Contaminated romaine lettuce has been linked to an E. coli outbreak that first appeared in Canada approximately seven weeks ago. A similar E. coli outbreak also recently erupted in the United States, including in Illinois, though American health officials have not yet officially linked it to romaine lettuce.
Canada: Romaine Lettuce Source of E. Coli Outbreak
Canadians reportedly started becoming sick from the recent E. coli outbreak in November 2017.
The Public Health Agency of Canada (PHAC) issued its first statement on the matter on December 11, when it announced that it was working with other agencies and provincial health partners “to investigate an outbreak of Escherichia coli O157, commonly called E. coli.” At that point, there were 21 known cases of E. coli infection, none fatal, in three provinces, including Quebec, New Brunswick, and Newfoundland and Labrador. Those infected ranged in age from 5 to 72; ten of them were hospitalized. The PHAC linked the outbreak to romaine lettuce, though no product recalls had been associated with the illness.
By December 21, the investigation of the PHAC and its health partners had officially identified exposure to romaine lettuce as the source of the E. coli outbreak, though the specific cause of contamination still has not been determined.
As of December 28, the date of the PHAC’s most recent announcement, the Canadian E. coli outbreak has resulted in at least 41 illnesses and one death. The bacteria has also spread to as many as five provinces, now also including Ontario and Nova Scotia.
The PHAC cautions that the outbreak appears to be ongoing. Additional infections continue to be reported, suggesting that contaminated romaine lettuce may still be on the market in grocery stores, restaurants, and other places that serve food. With this in mind, the agency has urged those living in the afflicted Canadian provinces to consume other types of lettuce instead of romaine for the time being.
U.S. Outbreak: E. Coli “Closely Related,” Cause Uncertain
While the number of Canadians suffering from the current E. coli outbreak continues to grow, the United States has itself been undergoing a similar public health crisis. According to the Centers for Disease Control and Prevention (CDC), as many as 24 Americans have been sickened and one killed by a “multistate outbreak of Shiga toxin-producing E. coli O157:H7 infections.”
As of January 11, 2018, fifteen states have known cases of E. coli infection, including Illinois. The first of this recent crop of E. coli-related illnesses in the United States reportedly began on November 15, 2017.
According to the CDC, the strains of E. coli in both the U.S. and Canadian outbreaks are “closely related genetically,” which suggests that those who have fallen ill are “more likely to share a common source of infection.” While the CDC suggests a strong similarity in the types of infections, it is not yet willing to confirm that exposure to romaine lettuce is the cause of the American E. coli outbreak.
“Because we have not identified a source of the infections,” the statement read, “CDC is unable to recommend whether U.S. residents should avoid a particular food. This investigation is ongoing, and more information will be released as it becomes available.”
Romaine Lettuce: A Warning and A Recall
While the CDC, the Food and Drug Administration, and local public health agencies continue to investigate the causes of the current E. coli outbreak in the United States, some are not waiting for their results before taking action.
On January 5, 2018, Consumer Reports, the magazine for the nonprofit consumer advocacy organization of the same name, issued a warning for Americans to stop eating romaine lettuce until the source of the outbreak has been identified and contaminated products have been removed from the marketplace.
“Even though we can’t say with 100% certainty that romaine lettuce is the cause of the E. coli outbreak in the U.S.,” said James Rogers, Consumer Reports’ director of food safety and research, “a greater degree of caution is appropriate given that romaine lettuce is almost always consumed raw.”
At least one cautious restaurant chain has already followed suit. On January 9, Wendy’s announced that it would be taking Caesar salads off its menu while the CDC investigates the current outbreak.
According to a Wendy’s spokesperson, no other menu items at the chain are affected, since the company uses different types of lettuce in its sandwiches and other salads. The spokesperson insisted that Wendy’s pulled its Caesar salads only out of an abundance of caution. Wendy’s has not traced any E. coli infections to its customers, nor has it found any issues with its supply chain.
E. Coli Facts
E. coli (Escherichia coli) are a large and diverse group of bacteria found in the environment, certain foods, and the intestines of humans and animals, including cattle, poultry, and other livestock. Most E. coli outbreaks are linked to meat products, but vegetation, including romaine lettuce, may occasionally be the cause.
Raw fruits and vegetables can become contaminated with E. coli by coming into contact with feces from infected animals. This fecal contamination may result from direct contact with the animals themselves or from interaction with infected soil, water, or improperly composted manure.
Bacterial contamination may also occur during the handling, storage, and transportation of produce, or it may be the product of cross-contamination from infected raw meat, poultry, or seafood in grocery stores, in refrigerators, and on counters and cutting boards.
While most strains of E. coli are harmless to humans, some forms may cause serious illness, including:
- Gastroenteritis
- Urinary Tract Infections
- Pneumonia
- Respiratory Impairment
- Hemorrhagic Colitis
- Crohn’s Disease
- Bowel Necrosis and Perforation
- Neonatal Meningitis
Certain types of E. coli could cause even more serious bodily damage. For example, E. coli 0157:H7, the strain identified in the recent Canadian and American outbreaks, may produce Shiga toxin, which is classified as a bioterrorism agent. In extreme cases, Shiga toxin can cause the premature destruction of red blood cells, clogging the kidneys and causing hemolytic-uremic syndrome, a disease that could lead to kidney failure and even death.
Most people with E. coli infections begin feeling ill within three to four days after ingesting infected food or drink, though illnesses can start anywhere from one to ten days after exposure. Symptoms of E. coli infection may include the following:
- Abdominal Pain/Cramps
- Diarrhea (Sometimes Bloody)
- Vomiting
- Fever
Treatment typically involves the replacement of fluids and electrolytes to combat the dehydration that often results from E. coli infection.
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