People across the US are throwing away romaine lettuce due to an E. coli outbreak - here's how to avoid getting sick

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People across the US are throwing away romaine lettuce due to an E. coli outbreak - here's how to avoid getting sick

prepackaged salad romaine

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Pre-Packaged salad sits on the shelf at a Bell Market grocery store June 19, 2003 in San Francisco, California. Packaged salad which was near non-existent a decade ago has become the second fastest selling item on grocery shelves behind bottle water, overall the retail market for bagged salad is $2 billion annually.

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  • More than 53 people have gotten sick in 16 US states after eating romaine lettuce contaminated with E. coli bacteria.
  • Romaine lettuce from the growing region of Yuma, Arizona is the source of the outbreak.
  • For now, the CDC recommends avoiding all romaine lettuce unless you are certain it doesn't come from that region.
  • Since the origin of produce can be hard to determine, some experts recommend avoiding all romaine until the situation is resolved.


People should avoid all romaine lettuce unless they can confirm that lettuce does not come from the growing region of Yuma, Arizona, according to the latest warning from the Centers for Disease Control and Prevention (CDC).

Romaine lettuce - including the pre-chopped variety as well as whole heads and hearts - from that region has been linked to a multistate outbreak of a nasty strain of E. coli that can cause bloody diarrhea, stomach cramps, vomiting, and kidney failure.

So far, the CDC has documented at least 53 cases in 16 states, with 31 people hospitalized. At least five individuals developed a type of kidney failure called hemolytic uremic syndrome. However, those numbers do not yet include a group of people who got sick after eating contaminated heads of romaine at a correctional facility in Alaska.

So far, there have been no deaths connected to the outbreak.

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ecoli outbreak us map 04.18

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E. coli cases per state, as of April 18

When will it be safe to buy romaine lettuce?

Since it's hard to know where the lettuce that ends up on your plate comes from, the CDC is suggesting a very cautious approach for now: if you don't know the exact origin of your romaine, throw it out.

That's even true if some of it has been eaten and no one got sick, since it can take up to 10 days for symptoms of E. coli show up.

Most of the romaine lettuce that's grown between November and March comes from the Yuma region, but salad mixes rarely identify where their ingredients come from. In some cases, it may not be clear whether a mix of "spring greens" contains romaine either, so be careful about that, too.

If you aren't certain, the CDC again advises disposing of your lettuce. Groups like Consumer Reports are urging people to avoid all romaine for now, even if it doesn't seem to be from Arizona.

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Because the CDC is still investigating the E. coli outbreak, they're expecting new cases to continue popping up - which means the guideline about romaine lettuce does not have a firm end-date yet.

caesar salad

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A nasty strain of E. coli

Leafy greens like romaine or spinach are the most common sources of foodborne illness infections, according to an analysis by the CDC. There are many opportunities for bacteria to spread to these products and they're usually eaten raw, which means bacteria aren't killed by cooking. Washing produce can reduce some contamination, but it doesn't kill bacteria.

This particular strain of the bacteria, E. coli O157:H7, is one that sickened 25 people who ate leafy greens (including romaine lettuce) last November and December. One Californian died during that outbreak. In May of last year, O157:H7 also turned up in soy-nut butter. Thirty-two people got sick, and nine developed kidney failure.

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O157:H7 usually originates in the guts of cattle, but it can also be found in goats, sheep, deer, and elk as well. It can travel from cattle farms to nearby fields where lettuce is grown and contaminate the greens in the soil. It can also get on the lettuce when food-handlers don't wash their hands properly after coming into contact with E. coli-harboring feces.

The O157:H7 strain is especially dangerous for people because it produces a nasty Shiga toxin, which can make us really sick. This kind of Shiga-toxin-producing E. coli, or STEC, as it's sometimes called, spreads to humans when little bits of feces get inside our mouth. That's why a bit of undercooked meat, raw milk, or contaminated lettuce can make you ill.

So until the CDC issues an all-clear update, continue to avoid romaine.

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