In the Spring of 2016, the CDC reported that thirty-two people infected with the outbreak strains of E. coli O157:H7 were reported from 12 states – Arizona 4, California 5, Florida 2, Illinois 1, Massachusetts 1, Maryland 1, Missouri 1, New Jersey 1, Oregon 11, Virginia 2, Washington 2 and Wisconsin 1. Twelve people were hospitalized. Nine people developed hemolytic uremic syndrome, a type of kidney failure. No deaths were reported. Twenty-six (81%) of the 32-ill people in this outbreak were younger than 18 years. Epidemiologic, laboratory, and traceback evidence indicated that I.M. Healthy brand SoyNut Butter manufactured by Dixie Dew was the likely source of this outbreak.

Both I.M. Healthy and Dixie Dew filed for Chapter 7 Bankruptcy.  Each company paid their insurance proceeds into the Bankruptcy Court in Chicago for a total of $11,250,000.  As part of that process twenty-six people filed claim and each of their claims were valued by a Court-appointed evaluator.  The values of the cases ranged from $25,000 to $25,000,000 individually based upon the severity of the illnesses for a total of $70,000,000. Each person received a pro-rata share of $6,000,000 in October 2018.  It is expected that the Court will order the balance, $5,250,000, to be disbursed by the Court on January 10, 2018.

Once the Bankruptcy Court rules, the 26 claimants will continue litigation against the supply chain and retailers who sold the product.

Total Sick – 350
Hospitalized – 162
Kidney Failure – 31
Deaths – 7

In 2017 in Canada, a total, of 42 cases of E. coli O157 illness were reported in five eastern provinces: Ontario (8), Quebec (15), New Brunswick (5), Nova Scotia (1), Newfoundland and Labrador (13). Seventeen individuals were hospitalized. One individual died. Individuals who became ill were between the ages of 3 and 85 years of age. The majority of cases (74%) were female.

In 2017 in the United States, 25 people infected with the outbreak strain of STEC O157: H7 had been reported from 15 states. Ill people ranged in age from 1 to 95 years, with a median age of 26. Among ill people, 67% were female. Nine ill people were hospitalized, including two people who developed the hemolytic uremic syndrome. One death was reported from California.

In the Spring of 2018 in Canada, there were eight Canadian illnesses of E. coli O157 with a similar genetic fingerprint to illnesses reported in the U.S. investigation.

In the United States as of June 27, 2018, 210 people infected with the outbreak strain of E. coli O157: H7 were reported from 36 states. Ill people ranged in age from 1 to 88 years, with a median age of 28. Sixty-seven percent of ill people were female. Of 201 people with information available, 96 (48%) were hospitalized, including 27 people who developed the hemolytic uremic syndrome. Five deaths were reported from Arkansas, California, Minnesota (2), and New York.

In Canada, as of November 23, 2018, there had been 22 confirmed cases of E. coli illness investigated in Ontario (4), Quebec (17), and New Brunswick (1). Eight individuals were hospitalized, and one individual suffered from the hemolytic-uremic syndrome. Individuals who became ill were between 5 and 93 years of age. The cases are evenly distributed among male and female individuals.

As of today, forty-three people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 have been reported from 12 states. Illnesses started on dates ranging from October 8, 2018 to October 31, 2018. Sixteen people have been hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure.

Epidemiologic and traceback evidence from the United States and Canada indicates that romaine lettuce harvested from the Central Coastal growing regions of northern and central California is a likely source of the outbreak.

Ill people in this outbreak were infected with E. coli bacteria with the same DNA fingerprint as the E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada. The current outbreak is not related to a spring 2018 multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce.

CDC is advising that consumers not eat any romaine lettuce harvested from the Central Coastal growing regions of northern and central California. No common grower, supplier, distributor, or brand of romaine lettuce has been identified.

Surprised?  I did not think so.  Cattle feces from a CAFO gets into the water supply that is used to irrigate romaine lettuce – what possibly could go wrong?

Of note, the FDA still has not been transparent (except that “romaine [lettuce] from the Yuma growing region as the likely source of contamination”) as to where the romaine was consumed (except for the “Alaskan correctional facility back to a single farm – [Harrison]”).  Nor, has the FDA been transparent what farms grew the romaine, where and who processed it and who shipped it.  The FDA in fact knows most, if not all, of this, but refuses to release the information citing, “trade secrets.”

As the CDC reported in its final assessment of the outbreak on June 28, 2018, there are 210 cases in 36 states: Alabama (3) Alaska (8), Arkansas (1), Arizona (9), California (49), Colorado (3), Connecticut (2), Florida (3), Georgia (5), Idaho (12), Illinois (2), Iowa (1), Kentucky (1), Louisiana (1), Massachusetts (4), Michigan (5), Minnesota (12), Mississippi (1), Missouri (1), Montana (9), Nebraska (1), New Jersey (8), New York (11), North Carolina (1), North Dakota (3), Ohio (7), Oklahoma (1), Oregon (1), Pennsylvania (24), South Dakota (1), Tennessee (3), Texas (4), Utah (1), Virginia (1), Washington (8), and Wisconsin (3). 5 deaths were reported from Arkansas, California, Minnesota (2), and New York.  8 illnesses were reported in Canada linked to the same outbreak.

On August 6, 2018, the FDA posted an update on the status of its ongoing environmental assessment on the likely, what used to be called the “root cause.” The FDA’s update was as follows:

On July 31 and August 1, 2018, the FDA participated in a meeting of the Leafy Greens Food Safety Task Force that was formed in response to the serious outbreak of E. coli O157:H7 associated with romaine lettuce that occurred earlier this year. During the meeting FDA shared preliminary hypotheses from the Environmental Assessment in Yuma to facilitate conversations with state and local officials, industry and local growers on the hypotheses and associated actions necessary to prevent such an outbreak from occurring again.

As FDA has previously stated, samples of canal water have tested positive for the outbreak strain of E. coli. FDA continues to consider that contaminated water coming into contact with produce, either through direct irrigation or other means, is a viable explanation for the pattern of contamination. But other hypotheses were discussed as well. FDA notes that the canal is close to a Concentrated Animal Feeding Operation (CAFO), a facility with a large number of cattle on the premises. The CAFO can hold in excess of 100,000 head of cattle at any one time and the FDA traceback information showed a clustering of romaine lettuce farms nearby.

Our experts continue to work on examining potential links between the CAFO, adjacent water, and geologic and other factors that may explain the contamination and its relationship to the outbreak. Additional sampling activities will be conducted to further explore and narrow down hypotheses in the near future. Our findings will be detailed in a finalized environmental assessment report.

We urge other government and non-government entities, produce growers in the region, and those engaged in managing the canal systems to work with FDA and marshal and deploy resources to achieve our collective food safety goal. Broad engagement from the surrounding community is critical to developing and implementing remediation measures to reduce the potential for another outbreak. We believe local in-depth knowledge and actions are critical in helping resolve this issue in order to protect public health.

The Environmental Assessment report will be made publicly available when complete.

And, then there is this – for those “geographically challenged,” Yuma is near the dark purple in the lower left corner:

To date, we have filed 10 lawsuits and are making great progress tracing back from restaurants and grocery stores that sold the E. coli-tainted romaine in the spring.  And, once the “points of sale” flip the supply chain of the romaine, we are making great progress finding out who brokered the sale and who processed the romaine.  We are making slower process identifying specific farms, but that information is coming. Once we have the names of more farms, we will move back up other chains of distribution identifying additional shippers, brokers, processors and eventually more restaurants and grocery stores.

Having discovery and subpoena power is a great tool for truth.

Here is what the FDA has told the public thus far about the source of the 2018 Yuma Romaine Lettuce Outbreak that has sickened over 200 in the US and Canada and killed 5 in the US:

Eventually, at least for the 105 people who have hired us, we will fill in all the blanks.  I must admit as someone interested in food safety and transparency, having a lawyer in Seattle fill in the blanks that the FDA should is not how it should be.  The time has come for the FDA to reassess what are considered “trade secrets” or “confidential.”  FSIS did it a decade ago and the sky did not fall.

The CDC reports today that 210 people in 36 states have become ill with the outbreak strain of E. coli O157:H7. These people reported becoming ill in the time period of March 13, 2018 to June 6, 2018. There have been 96 hospitalizations and five deaths. There are cases in 36 states: Alabama (3) Alaska (8), Arkansas (1), Arizona (9), California (49), Colorado (3), Connecticut (2), Florida (3), Georgia (5), Idaho (12), Illinois (2), Iowa (1), Kentucky (1), Louisiana (1), Massachusetts (4), Michigan (5), Minnesota (12), Mississippi (1), Missouri (1), Montana (9), Nebraska (1), New Jersey (8), New York (11), North Carolina (1), North Dakota (3), Ohio (7), Oklahoma (1), Oregon (1), Pennsylvania (24), South Dakota (1), Tennessee (3), Texas (4), Utah (1), Virginia (1), Washington (8), and Wisconsin (3).

(PHAC) identified eight ill people in several Canadian provinces infected with the same DNA fingerprint of E. coli O157:H7. On June 22, 2018, PHAC reported that the outbreak in Canada appears to be over.

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak. To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli 0157:H7 with the same genetic fingerprint as the outbreak strain.

Below it the Yuma growing region which straddles the Colorado River and the California and Arizona border and Gila River.

On April 19, 2018, Alaska health partners announced that eight persons with E. coli O157:H7 infections from a correctional facility have been confirmed as part of the outbreak. These individuals ate whole-head romaine lettuce from the Yuma growing region. Following this announcement the FDA advised consumers to avoid all romaine lettuce from the Yuma growing region. In the following weeks FDA continued its traceback investigation, part of which was able to trace the Alaskan correctional facility back to Harrison Farms.

Note above the location of Harrison Farms to the West Main Canal.  Although the FDA did not name the canal where the positive E. coli O157:H7 samples were drawn, the location of the canal to Harrison Farms in more than coincidental.

And, we figured out yet another Point of Service with a cluster of illnesses, Distributor and Processor today – St. Lukes Hospital in Boise, Grasmick and Church Brothers/True Leaf – see above.

And, we figured out yet another Point of Service with a cluster of illnesses, Distributor and Processor today – Costco in Boise and True Leaf – see above.

And, we figured out yet another Point of Service with a cluster of illnesses, Distributor and Processor today – Papa Murphy’s (CA), ProPacific Fresh Inc., C.H. Robinson Company and Greengate Fresh – See above.

More to follow.

By the way, this is what the FDA has given us so far:

Given the size of the outbreak, at least 218 in the US and Canada, and the number of unnamed farms and fields implicated, I am not surprised that the source of the outbreak was broad environmental contamination – like water.  As a study that was performed in the Yuma growing area from 2007-2009 said: “Despite the fact that Arizona leafy greens has never been associated with foodborne outbreaks, this study is contributing with relevant information that can be used for future regulatory guidelines”.  Well, that clearly has changed. Survey of Selected Bacteria in Irrigation Canal Water – Third Year_0

This outbreak appears to be over as of June 28, 2018.

Epidemiologic, laboratory, and traceback evidence indicated that romaine lettuce from the Yuma growing region was the likely source of this outbreak.

The FDA and state and local regulatory officials traced the romaine lettuce to many farms in the Yuma growing region. The FDA, along with CDC and state partners, started an environmental assessment in the Yuma growing region and collected samples of water, soil, and manure. CDC laboratory testing identified the outbreak strain of E. coli O157:H7 in water samples taken from a canal in the Yuma growing region. WGS showed that the E. coli O157:H7 found in the canal water is closely related genetically to the E. coli O157:H7 from ill people. Laboratory testing for other environmental samples is continuing. FDA is continuing to investigate to learn more about how the E. coli bacteria could have entered the water and ways this water could have contaminated romaine lettuce in the region.

As of June 27, 2018, 210 people infected with the outbreak strain of E. coli O157:H7 were reported from 36 states. Illnesses started on dates ranging from March 13, 2018 to June 6, 2018. Ill people ranged in age from 1 to 88 years, with a median age of 28. Sixty-seven percent of ill people were female. Of 201 people with information available, 96 (48%) were hospitalized, including 27 people who developed hemolytic uremic syndrome, a type of kidney failure. Five deaths were reported from Arkansas, California, Minnesota (2), and New York.  (PHAC) identified 8 ill people in several Canadian provinces infected with the same DNA fingerprint of E. coli O157:H7. On June 22, 2018, PHAC reported that the outbreak in Canada appears to be over.

Canada called the imported romaine lettuce E. coli outbreak over after eight people were sickened.  It is expected that the CDC will update the US part of the outbreak in the morning.  The numbers of ill are likely to be far above 200 and the number of deaths may likely rise as well.  Those with long-term complications – (HUS) will still be extraordinary high, as will be the percent of hospitalizations.

Thus far the FDA has been “somewhat silent” on the chain of distribution and will unfortunately remain so.  Here is what they have told the public as of the end of May:

We have been busy doing both a trace forward and trace back.  With over 100 clients, most can identify the specific place that they consumed romaine (point of service) in the 3-5 days before the onset of illness.  Some have multiple purchases and consumptions, which for now, make linking the supply chain a challenge.  But I like a challenge.

I expect that the various retailers (points of service) will continue to provide information on the supply chain (distribution center, processor, grower/harvester) – either willingly or by subpoena.  And, once we have that information (trace back), we can than trace forward to eliminate situations where E. coli culture matched victims had multiple purchases in the incubation period.

Check back for more information.

Retailers above, please give me a call.