A health warning to avoid romaine lettuce was issued on Tuesday, Nov. 20, by the Centers for Disease Control and Prevention.

People should not buy or eat romaine lettuce; restaurants should stop serving it; and anyone who has it on hand should throw it out and clean the refrigerator immediately.

This advisory was issued as a precaution after 32 people in 11 states have become ill in the last month with an aggressive form of E. coli, a bacteria blamed for a number of food-borne outbreaks in recent years.

This E. coli outbreak was first identified on Oct. 8 and has led to the hospitalization of 13 people, including one person who developed kidney failure. So far no deaths have been reported.

Roughly a third of the cases were reported in California; the others are concentrated in the northeast and in the Great Lakes region.

Another 18 people have gotten sick in Canada. The source has not yet been identified, but the lettuce was most likely grown in the US or Canada.

While the bacteria in these cases are genetically different from an E. coli outbreak associated with Romaine lettuce earlier this year, the strain in this current outbreak (identified as Shiga toxin-producing Escherichia coli O157:H7) has been involved in other outbreaks.

The most serious one was in 1993 that killed four children and left nearly 200 other people very ill from eating contaminated hamburger meat.

Symptoms of E. coli Infection

– People usually get sick from Shiga toxin-producing E. coli (STEC) 2–8 days (average of 3–4 days) after swallowing the germ.
– Some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS). Up to half of the people with known infections in this outbreak have needed to be hospitalized.
– E. coli infection is usually diagnosed by testing a stool sample.
– Antibiotics are not recommended for patients with suspected E. coli infections. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing kidney problems, and a benefit of treatment has not been clearly demonstrated.

What to do

– Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick.
– This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.
– If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.
– Wash and sanitize drawers or shelves in refrigerators where romaine was stored.
– Restaurants and retailers should not serve or sell any romaine lettuce, including salads and salad mixes containing romaine.

Take action if you have symptoms of an E. coli infection

– Talk to your health care provider.
– Write down what you ate in the week before you started to get sick.
– Report your illness to the health department.
– Assist public health investigators by answering questions about your illness.

For more information go to: https://www.cdc.gov/ecoli/2018/o157h7-11-18/index.html .