Since the previous update on November 22, an additional 27 ill people have been reported. As of November 25, 2019, a total of 67 people infected with the outbreak strain of E. coli O157:H7 have been reported from 19 states.

Illnesses started on dates ranging from September 24, 2019, to November 14, 2019. Ill people range in age from 3 to 89 years, with a median age of 25. Sixty-seven percent of ill people are female. Of 50 ill people with information available, 39 hospitalizations have been reported, including six 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.

FDA and states continue to trace 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.

CDC continues to advise that consumers not eat and retailers not sell any romaine lettuce grown in Salinas, California. The investigation is ongoing to determine the source of contamination and if additional products are linked to illness.

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.