ATLANTA – Consumers are being advised to avoid eating romaine lettuce until the cause of a dangerous strain of E. coli bacteria found in the popular vegetable in the U.S. and Canada has been found.
Consumer Reports and the Centers of Disease Control reported in the past seven weeks that 58 people have become ill, with five hospitalized and two who died, from E. coli bacteria likely from eating raw romaine lettuce. No local cases have been reported.
The infections have occurred in California, Canada and 12 other states, according to Consumer Reports. The five hospitalized are in the United States with the one death in the U.S. and one in Canada. CDC health officials are investigating the outbreaks but have stopped short of recommending people avoid romaine lettuce or any other food.
This strain of E. coli, 0157:H7, produces a toxin that in some cases can lead to serious illness, kidney failure and even death, officials said.
Consumer Reports’ food safety experts advised that consumers stop eating romaine lettuce until the cause of the outbreak is identified and the offending product is removed from store shelves.
“Even though we can’t say with 100 percent certainty that romaine lettuce is the cause of the E. coli outbreak in the U.S., a greater degree of caution is appropriate, given that lettuce is almost always consumed raw,” James Rogers, Ph.D., director of Food Safety and Research at Consumer Reports, said.
While anyone can get sick if they are infected with E. coli 0157:H7, young children, the elderly and anyone who has a condition such as cancer or diabetes that weakens the immune system are at greater risk.
“People in these groups should be particularly vigilant about avoiding romaine lettuce,” Rogers said.
The CDC announced recently in a press release that, along with the U.S. Federal Food and Drug Administration, it is investigating the E. coli infections in the U.S. According to the agency, the type of E. coli making people sick is genetically similar to the bacteria involved in the Canadian outbreak.
Still, the agency said it does not have enough information to recommend people in the U.S. avoid a particular food.
No source has been identified yet.
“There is not enough epidemiologic evidence at this time to indicate a specific source of the illnesses in the United States,” Brittany Behm, a CDC representative, said. “Although some sick people reported eating romaine lettuce, preliminary data available at this time shows they are not more likely than healthy people to have eaten romaine, based on a CDC food consumption survey.”
Health officials, Behm said, take action when there is clear and convincing information linking illness to a contaminated food.
“The FDA should follow the lead of the Canadian government and immediately warn the public about this risk,” Jean Halloran, director of Food Policy Initiatives at Consumers Union, the policy and mobilization division of Consumer Reports, said. “The available data strongly suggest that romaine lettuce is the source of the U.S. outbreak. If so, and people aren’t warned, more may get sick. FDA needs to act promptly to protect consumers’ health. People could eat a lot of potentially contaminated romaine while waiting for a company recall or for the CDC and FDA to identify the specific source of the outbreak and order a mandatory recall of the affected products.”
Here’s how lettuce becomes tainted.
Outbreaks of toxin-producing E. coli are more typically linked to beef as the bacteria can get into the meat during slaughter and processing, especially ground beef, but infections from produce are not unheard of. Leafy greens, including romaine lettuce, were the cause of outbreaks from E. coli 0157:H7 in 2006, 2011, 2012 and 2013.
“Vegetables can be contaminated if animal feces are in the field or in irrigation or washing water,” Rogers said. “The bacteria can also be transmitted if a person who is carrying the bacteria doesn’t wash his or her hands after using the bathroom and then processes or prepares food.”
Washing greens is a good idea, but won’t necessarily get rid of dangerous E. coli, which can cling to nooks and crannies in the leaves, Rogers said.
Consumers should consider what they should do now. Neither the CDC nor Canadian health officials have provided any information on where the romaine lettuce potentially involved in the illnesses was grown or processed, so for now, consumers should assume that any romaine lettuce, even when sold in bags and packages, could possibly be contaminated, Rogers said. Don’t buy romaine lettuce and don’t use any still be at home until there is more information on the source of contamination. In their warning, the Canadian health officials noted that romaine lettuce can have a shelf life of up to five weeks, so lettuce that was purchased a few weeks ago could still be contaminated. Check salad blends and mixes, too, and avoid those that contain romaine.
The symptoms of E. coli infections include severe stomach cramps, diarrhea – often bloody and vomiting. Some people may have a slight fever. The symptoms typically start one to three days after eating a contaminated food, but may occur as late as 10 days afterward. The CDC recommends seeing a doctor if someone has a high fever, bloody diarrhea, severe vomiting or if diarrhea lasts longer than three days.
About five to 10 percent of people infected with E. coli, 0157:H7, may develop hemolytic uremic syndrome, a serious condition which affects the blood vessels and can lead to kidney failure and death. This condition, which includes symptoms such as extreme fatigue, decreased urination and paleness in the cheeks and under the eyes, typically occurs about seven days after E. coli symptoms first start.