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Do Not Eat Romaine Lettuce Until Further Notice. We’re Sorry.

On January 27, we were happy to report that it was deemed okay to eat romaine lettuce again. Now, unfortunately, we must follow up and inform you that consumers should avoid eating romaine lettuce again, as a new E. coli outbreak has gotten 35 people sick across the United States.  This new romaine lettuce E. coli outbreak spread throughout 11 states and has been linked to bagged, chopped romaine lettuce grown in Yuma, Ariz. It is now recommended that you do not eat romaine lettuce at this time.

This advice, coming from Consumer Reports goes beyond that of the Centers for Disease Control and Prevention, which is recommending that consumers buy or order bagged romaine lettuce at a supermarket or restaurant only after confirming that it didn’t originate in the Yuma growing region. Investigators haven’t pointed to any particular romaine suppliers or growers, but many domestic greens are grown in the Yuma region at this time of year. They state that the CDC also advises that if you’ve purchased bagged, chopped romaine lettuce—including salads and salad mixes containing romaine—you should throw it away immediately. Consumer Reports’ experts believe, however, that it could be difficult for consumers to determine where the romaine they purchase is from, which is why they believe it’s best to avoid the lettuce altogether.

“Consumer Reports is making this recommendation given the potentially fatal consequences of E. coli, the fact that there are still several unknowns about this outbreak, and that no type of romaine has been ruled definitively safe by government officials,” says James E. Rogers, Ph.D., director of food safety research and testing at Consumer Reports. “While we are making this decision out of an abundance of caution, this warning is particularly important for vulnerable people like the elderly, pregnant women, and young children.”

CDC investigators don’t believe this outbreak is connected to the one that occurred late last year in the United States and Canada, although it is the same potentially deadly strain, E.coli O157:H7. No deaths have been reported, but 22 people have been hospitalized. Three of those patients have a type of kidney failure called hemolytic uremic syndrome, which is often associated with the O157:H7 E.coli strain.

The outbreak is widespread: Nine people were infected in Pennsylvania, eight in Idaho, and seven in New Jersey. There were also cases in Connecticut, New York, Ohio, Illinois, Michigan, Missouri, Virginia and Washington state. The CDC says all the victims were sickened between March 22 and March 31, with most reporting that they ate romaine within a week of getting sick.

Laura Gieraltowski, Ph.D. MPH, Foodborne Outbreak Response Team lead at the CDC, suspects there will be more cases reported in the days and weeks ahead, as illnesses that began after March 27 may not have been counted yet. Many of the cases so far were contracted from salad mixes used in restaurants, but some cases have been linked to bagged romaine purchased in stores.

One Pennsylvania company, Fresh Foods Manufacturing, announced on Saturday a voluntary recall of 8,757 pounds of retail salad products. Although none of the confirmed E. coli cases have yet been linked to Fresh Foods, the company is concerned that its romaine supplier may have been involved in the outbreak.

“The people who make up the fresh produce industry are keenly interested in finding out what went wrong with our extensive food safety programs,” Bob Whitaker, Ph.D., chief science and technology officer at the industry group Produce Marketing Association, said in a statement.

The federal response to this outbreak stands in contrast to the E. coli outbreak this past winter, when investigators at the CDC and the Food and Drug Administration did not make definitive consumer recommendations. Gieraltowski says the earlier outbreak was never conclusively linked to romaine (although Canadian investigators of the same outbreak issued a romaine recall based on their findings).

Food policy advocates—including Jean Halloran, director of food policy initiatives at Consumers Union, the advocacy division of Consumer Reports—had been critical of the muted government response to this past winter’s outbreak. Halloran says the rapid response to this newer outbreak is an improvement but that investigators should go further.

“It is unrealistic to expect consumers to figure out whether their romaine was produced in Arizona or somewhere else, especially when eating in a restaurant,” she says. “FDA should just advise consumers to avoid romaine lettuce until further notice.”

Rogers strongly urges investigators to “dig deep into why this has happened for the second time in five months with this specific product.”  He says this strain of E. coli is uncommon in leafy greens, and says it’s important for consumers to learn more about why there have been two outbreaks in such a short time frame.

How to Protect Yourself

The CDC’s Gieraltowski encourages consumers to ask restaurants if they source their romaine from Yuma, and to inspect any bagged lettuce or salad mixes for its origins.

Consumer Reports, however, recommends that consumers avoid romaine at restaurants altogether—employees may simply not know where their lettuce comes from.

Consumer Reports also advises that you not buy any retail romaine for the time being, including unbagged whole heads or hearts of romaine. Although no E. coli has yet been linked to the latter, Rogers says it’s best to be cautious.

“Since we do not know how the CDC/FDA came to the conclusion to advise against eating only bagged romaine, we would advise consumers not eat anyromaine until we get more information,” he says.

Rogers adds that E. coli can cling to nooks and crannies in lettuce leaves, so washing them at home probably will do little to get rid of dangerous bacteria if it’s present.

Symptoms of infection with E. coli 0157:H7 to watch out for are severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may also have a slight fever.

The symptoms typically start one to three days after eating contaminated food, but may also occur as late as 10 days afterward. The CDC recommends seeing a doctor if you have a high fever, bloody diarrhea, or severe vomiting, or if diarrhea lasts longer than three days.

Federal investigators will likely issue an update on the outbreak this week.

How do you, as a consumer, feel about this? Let us know! Send an email to Outreach@ConsiderTheConsumer.com, find us on Twitter or Facebook, or even connect with us directly on our website! We look forward to hearing from all of you.

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