Don't Eat Romaine Lettuce, Consumer Reports' Experts Advise

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Update: On Dec. 18, the CDC said that the number of illnesses in this outbreak has now reached 138 and a total of 78 people have been hospitalized. The last illness began on Dec. 1. There are still no deaths reported. Two new states, South Carolina and Tennessee, were added to the list of states with illnesses, for a total of 25 states.

The FDA says it identified a Salinas, Calif., grower as the likely source of the tainted romaine lettuce and that it is investigating the source of the contamination, but the agency did not name the grower.

It also noted that it is currently investigating two other outbreaks caused by different strains of E. coli O157:H7, but still linked to romaine lettuce from Salinas. In one, the Wisconsin Department of Health identified one of the E. coli strains in an unopened bag of Fresh Express Leafy Green Romaine collected from an ill person's home. The other outbreak, with cases in the U.S. and Canada, has been linked to Fresh Express Sunflower Crisp Chopped Salad Kits.

Update: On Dec. 4, the Centers for Disease Control and Prevention announced the number of illnesses in this outbreak rose to 102, and the number of hospitalizations rose to 58. No deaths have been reported. People have become ill in a total of 23 states: Arizona (3), California (4), Colorado (6), Florida (1), Iowa (1), Idaho (3), Illinois (1), Maryland (4), Michigan (1), Minnesota (3), Montana (1), Nebraska (1), New Jersey (7), North Carolina (1), New Mexico (2), Ohio (12), Oregon (1), Pennsylvania (8), South Dakota (1), Texas (4), Virginia (4), Washington (2), and Wisconsin (31).

Update: On Nov. 26, the Centers for Disease Control and Prevention said that the number of illnesses in this outbreak increased from 40 to 67 and hospitalizations from 28 to 39. Six people have developed a form of kidney failure, but no deaths have been reported. Two new states were added to the list of locations where people became ill—Oregon and Texas—for a total of 19 states. This article was originally published on Nov. 23.

Consumer Reports food safety experts said Friday that people should avoid all romaine lettuce and that any currently in refrigerators should immediately be thrown out because of the risk of E. coli contamination.

The Food and Drug Administration announced Friday that romaine lettuce grown in Salinas, Calif., is likely responsible for a multistate E. coli O157:H7 outbreak that was first reported earlier this week. 

On Friday, the Centers for Disease Control and Prevention said the number of illnesses had risen to 40 people in 16 states. Of those reported infected, 28 have been hospitalized but there were no reported deaths. The states involved are Arizona, California, Colorado, Idaho, Illinois, Maryland, Michigan, Minnesota, Montana, New Jersey, New Mexico, Ohio, Pennsylvania, Virginia, Washington, and Wisconsin.

Yesterday, Missa Bay recalled 97,272 pounds of packaged salad kits and bowls it shipped to 22 states. The romaine lettuce in those salads was grown in Salinas.

The FDA is currently advising consumers to avoid lettuce grown in Salinas and directing them to read the labels on the lettuce they buy. According to the FDA, lettuce grown in other areas does not appear to be linked to the current outbreak. Hydroponic or greenhouse lettuce also does not seem to be involved­­.

But CR’s experts think it is prudent and less confusing for consumers to avoid romaine altogether, especially because romaine is also sold unpackaged and in restaurants, and customers can’t always be sure of the origin that lettuce.

“Much of the romaine lettuce on the market at this time of year is from Salinas,” says James E. Rogers, Ph.D., director of food safety research and testing at Consumer Reports. “Last year, also right before Thanksgiving, there was an E. coli O157:H7 outbreak, and the FDA and the CDC warned people against eating any romaine lettuce and called on stores and restaurants to stop selling it.” ­

The FDA is also asking the leafy green industry to voluntarily stop shipping Salinas romaine for the rest of the growing season. A spokesperson for the California Leafy Greens Marketing Agreement told CR that the growing season is almost over, with production shifting to California’s Imperial Valley and Central Coast, and to Yuma, Ariz.

How Can You Tell Where Romaine Was Grown?

After romaine was involved in two E. coli outbreaks in 2018—one in November and one in the spring (which involved lettuce grown in Yuma)—the FDA worked with the leafy greens industry to create a voluntary labeling program that would help consumers know the origin of the romaine lettuce they were buying. The information would be found on tags on the lettuce, on packaging, or on signs at the point of purchase.

“We have seen a lot of growers provide the harvesting location of their romaine,” says Peter Cassell, spokesperson for the FDA. “If the lettuce was produced in Salinas, consumers should avoid it. And if you can’t confirm that romaine lettuce isn’t from Salinas, consumers should avoid it.”

When the growing area labels were first introduced, CR food safety experts found that as a warning system for consumers to protect themselves in real time, the program had flaws, and that stronger measures would be needed to keep consumers safe. The system is unrealistic, Rogers says, because it relies on shoppers knowing there has been an outbreak, remembering its origin, and also knowing to look for the label.

The LGMA spokesperson said that the organization believes that Salinas growers will follow the FDA’s request to stop shipping romaine. But Rogers points out that there is no way to enforce it.

Even so, Rogers says it is safer in the midst of a rapidly changing outbreak to simply forgo all raw romaine for now, especially for people who are vulnerable to food poisoning and its effects, meaning the elderly, the very young, and pregnant women.

“If the package is clearly marked with the growing area and it is not Salinas, or you can find hydroponic or greenhouse-grown romaine—which wouldn’t be affected—that’s fine,” Rogers says. “But we think that consumers will not find it so easy to make that determination, and we would rather see them play it safe and choose other types of lettuce right now.”

Making Lettuce Safer

How the romaine involved in this outbreak became contaminated isn't known, but in past outbreaks, the likely source was irrigation water tainted with E. coli-containing cattle feces from a nearby cattle operation. 

According to a release issued by the LGMA regarding this outbreak: "A very stringent set of food safety practices is enforced on leafy greens farms through the LGMA system. The role of the LGMA is to verify through government inspection that leafy greens producers are following a set of food safety practices on the farm. Each LGMA member is subject to 4 to 5 on-farm audits each year that are conducted by government officials."

But CR experts note that clearly it isn't enough. 

“This latest outbreak is an urgent reminder that the FDA and food companies must take tougher action to protect the public,” said Michael Hansen, Ph.D. senior scientist at Consumer Reports. “The FDA should immediately require growers to abide by strong standards to ensure irrigation water is safe and sanitary.  It's also critical for the FDA to implement mandatory farm-to-fork industry recordkeeping requirements so it can quickly identify the source of foodborne illness outbreaks."

Consumer Reports supports a bill introduced just this week, the Expanded Food Safety Investigation Act, that would give the FDA the power to inspect animal feedlots for pathogens that may be triggering outbreaks. 



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