CDC Warning: Stop Eating Romaine Lettuce

Public health officials from the Centers for Disease Control and Prevention (CDC) have issued a very special and very dire warning regarding an E. Coli outbreak that has now spread to at least 16 states and sickened at least 60 people so far, including eight prison inmates in Alaska. The CDC warning? Don’t eat Romaine lettuce from anywhere until further notice.

The original warning pertained to chopped romaine lettuce, but new information has led the agency to expand its warning to include whole heads and hearts of romaine, as well. The increased scrutiny of the outbreak came when eight men in the Anvil Mountain Correctional Center in Nome, Alaska became sick after eating lettuce from whole heads of romaine grown in Yuma, Ariz. Even though they haven’t pinpointed the exact source of the outbreaks, all the information they have gathered indicates the Yuma area is the center of the contamination. As of now, no common grower, supplier or distributor has been identified as the source

What is E. Coli?

Of the 60 reported illnesses so far, just over half (31 total) have been hospitalized, including at least five who have developed HUS, or hemolytic uremic syndrome, which is a potentially fatal disease that can lead to kidney failure. So far, no deaths have been reported.

Escherichia coli (E. coli) bacteria normally live in the intestines of people and animals. Most E. coli bacteria are actually harmless and play an important part in a healthy human intestinal tract. Unfortunately, some E. coli bacteria are pathogenic, which means they are capable of causing cause illness, and the types of E. coli that can cause symptoms like stomach cramps, diarrhea and worse are usually transmitted through ingestion of contaminated water or food, or through contact with animals or other people carrying the pathogen. Infections usually start after a person swallows a tiny amount of feces through contaminated food, consumption of unpasteurized (raw) milk, drinking unclean water or contact with the feces of infected people.

The most common pathogenic strains of E. coli Shiga toxin-producing E. coli (STEC), also referred to as E. coli O157: H7. Symptoms of STEC infection vary, but they can include severe stomach cramps, diarrhea (which can sometimes be bloody), fever, body aches, and vomiting. As noted, some of these symptoms can lead to complications, up to and including kidney problems like HUS. Approximately 5-10 percent of those diagnosed with STEC infection develop HUS. HUS develops about 7 days after symptoms first appear, when diarrhea is improving. Some of the most common clues to contraction of HUS include frequent urination, lethargy or a lack of energy, and losing the pink color in cheeks and inside the lower eyelids. People with HUS should be hospitalized immediately. While most who contract HUS recover within a few weeks, many suffer permanent damage or die.

How to Know if You Need a Doctor

Most people with a STEC infection will start feeling sick within 3-4 days after eating or drinking something contaminated with the bacteria. However, illnesses can start anywhere from 1 to 10 days after exposure. If you or a loved one have diarrhea that lasts more than 3 days, whether or not it is accompanied by blood, and/or you also have a high fever or you are vomiting so much you can’t keep anything down, including liquids, you should contact your doctor.

For the time being, whether or not they have experienced symptoms of contamination, consumers of any romaine lettuce product anywhere in the United States are being asked to throw it all away immediately or return it to the store where they purchased it for a refund and so they can dispose of it. Health officials advise this, even if some has been eaten already to no ill effect.

How Lettuce Becomes Contaminated

In most cases, the presence of E. Coli contamination usually happens because of the way certain foods are handled. Romaine lettuce is sometimes packed in the fields and is directly shipped to distributors and to grocery stores and restaurants. Other times, the vegetables are sent to a central processing plant, where they are packed under different brands before being shipped to retailers and restaurants. Because of this, it is often difficult to identify the origin of the contaminated lettuce.

The number of cases of illnesses in this outbreak has grown significantly over the last week or so, but the most troubling aspect of this outbreak is the hospitalization rate for this outbreak, which the CDC pegs at 58 percent, which is significantly higher than the 30 percent normally associated with infections involving E. coli O157: H7. CDC officials are hard at work, trying to determine why this outbreak seems to be leading to more hospitalizations. In addition, state and local health officials are continuing to interview sick people to ask about the foods they ate and other exposures before they became ill.

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