According to the FDA, there are presently three outbreaks under investigation. These outbreaks are each caused by strains that are different from each other and different. One of the additional outbreaks, in Washington state (13 sick), is potentially linked to romaine lettuce. The other outbreak, with cases in the U.S. and Canada, is linked to Fresh Express Sunflower Crisp Chopped Salad Kits (8 sick in US and 25 sick in Canada).
Note: According to the FDA – “The FDA, CDC and our state partners have identified a common grower between each of the outbreaks, which is a notable development.”
According to the CDC, since the previous update on December 4, an additional 36 ill people have been reported. As of December 17, 2019, a total of 138 people infected with the outbreak strain of E. coli O157:H7 have been reported from 25 states. States with Cases: AZ (3), CA (4), CO (6), FL (2), IA (1), ID (3), IL (10), MD (5), MI (1), MN (5), MT (1), NE (2), NJ (9), NC (2), NM (2), OH (12), OR (1), PA (17), SC (1), SD (1), TN (1), TX (6), VA (6), WA (4), WI (33). Two have been reported in Canada.
Note: According to the CDC, as there are an estimated 26 unreported illnesses for every STEC O157 case reported to PulseNet, the true size of this outbreak is likely much larger than the 140 illnesses reported through PulseNet to date, suggesting that thousands of people (3,640) have been actually sickened in this outbreak thus far.
Illnesses started on dates ranging from September 20, 2019, to December 1, 2019. Ill people range in age from less than 1 to 89 years, with a median age of 26. Sixty-two percent of ill people are female. Of 136 ill people with information available, 72 hospitalizations have been reported, including 13 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 the likely source of this outbreak.
The Wisconsin Department of Health Services recently reported that they identified the outbreak strain of E. coli O157:H7 in an unopened bag of Fresh Express ® brand Leafy Green Romaine collected from an ill person’s home. Salinas, California was the source of the romaine identified in the bag.
FDA and states continue to trace the source of the romaine lettuce eaten by ill people. FDA posted an update on on their investigation on December 12, 2019. The investigation is ongoing to determine the source of contamination and if additional products are linked to illness.
CDC continues to advise that consumers not eat and retailers not sell any romaine lettuce grown in Salinas, California. CDC will provide more information as it becomes available.
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.
E. coli O157:H7 outbreaks associated with lettuce and other leafy greens are by no means a new phenomenon. Outlined below is a list of E. coli outbreaks involving contaminated lettuce or leafy greens in the past decade:
|Sept. 2009||Lettuce: Romaine or Iceberg||E. coli O157:H7||29||Multistate|
|Sept. 2009||Lettuce||E. coli O157:H7||10||Multistate|
|April 2010||Romaine||E. coli O145||33||5:MI, NY, OH, PA, TN|
|Oct. 2011||Romaine||E. coli O157:H7||60||Multistate|
|April 2012||Romaine||E. coli O157:H7||28||
|June 2012||Romaine||E. coli O157:H7||52||Multistate|
|Sept. 2012||Romaine||E. coli O157:H7||9||1:PA|
|Oct. 2012||Spinach and Spring Mix Blend||E. coli O157:H7||33||Multistate|
|Apr. 2013||Leafy Greens||E. coli O157:H7||14||Multistate|
|Aug. 2013||Leafy Greens||E. coli O157:H7||15||1:PA|
|Oct. 2013||Ready-To-Eat Salads||E. coli O157:H7||33||Multistate|
|Apr. 2014||Romaine||E. coli O126||4||1:MN|
|Apr. 2015||Leafy Greens||E. coli O145||7||3:MD, SC, VA|
|June 2016||Mesclun Mix||E. coli O157:H7||11||3:IL, MI, WI|
|Nov. 2017||Leafy Greens||E. coli O157:H7||67||Multistate and Canada|
|Mar. 2018||Romaine||E. coli O157:H7||219||Multistate and Canada|
|Nov. 2018||Romaine||E. coli O157:H7||88||Multistate and Canada|
|Sept. 2019||Romaine||E. coli O157:H7||23||Multistate|
|Nov. 2019||Romaine||E. coli O157:H7||140||Multistate and Canada|