Romaine E. coli Outbreak

Update 5/2/17 8:00 pm

We have two different things going on in what people are understanding as one outbreak.

  1. Whole head romaine that sickened 8 at a prison in Alaska
  2. Chopped bagged romaine that has now sickened 121 people in 25 states; 52 hospitalizations and 1 death.

The FDA has identified a grower who produced the whole head romaine that sickened the 8 in Alaska.  The FDA says that the remainder of the illnesses are not linked to this farm (source).  All romaine from this farm was harvested March 6-15 and is past it’s 21 day shelf life.  The actual source of the contamination has yet to be identified.  It could have “occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching the Alaska correctional facility where it was served.”

Arizona Leafy Greens Marketing Agreement (LGMA) has confirmed that all romaine harvest has ceased in the Yuma area (source).

Grower(s) and a source of the outbreak has yet to be identified for the chopped bagged romaine.  Most people with illnesses have reported eating salad at a restaurant, and the FDA has determined that romaine lettuce was the only common ingredient among all salads eaten.  The restaurants reported using bagged, chopped romaine lettuce to make the salads.

To date, our traceback has revealed that romaine lettuce potentially contaminated with E. coli O157:H7 came from the Yuma growing region, but was supplied to restaurants and retailers through multiple processors, grower/shipper companies, and farms.

Because a crop from one grower can be packed by different shipper companies, and go to different processing facilities, this adds complexity to traceability.  However, nearly all growing and processing operations undergo annual 3rd party audits.  These audits require mock recalls to be done every 6 months, and each mock recall must be completed within 2 hours with 100% of the product located.  The complexity of the supply chain beyond these operations includes multiple distribution channels covering a large geographical area.  The FDA is currently investigating multiple groupings of illnesses based on their geographic locations and trying to converge on a single source or grower.


Update 4/25/18 3:00 pm

California, Florida, and Mexico produced romaine is not affected in this outbreak.

I’d like to expand on a point I made in the original post.  I said that there has only been one recall associated with this outbreak.  To my knowledge, that point remains true.  What I’d like to expand on is the advisory from the CDC not to consume any romaine lettuce from Yuma, AZ.

As mentioned, a recall is when a specific product has been definitively associated with the outbreak.  The CDC has not definitely associated a source of the outbreak, therefore they cannot recall specific romaine products.  Once a grower has been identified, the CDC can recall specific romaine products produced by that particular grower(s).  At this point, the advisory from the CDC to avoid romaine from the Yuma area is a recommendation.  They are warning the public to consume with caution.  Really, that’s all they can do until they have identified the grower(s) and the specific products that may be affected.

Although the case count has increased, that does not mean that the outbreak is growing (or ongoing).  The additional people who are ill have been sick all along, they are only now confirmed to be linked to this outbreak.  People tend to fall ill 2-8 days after swallowing the germ (source).  It can take 2-3 weeks to determine whether or not that illness is associated with an outbreak (source).  The last reported illness began on April 12th.


Update as of 4/20/18 2:45 pm:

The CDC and FDA are expanding their advice to consumers to avoid all romaine lettuce grown out of the Yuma, AZ area, including whole heads and hearts.


Original post 4/20/18 2:00 pm:

As many consumers are now aware, the CDC has released a statement regarding a multi-state outbreak of E. coli 0157:H7 linked to chopped romaine lettuce grown out of Yuma, Arizona.

Typically when we see reports of outbreaks, our initial reaction is to go into our refrigerator or pantry and dispose of any product remotely represented by the outbreak.  For example, when there was a recall on Bush’s Baked Beans, I went to my pantry and looked at the three cans I had on the shelf.  I really just wanted to throw them all out, because that’s easier than actually determining which specific kind, lot code, etc. is involved in the recall, right?  But as a food safety professional, I understand the challenges and regulations that go into ensuring the food we supply is safe.  I understand the checks that are in place, the purpose of lot codes, and how recalls affect the market, often creating a ripple effect throughout the industry.  So I checked the flavor, the lot code, and the best by dates on the cans.  Fortunately, none were affected by the recall.  I put two back on the shelf, and kept the other out to have with my dinner.  Crisis averted, no harm, no foul.

So, why does it seem like we are seeing more outbreaks and recalls?  Because technically, we are.  But that’s not because our food is less safe.

Advances in technology are allowing us to detect pathogens easier and at smaller detectable levels.  For example, we used to be able to detect pathogens in parts per million, now we can detect pathogens in parts per billion.  That’s incredible!  It’s the same products we’ve always eaten, now we just have this instinctive fear that it’s less safe because we don’t notice minor changes in details of how the data is being reported. Our food is actually more safe now, because of these advances in technology.

Our effort is to release a statement of recall, especially, in the hopes that you don’t get sick, and that it doesn’t turn into a notice of outbreak – or vice versa.  A foodborne “outbreak” can be described when multiple people fall ill after eating the same food.  A “recall” is when a “specific product in question has been definitively linked to the outbreak” (source).  At this point, only one recall has been associated with this E. coli 0157:H7 outbreak.  That recall is from Fresh Foods Manufacturing Co.  For more information on which specific products have been recalled, click here.

As Jim Gorny of the FDA said, “The number one reason for a recall is to prevent consumption of a product that could cause harm” (source). It’s also about alerting people “about symptoms so they can seek treatment if they consumed the recalled products, and to alert consumers as well as foodservice providers as soon as possible about the possibility of cross contamination from the recalled products.”  Investigating and researching the source of contaminated foods is a lengthy, detailed, and exhaustive process.  The supply chain is complex, and although measures are in place at every level to ensure rapid response, identifying the specific strain of the pathogen in question takes time.

The California Leafy Greens Marketing Agreement has released some guidance for consumers to help navigate purchasing romaine during this outbreak.  For the full text, click here.  I highly recommend reading the full text.  LGMA does an excellent job of expressing concern for the public, while reminding consumers that “The California and Arizona Leafy Greens Marketing Agreements represent the U.S. produce industry’s most rigorous food safety program” [emphasis mine].

Illnesses related to this outbreak were first reported on March 13, with the most recent report occurring on April 7th.  Likely, any product involved in this outbreak would have been harvested and shipped in early March.  “Because of the perishable nature of romaine lettuce, it is very unlikely that any romaine lettuce from Yuma, AZ that was purchased and consumed in mid-to-late March is still available in stores or other distribution channels.”

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