or brand of romaine lettuce has been identified.

This outbreak is caused by the same strain of E. coli O157:H7 that caused outbreaks linked to leafy greens in 2017 and to romaine lettuce in 2018.