Investigation of E. coli O157:H7 Outbreak Linked to Romaine from Salinas, California, November 2019

Jan 02, 2020 | Michelle Shapiro

Recommendation

FDA, CDC, and state health authorities are investigating an outbreak of illnesses caused by E. coli O157:H7 in the U.S. Epidemiologic, laboratory, and traceback evidence indicates that romaine lettuce from the Salinas, California growing region is the likely source of this outbreak. Current traceback investigations have identified a common grower in Salinas. FDA, CDC, and California partners have deployed a team to conduct new investigations at several ranches used by this grower as we try to identify the source of the contamination. According to CDC, there have been 138 cases reported in 25 states. The latest date that one of these patients reported becoming ill was on December 1, 2019.

Consumers: Consumers should not eat romaine lettuce harvested from Salinas, California. Additionally, consumers should not eat products identified in the recall announced by the USDA on November 21, 2019.

Romaine lettuce may be voluntarily labeled with a harvest region. If this voluntary label indicates that the romaine lettuce was grown in “Salinas” (whether alone or with the name of another location) do not eat it. Throw it away or return it to the place of purchase. If romaine lettuce does not have information about harvest region or does not indicate that it has been grown indoors (i.e., hydroponically- and greenhouse-grown), throw it away or return it to the place of purchase. Consumers ordering salad containing romaine at a restaurant or at a salad bar should ask the staff whether the romaine came from Salinas. If it did, or they do not know, do not eat it.

At this time, romaine lettuce that was harvested outside of the Salinas region has not been implicated in this outbreak investigation. Hydroponically- and greenhouse-grown romaine, which is voluntarily labeled as “indoor grown,” from any region does not appear to be related to the current outbreak. Consumers don not need to avoid using romaine harvested from these other sources.

Restaurants and Retailers: Restaurants and retailers should not serve or sell romaine harvested from Salinas, California. If you do not know the source of your romaine lettuce, and if you cannot obtain that information from your supplier, you should not serve, nor sell it.

Suppliers and Distributors: Suppliers, distributors and others in the supply chain should not ship or sell romaine harvested in Salinas, California. If the source of the romaine lettuce is unknown, you should not ship, nor sell the product.

For Restaurants, Retailers, Suppliers and Distributors: Currently, the FDA does not have enough traceback information to identify the specific source of the contamination that would allow us to request a targeted recall from specific growers.

FDA requested that industry voluntarily withdraw romaine grown in Salinas from the market and is requesting that industry withhold distribution of Salinas romaine for the remainder of the growing season in Salinas. Without more specific traceback information, this was the most efficient way to ensure that contaminated romaine was off the market.

Update: December 19, 2019

FDA continues to actively investigate the cause of this outbreak. An investigation team consisting of staff from FDA, CDC, the California Department of Public Health and the California Department of Food and Agriculture are attempting to identify any factors that could have led to contamination at a common farm identified by traceback. This investigation involves assessing and sampling soil, animal droppings, compost, water, and other potential environmental sources at the ranches of this grower. The samples and information collected during the farm investigations will be analyzed.

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. The source of the romaine identified in the bag was Salinas, California. It was determined that one of the growers of this product also supplied romaine linked to other E. coli outbreaks that FDA is investigating.

These outbreaks are each caused by strains that are different from each other and different from the larger outbreak. One of the additional outbreaks, in Washington state, 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.

Read the full update


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About Michelle Shapiro

Michelle Shapiro is a communication specialist for the Environmental Health & Disability team at NACCHO.

More posts by Michelle Shapiro

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