More Than 100 E. Coli Illnesses Now Linked to Romaine Lettuce

WEDNESDAY, Dec. 4, 2019 (HealthDay News) -- It's still not 100% safe to enjoy caesar salads: Federal health officials say more Americans have been sickened with E. coli after eating romaine lettuce thought to be grown in Salinas, Calif.

Case numbers have jumped from 67 reported a week ago to 102 on Wednesday, according to a news release issued by the U.S. Centers for Disease Control and Prevention. Twenty-three states have now reported cases, up from 19 last week.

In more than half of the cases (58), illnesses have been so severe as to require hospitalization, although no deaths have yet been reported.

The U.S. Food and Drug Administration first issued a warning on Nov. 22 that consumers should avoid all romaine lettuce grown in Salinas, Calif., due to possible contamination with E. coli bacteria. That warning still stands, the agency said.

The goal "is to limit exposure and help prevent additional people from becoming sick," FDA Deputy Commissioner for Food Policy and Response Frank Yiannas said in an agency news release issued last month.

"Our investigation has led us to farms in Salinas, California, and while the FDA is sending investigators there to look for the source of contamination, we are updating our advice today to help protect the public health and to help ensure we contain this outbreak," he said. "Consumers should not eat any romaine lettuce harvested from Salinas, California."

Romaine lettuce harvested elsewhere is thought to be safe to eat, Yiannas added.

He added that the latest advisory extends to packaged salads included in a U.S. Department of Agriculture advisory issued on Nov. 21.

A complete list of those products can be found here.

In the meantime, consumers have ways of knowing where the romaine lettuce sold in supermarkets was raised, Yiannas said.

"Romaine lettuce may be voluntarily labeled with a harvest region," he said. "If romaine lettuce has 'Salinas' on the label in any form [whether alone or with the name of another location] do not eat it. Throw it away or return it to the place of purchase."

And if there is no labeling on lettuce indicating its origin, or labeling does not indicate that it has been grown indoors, better to be safe than sorry and "throw it away or return it to the place of purchase," Yiannas said.

"Consumers ordering salad containing romaine at a restaurant or at a salad bar should ask the staff whether the romaine came from Salinas," he added. "If it did, or they do not know, do not eat it."

Suppliers, distributors, retailers and restaurants are also being asked to cease transporting, selling or serving romaine lettuce grown in Salinas, the FDA said.

The FDA noted that the strain of E. coli identified in the current outbreak is a familiar one.

"Genetic analysis of the E. coli O157:H7 strains from patients in this current outbreak are similar to strains of E. coli O157:H7 associated with a previous outbreak from the fall of 2017 and the fall of 2018 that affected consumers in both Canada and the United States," the agency said.

Symptoms of E. coli infection -- which develop a few days after swallowing the germ -- typically include diarrhea (often bloody), severe stomach cramps and vomiting. People who develop such symptoms should contact their doctor, the CDC said.

Most people do recover within a week, the agency said, but some illnesses can last longer and be more severe.

More information

The U.S. Centers for Disease Control and Prevention has more on E. coli.