The E. coli Romaine Lettuce Outbreak: What You Need to Know

Over the past 2 months, there has been an outbreak of E.coli within the United States, with 149 people infected with this bacteria in 29 states, based on the most updated information from the Center of Disease Control (CDC). Moreover, 1 death has now been confirmed in the state of California as a result of this infection.

E.coli is a Gram-negative bacteria that is found naturally in the intestinal tracts of mammals, including humans. They play an important role in maintaining the health of our gastrointestinal tract, however certain strains of E.coli produce specific toxins that can end up doing serious harm to our bodies. What makes this outbreak especially concerning is that the E.coli involved (known as E.coli O157:H7) produces something called Shiga Toxin, which causes cellular destruction, specifically preventing our cells from producing proteins essential to their survival. This in turn results in damage to the gastrointestinal tract, our blood cells and the kidneys, which in turn result in symptoms of gastrointestinal bleeding, reduction in your blood cell counts and kidney injury. When these symptoms occur simultaneously, they are known as hemolytic-uremic syndrome, or HUS, which can be life-threatening in nature.

Unfortunately, antibiotics will NOT help with this type of infection, as killing the E.coli with antibiotics will result in release of more Shiga toxin, worsening the above symptoms and increasing the risk of triggering HUS. Treatment instead is usually supportive, and in more severe cases where kidney failure results, the initiation of hemodialysis may be required.

The outbreak appears to have started from contaminated lettuce that was manufactured in Yuma, AZ. Contamination may have occurred from a nearby water source or from animals that were near the where the lettuce was being grown; however it is often difficult to establish how the contamination occurred.  Romaine lettuce specifically was involved (all other types of lettuce are deemed safe), and currently the CDC is recommending that Romaine lettuce should be discarded unless you are certain it did not come from Yuma, AZ. As product labels do not identify growing regions accurately, the safest thing to do is simply discard all Romaine lettuce or products containing Romaine lettuce in your household, and refrain from eating this type of lettuce until it is confirmed that this outbreak has cleared. As this investigation is ongoing, be sure to follow up with the CDC updates on this outbreak in the meantime; their website is listed here.

If you did consume Romaine lettuce or Romaine lettuce products and develop symptoms of abdominal pain, bloating, bloody diarrhea, fevers, or nausea within 5 days of consuming the lettuce, be sure to notify your doctor, and do NOT take any antibiotics until this particular type of E.coli infection is ruled out. For more serious symptoms, be sure to seek medical care right away, however keep in mind that the overwhelming majority of people infected have resolution of their symptoms within a week’s time.

See below May 9th case count map from CDC:


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