Romaine a Common Thread of 3 E. coli Outbreaks with Unknown Sources

Federal health officials say the food source of three ongoing E. coli outbreaks is unknown, but a common thread that runs through all of them is romaine lettuce. Together, these three outbreaks have already resulted in 56 illnesses, 23 hospitalizations, and one death. Two of them have genetic links to previous romaine E. coli outbreaks and a romaine recall was issued in association with the third. Still, investigators say they don’t have enough information to identify what food source may be causing these outbreaks and in a couple of weeks they’ll have access to even less when the growing season in Salinas, CA ends and operations shift to Yuma, AZ.

Here’s a look at what we know about these mystery outbreaks.

E. coli lawyer-Mystery Date spoof called Mystery Source of E. coli outbreaks with romaine behind the door

The first two of these E. coli O157:H7 outbreaks were announced at the same time by the Centers for Disease Control and Prevention (CDC) on October 28.  They were discovered using PulseNet, a national subtyping database coordinated by the CDC.

When someone develops an E. coli infection, health officials test the E. coli to identify its “fingerprint.” These identifiers are then uploaded to PulseNet. When matching fingerprints appear, it means the people likely shared a common source of infection and there is an outbreak. The most sophisticated method used to do these tests is a process called Whole Genome Sequencing (WGS) which identifies the genetic fingerprint of the strain.

When two outbreaks showed up on PulseNet recently, the CDC contacted state and local health departments who began interviews with the people sickened and asked them what they ate before they became ill.

E. coli Outbreak Unkown Source 1

Several of the people sickened in this outbreak ate at a restaurant before they became ill. The CDC hasn’t released the name of that establishment. Using purchasing records from that restaurant the U.S. Food and Drug Administration (FDA) conducted a traceback investigation and was, at the end of October, conducting farm inspections and sampling. Note: The FDA’s involvement in the investigation indicates that the food source is not beef or poultry as those are regulated by the U.S. Department of Agriculture (USDA).

In this outbreak, 21 people have been sickened, eight have been hospitalized and one has died. Illnesses have been reported from the following eight states: CA (7), FL, (1) IL(1), MI (2), NJ (1), OH (7), UT(1) and WI (1). Illnesses were also reported in Canada.

WGS analysis shows that the E. coli strain of this outbreak has caused other outbreaks including a 2018 E. coli outbreak linked to romaine lettuce. That outbreak was also deadly. Linked to romaine grown in Yuma, AZ, the outbreak sickened 210 people, hospitalizing almost half of them. Twenty-seven people developed hemolytic uremic syndrome (HUS) a life-threatening form of kidney failure associated with E. coli infections. Five people died.


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E. coli Outbreak Unknown Source 2

Illnesses in this outbreak, reported between August 17, 2020, to October 8, 2020, include people ranging in age from 5 to 81 years old.  Twenty-three illnesses were reported from the follwong 12 states: CA (2), Il (1), KS(4), MI (2), MO (2), ND (4), OH (1), PA (2), TN (1), UT (1), WA (1) and WI (2).

Health officialssaid they had information for 15 of the people sickened. Of those, 10 required  hospitalization and two developed HUS.

The fingerprint of the E. coli O157:H7 strain associated with this outbreak also matches the strain of a previous outbreak, a 2019 outbreak with illnesses in the U.S. and Canada which matches the strain of two other romaine E. coli outbreaks in 2019, a romaine E. coli outbreak in 2018 with illnesses in the U.S. and Canada and a 2017 leafy greens outbreak in the U.S./ romaine outbreak in Canada linked romaine lettuce grown in Salinas, California.

E. coli Lawyer - Bulletin Board of E. coli Outbreaks

All of the patients sickened in this outbreak told health officials that they ate various types of leafy greens before they became ill. Specifically, nine of them reported eating iceberg lettuce, nine ate spinach, eight ate romaine and six remembered eating mixed blends of bagged lettuce.

E. coli Outbreak Unknown Source 3

This outbreak was initially discovered when the Michigan Department of Agriculture and Rural Development (MDARD) discovered E. coli O157:H7 in a routine sample of romaine lettuce collected from a Walmart store in Comstock Park, MI. When investigators from the Michigan Department of Health and Human Services conducted WGS, they discovered that the strain was highly related genetically to E. coli strain causing two recent illnesses in Michigan.

These findings prompted Tanimura & Antle to issue a recall for whole heads of romaine for possible E. coli contamination. The roamien was sold at Walmaft and Food Lion stores.

Days later, the CDC reported that the E. coli outbreak had expanded beyond Michigan to include 12 illnesses in six states and five hospitalizations. All of the people in this outbreak also reported eating leafy greens in the week before they became ill. Specifically, five reported eating romaine, five reported eating spinach, three reported eating iceberg and three reported eating red leaf lettuce.

One other thing that these outbreaks have in common is that they ended not because they were solved by health officials but because the growing season came to end. As noted Food Safety Attorney Fred Pritzker told the StarTribune, “We should not have to wait until the end of the growing season to declare “victory” over disease.”

If you developed an E. coli infection from contaminated food and would like a free consultation with an experienced E. coli lawyer, please contact our E. coli Legal Team. We have represented clients in every major E. coli outbreak in the U.S.  You can reach us by calling 1-888-377-8900, sending a text to 612-261-0856, or by completing the form below. The consultation is free and there is no obligation.

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