An E. coli O157:H7 romaine outbreak that includes illnesses reported by Maryland and Wisconsin has just been announced by the Centers for Disease Control and Prevention (CDC). The Maryland outbreak was announced on November 18, 2019, and the Wisconsin outbreak was announced on November 16, 2019, although the first indication of the Wisconsin illnesses was posted on ProMED-mail.
So far, the CDC says that 17 people are sick in 8 states. The case count by state is: Arizona (1), California (2), Colorado (1), Idaho (3), Maryland (2), Montana (1), Washington (1), and Wisconsin (6). The case count for Maryland posted by the CDC is different from the case count posted by the Maryland Department of Health, which is seven sick. So there may be as many as 22 people who are ill in this outbreak.
Seven people have been hospitalized. Two people have developed hemolytic uremic syndrome (HUS), a complication of a Shiga toxin-producing E. coli infection that causes kidney failure.
Illness onset dates range from September 24, 2019 to November 8, 2019. The patient age range is from 3 to 72 years. Whole genome sequencing (WGS) performed on isolates taken from ill persons show that the pathogens that made them sick are closely related genetically, so they likely share a common source of infection.
The Maryland Department of Health found E. coli O157 on the romaine lettuce in an unopened package of Ready Pac Foods Bistro® Chicken Caesar Salad taken from a sick person’s home in Maryland. That product had a “Best By” date of October 31, 2019. Officials are performing whole genome sequencing on that sample to determine if this pathogen is related to the E. coli found in patient isolates in this outbreak.
But, only people in Maryland said they ate the Ready Pac product sold at Sam’s Club. In initial interviews, people in other states did not report eating that particular product.
Food safety lawyer Eric Hageman said, “This is the fourth E. coli O157:H7 outbreak likely associated with romaine lettuce since December of 2017. E. coli O157:H7 causes serious, sometimes deadly, disease. We need to get to the bottom of what’s causing these products to continue becoming contaminated.”
The FDA traced the supply of romaine lettuce in the Ready Pac salad and has identified possible farms in Salinas, California. Officials think that the romaine lettuce used in that product was harvested in mid-October and is no longer within an expiration date, meaning it should not be available for sale.
If you purchased that Ready Pac Foods Bistro® Chicken Caesar Salads with a “Best By” date of October 31, 2019 and lot number 255406963, do not eat it. Throw it away if you still have the salad at home.
The symptoms of an E. coli O157:H7 infection include a mild fever, severe abdominal and stomach cramps, vomiting, and diarrhea that is typically bloody and watery. The symptoms of HUS include little urine output, pale skin, lethargy, and no pink color on the bottom eyelid. If you or someone in your family are sick with these symptoms, please see a doctor immediately. This is a serious infection and can cause kidney failure and even death.