RECALL NOTICE:DON’T EAT ROMAINE LETTUCE! - 11/21/18

Illustration with a triangle and exclamation mark and text reading Food Safety Alert

The CDC, public health and regulatory officials in several states, Canada, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (E. coli O157:H7) infections linked to romaine lettuce.

The CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak. This investigation is ongoing and the advice will be updated as more information is available.

  • 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. Follow these five steps to clean your refrigerator.
  • 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 healthcare 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.

 

What is the Problem and What is Being Done?

The FDA, along with CDC, state and local agencies, is investigating a multistate outbreak of E. coli O157:H7 illnesses likely linked to romaine lettuce. The Public Health Agency of Canada (PHAC), and Canadian Food Inspection Agency, are also coordinating with U.S. agencies as they investigate a similar outbreak in Canada.

Genetic analysis of the E. coli O157:H7 strains tested to date 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 that also affected consumers in both Canada and the U.S.  The 2017 outbreak of E. coli O157:H7 was associated with leafy greens in the U.S. and romaine in Canada. This year, romaine lettuce is the suspected vehicle for both the U.S. and Canadian outbreaks.  There is no genetic link between the current outbreak and the E.coli O157:H7 outbreak linked to romaine that occurred in the Spring of 2018.

The FDA is conducting a traceback investigation to determine the source of the romaine lettuce eaten by people who became sick. Additionally, FDA and states are conducting laboratory analysis of romaine lettuce samples potentially linked to the outbreak.

The most recent illness onset in the U.S. among these cases was October 31, 2018.  For this outbreak investigation, the average interval between when a person becomes ill and when the illness is reported to CDC is 20 days.

What Products are Recalled?

Currently, the FDA does not have enough traceback information to identify the source of the contamination that would allow us to request a targeted recall from specific suppliers. At this stage in the investigation, the most efficient way to ensure that contaminated romaine is off the market would be for industry to voluntarily withdraw product from the market, and to withhold distribution of romaine until public health authorities can ensure the outbreak is over and/or until FDA can identify a specific source of contamination. Until then, the FDA advises that consumers should not eat and discard romaine, or any mixed salads containing romaine, until more information on the source of the contamination and the status of the outbreak can be determined.

What are the Symptoms of E. Coli Infection?

The symptoms of Shiga toxin-producing (STEC) E. coli infections vary for each person but often include severe stomach cramps and bloody diarrhea. If there is fever, it is usually not very high (less than 101 degrees Fahrenheit/less than 38.5 degrees Celsius). Most people get better within 5–7 days. Some infections are very mild, but others are severe or even life-threatening.

Around 5–10 percent of those who are diagnosed with STEC infection develop a potentially life-threatening complication, known as hemolytic uremic syndrome (HUS).

Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. Most people with HUS recover within a few weeks, but some suffer permanent damage or die. People who experience these symptoms should seek emergency medical care immediately. Persons with HUS should be hospitalized because their kidneys may stop working (acute renal failure), but they may also develop other serious problems such as hypertension, chronic kidney disease, and neurologic problems.

Who is at Risk?

People of any age can become infected with Shiga toxin-producing (STEC) E. coli. Children under the age of 5 years, adults older than 65, and people with weakened immune systems are more likely than others to develop severe illness, including HUS, but even healthy older children and young adults can become seriously ill.

What Do Restaurants and Retailers Need To Do?

Retailers, restaurants, and other food service operators should not serve romaine lettuce until more is known about this outbreak.

Restaurants and retailers should always practice safe food handling and preparation measures. It is recommended that they wash hands, utensils, and surfaces with hot, soapy water before and after handling food.

  • Wash and sanitize display cases and refrigerators regularly.
  • Wash and sanitize cutting boards, surfaces, and utensils used to prepare, serve, or store food.
  • Wash hands with hot water and soap following the cleaning and sanitation process.

Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.

What Do Consumers Need To Do?

The FDA advises that consumers should not eat and discard romaine, or any mixed salads containing romaine, until more information on the source of the contamination and the status of the outbreak can be determined.

Consumers should always practice safe food handling and preparation measures. It is recommended that they wash hands, utensils, and surfaces with hot, soapy water before and after handling food.

Additional Information

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* We believe that none of the product being recalled were processed or offered through the Feeding America national office. 

To read more details on this alert, please visit this CDC web page.