Romaine lettuce

Nov. 26, 2019:

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce harvested from the Salinas, California, growing region.

Ohio is one of the states that has seen people infected with E.coli from romaine lettuce in this recent outbreak, and as of Nov. 25, there were 12 reported cases of people infected in Ohio. A map of states where people have been infected along with numbers of reported cases of people infected in those states can be found at https://www.cdc.gov/ecoli/2019/o157h7-11-19/map.html

Recall and Advice to Consumers, Restaurants, and Retailers

CDC advises that consumers not eat and retailers not sell any romaine lettuce grown in the Salinas, California, growing region. This includes all use-by dates and brands of romaine lettuce from this region.

Have questions? Visit the Frequently Asked Questions webpage at https://www.cdc.gov/ecoli/2019/o157h7-11-19/faq.html

• Most romaine lettuce products are labeled with a harvest location showing where they were grown.

• This advice includes all types of romaine lettuce grown in Salinas, California, such as whole heads of romaine, organic romaine, hearts of romaine, romaine in salad wraps, and packages of precut lettuce and salad mixes which contain romaine, including baby romaine, spring mix, and Caesar salad.

- 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.

• If you have romaine lettuce or packaged foods containing romaine at home:

- Look for a label showing where the romaine lettuce was grown. It may be printed on the package or on a sticker.

- If the label says “grown in Salinas” (whether alone or with the name of another location), don’t eat it. Throw it away.

- If it isn’t labeled with a growing region, don’t eat it. Throw it away.

- If you don’t know if the lettuce is romaine or whether a salad mix or wrap contains romaine, don’t eat it. Throw it away.

- Wash and sanitize drawers or shelves in refrigerators where romaine lettuce was stored. Follow these five steps to clean your refrigerator, which are found at https://www.cdc.gov/foodsafety/communication/clean-refrigerator-steps.html

• If you are buying romaine lettuce at a store:

- Look for a label showing where the romaine lettuce was grown. It may be printed on the package or on a sticker.

- If the label says “grown in Salinas” (whether alone or with the name of another location), don’t buy it.

- If it isn’t labeled with a growing region, don’t buy it.

• Restaurants and retailers should check the label on bags or boxes of romaine lettuce, or ask their suppliers about the source of their romaine lettuce.

- Look for a label showing where the romaine lettuce was grown. It may be printed on the package or on a sticker.

- If the label says “grown in Salinas” (whether alone or with the name of another location), don’t sell or serve it.

- If it isn’t labeled with a growing region, don’t sell or serve it.

• Suppliers, distributors, and others in the supply chain should not ship or sell romaine harvested in Salinas, California.

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 your local health department.

• Assist public health investigators by answering questions about your illness.

• Wash your hands thoroughly (go to https://www.cdc.gov/ecoli/ecoli-prevention.html for more details on washing hands thoroughly and other prevention tips for this disease) after changing diapers, using the toilet, and before and after preparing food to lower the chance of infecting others.

Latest Outbreak Information as of Nov. 25, 2019

• A total of 67 people infected with the outbreak strain of E. coli O157:H7 have been reported from 19 states.

- A total of 39 hospitalizations have been reported. Six people have developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

• Epidemiologic, laboratory, and traceback evidence collected to date indicate that romaine lettuce from the Salinas, California, growing region may be contaminated with E. coli O157:H7 and is making people sick.

• The investigation is ongoing to determine the source of contamination and if additional products are linked to illness.

• CDC will provide more information as it becomes available.{div}• Have questions? Visit the Frequently Asked Questions webpage at https://www.cdc.gov/ecoli/2019/o157h7-11-19/faq.html

Symptoms of E. coli Infection

• People usually get sick from Shiga toxin-producing E. coli (STEC) 2 to 8 days (average of 3 to 4 days) after swallowing the germ.

• Some people with E. coli infections may get a type of kidney failure called hemolytic uremic syndrome (HUS).

E. coli infection is usually diagnosed by testing a stool sample.

• Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing HUS, and a benefit of treatment has not been clearly demonstrated.

For more information on symptoms of this disease, see Symptoms of E. coli Infection at https://www.cdc.gov/ecoli/ecoli-symptoms.html

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