This outbreak appears to be over. E. coli is an important cause of illness in the United States.
CDC, public health and regulatory officials in several states, Canada, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 (E. coli O157:H7) infections linked to romaine lettuce from the Central Coastal growing regions in northern and central California. This outbreak appears to be over.
Advice to Consumers, Restaurants, and Retailers
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On December 13, 2018, Adam Bros. Farming, Inc., in Santa Barbara County recalled[PDF – 10.1 KB] red leaf lettuce, green leaf lettuce, and cauliflower harvested November 27-30, 2018, because they may be contaminated with E. coli O157:H7. Do not eat, sell, or serve any recalled products.
As a result of this recall, Spokane Produce, Inc. of Spokane, Washington recalled sandwiches and other products under the Northwest Cuisine Creations and Fresh & Local labels.
Contaminated lettuce that made people sick in this outbreak should no longer be available.
Take action if you have symptoms of an E. coli infection:
Talk to your healthcare provider.
Write down what you ate in the week before you started to get sick.
Report your illness to the health department.
Assist public health investigators by answering questions about your illness.
Follow these steps to help keep you healthy and your fruits and vegetables safer to eat:
Wash your hands before and after preparing fruits and vegetables.
Wash or scrub all fruits and vegetables under running water before eating, cutting, or cooking.
Fruits and vegetables labeled “prewashed” do not need to be washed again at home.
Use separate cutting boards for fruits and vegetables and for raw meats, poultry, seafood, or eggs.
Use separate plates and utensils for cooked and raw foods.
Store fruits and vegetables away from, and not next to or below, raw meat, poultry, or seafood. These items can drip juices that may have germs.
Follow these general ways to prevent E. coli infection:
Wash your hands. E. coli infections can spread from one person to another. Wash hands after using the restroom or changing diapers, before and after preparing or eating food, and after contact with animals.
Don’t prepare food or drink for others when you are sick.
Cook meats thoroughly to kill harmful germs. Cook steaks and roasts to at least 145˚F and let rest for 3 minutes after you remove meat from the grill or stove. Cook ground beef and pork to at least 160˚F. Use a food thermometer to check the temperature of the meat.
Don’t spread germs from raw meat around food preparation areas. Thoroughly wash hands, counters, cutting boards, and utensils after they touch raw meat.
Avoid raw milk, other unpasteurized dairy products, and unpasteurized juices.
Advice to Clinicians
Antibiotics are not recommended for patients with E. coli O157 infections. Antibiotics are also not recommended for patients in whom E.coli O157 infection is suspected, until diagnostic testing rules out this infection.
Some studies have shown that administering antibiotics to patients with E. coli O157 infections might increase their risk of developing hemolytic uremic syndrome (a type of kidney failure), and the benefit of antibiotic treatment has not been clearly demonstrated.
Final Outbreak Information
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At A Glance
Reported Cases: 62
Photo of romaine lettuce in a wood bowl.
This outbreak appears to be over as of January 9, 2019.
Sixty-two people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 were reported from 16 states and the District of Columbia.
Illnesses started on dates ranging from October 7, 2018, to December 4, 2018.
Twenty-five people were hospitalized, including two people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths were reported.
The Public Health Agency of Canada identified ill people infected with the same DNA fingerprint of E. coli O157:H7 bacteria in Canada.
Epidemiologic, laboratory, and traceback evidence from the United States and Canada indicated that romaine lettuce harvested from the Central Coastal growing regions of northern and central California was the likely source of the outbreak.
The FDA, along with CDC and state partners, investigated farms and cooling facilities in California that were identified in traceback. CDC identified the outbreak strain of E. coli O157:H7 in sediment collected within an agricultural water reservoir on an Adam Bros. Farming Inc. farm in Santa Barbara County, which was identified in the traceback investigation.