Before you do anything else, throw out any romaine lettuce in the house. While you’re at it, check your egg cartons because you may also need to dump the eggs. We’ll tell you below how to check if your eggs are part of an ongoing recall. We are continuing to track the romaine lettuce contamination — see the latest update below.
On Wednesday, May 2, the Centers for Disease Control and Prevention (CDC) reported the first death associated with the E. coli outbreak linked to romaine lettuce grown in the Yuma, Arizona, winter lettuce growing region. The CDC also added 23 more people from an additional three states to the case count. In all, reports of illnesses confirmed as part of this outbreak now total 121 people from 25 states.
Of the 121 people the CDC included in the outbreak count so far, 52 have been hospitalized. In most E. coli outbreaks, about 30 percent of the case count is hospitalized. In the current outbreak, 43 percent required hospitalization. The CDC warns the numbers will grow.
“There is a reporting lag, and we may still see cases come in,” CDC spokeswoman Brittany Behm said, according to Consumer Reports. “The outbreak is ongoing, and that’s why we are constantly evaluating new information to give the best advice to the public.”
When food starts making people sick, the Food and Drug Administration (FDA) and the CDC swing into action. The federal agencies employ inspectors and sophisticated tech, including bacteria DNA fingerprinting via the CDC’s Pulsenet toolkit, to track the incidence, spread, and sources of outbreaks, but the science isn’t yet perfect. Read on to learn how you can protect yourself and your family.
Throw out all romaine lettuce you didn’t grow yourself
The CDC has been tracking and working on this outbreak since April 10. On April 18, news of people getting sick after eating romaine lettuce contaminated with E. coli bacteria prompted an initial CDC advisory.
At first, the CDC issued a warning about all chopped romaine lettuce from the Yuma, Arizona, region. Most romaine lettuce sold in the U.S. is grown in the Yuma area. The advisory included chopped romaine sold separately or mixed with other greens or vegetables. As the outbreak spread, however, the advisory was widened to include whole heads and hearts of romaine.
Unless you can be absolutely sure romaine lettuce you are about to eat isn’t from Yuma, Arizona, don’t take a chance.
If you order a salad or dish containing romaine in a restaurant, don’t count on the wait staff knowing where it came from. Romaine lettuce is usually at the top of the healthy vegetable list, but not right now. Skip it.
Grocery store attendants may not be sure of food sourcing either, so unless someone can show you convincing documentation, take a pass. You do not want to mess with E. coli.
E. coli infections can cause gastrointestinal distress. See below for more information about signs and symptoms to watch for.
As of Wednesday, May 2, the FDA and CDC still advise people not to buy, eat, or keep any romaine lettuce unless they know for sure that it is not from Arizona.
The CDC lists the states where infections in this outbreak have occurred and the number of cases in each on a Case Count Map. The people in the case count began to get sick from March 13, 2018, to April 21, 2018. Because it takes an average of two to three weeks for a person infected with E. coli to become ill and the illness reported, infections after April 7, 2018, might not yet have been reported.
The 121 people who have become ill range from 1 to 88 years of age, 63 percent of the group are female. The median (or middle) age is 29. The single death reported occurred in California.
FDA commissioner Scott Gottlieb did offer a partial reprieve, or the promise of one, on Twitter. Gottlieb tweeted the following: “Romaine has a short shelf life, and the winter growing season is ending in Yuma. It’s likely that any romaine sold now is from California, not Arizona. Consumers should continue asking grocers and restaurants to make sure their romaine isn’t from Yuma.”
Romaine has a short shelf life and the winter growing season is ending in Yuma. It’s likely that any romaine sold now is from California, not AZ. Consumers should continue asking grocers and restaurants to make sure their romaine isn't from Yuma. https://t.co/We02xgGjGj.
— Scott Gottlieb, M.D. (@SGottliebFDA) April 23, 2018
Signs and symptoms of E. coli infection
The E. coli bacteria in the romaine lettuce outbreak produces a toxin called Shiga. You may also see references to STEC, short for Shiga toxin-producing E. coli. Whatever they call it, you don’t want it.
The CDC reference for STEC infections states most people get sick two to eight days after eating food contaminated with the bacteria — on average, it’s three to four days. So it’s not fast-acting, which can make figuring out what made you sick tough, especially if you eat out often.
Common symptoms include diarrhea, bad stomach cramps, and vomiting. In most cases, people recover within seven days.
More severe symptoms are uncommon but serious and can be fatal. Of the 121 infections confirmed so far from this STEC outbreak, 54 people were hospitalized, and 14 developed hemolytic urine syndrome. HUS develops just when diarrhea starts to improve from a STEC infection, typically about seven days after the original symptoms began.
HUS symptoms, which can be signs of kidney failure, include decreased urination frequency, extreme fatigue, and loss of color in the cheeks and on the inside of lower eyelids.
If you have the symptoms of HUS or see them in a family member, don’t take chances by waiting to see if the symptoms get better. According to CDC guidance, people with HUS should be hospitalized for observation and treatment.
E. coli outbreak targeting women and millennials
The E. coli infection demographics are skewing toward women and millennials. Of the 121 cases confirmed by the CDC 63 percent are female. The age range is 1 to 88 years old, with a median age of 29 years.
USA Today offered explanations for the high percentage of women affected by this E. coli outbreak. A 2012 study called Sex-Based Differences in Food Consumption that was published in the journal Clinical Infectious Diseases found that “a higher proportion of men reported eating meat and certain types of poultry than women, whereas a higher proportion of women ate fruits and vegetables.”
The study concluded that understanding how food consumption differs by sex could help investigators pinpoint foods associated with outbreaks when most cases involve members of one sex.
The preference by gender for specific foods could suggest why more men were infected by a 2016 E. coli outbreak from meat but women were the majority during a chicken salad outbreak in 2015, USA Today reports.
Bruce Lee, a Johns Hopkins University associate professor of international health, told USA Today the greater number of women in the current case count could also be because men don’t report disease symptoms as readily as women.
Prior to the romaine lettuce advisories, the problem was with eggs — 200 million of them. On April 13, the FDA announced that egg distributor Rose Acre Farms of Seymour, Indiana, voluntarily recalled 206,749,248 eggs. The eggs, which came from a farm in Pantego, North Carolina, were distributed to many outlets, including Food Lion and Walmart grocery stores. Pantego is in North Carolina’s Hyde County.
The eggs were delivered to retail stores and restaurants in Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, and West Virginia.
The eggs were recalled because of potential contamination with Salmonella Braenderup. This type of salmonella can sometimes be fatal in young children, frail or elderly people, and others with weakened immune systems. As of April 13, 22 illnesses had been reported.
The Hyde County farm produces 2.3 million eggs each day from 3 million laying hens. A USDA inspector is on-site daily. Federal inspectors from the USDA were at the farm from March 26 to April 11, according to USA Today. The inspectors reported finding dozens of rodents, dirty equipment, and poor worker hygiene. Farm employees were observed touching dirty floors, equipment, and their own bodies without washing their hands.
Rose Acre Farms stated in an email that the report “is based on raw observations and in some cases lack proper context.”
Here’s how to check your eggs
If your eggs are still in the carton, look for markings on the carton or package. The eggs in the recall were all produced at plant number P-1065, which you will see somewhere on the packaging. Following the plant number, look for a three-digit Julian date or lot code ranging from 011 to 102.
Did you hit the first two numbers of the contaminated egg lottery? If you want to go for the trifecta, you can also access the FDA recall notice to check UPC codes, but since CDC recalls and warnings are routinely expanded as the agency gets more data, do you really need to keep checking? If you match the plant number and date code, both of which this writer found on a full carton of 18 eggs, why take a chance? Just throw them out or return them to the store for a refund.
Signs and symptoms of salmonella infection
Salmonella bacteria infections act faster than E. coli. Most people with salmonella infections are hit with symptoms within 12 to 72 hours. The symptoms include diarrhea, fever, and stomach cramps.
Most people get better from salmonella infections in four to seven days. If the diarrhea is severe, however,so some people need to be hospitalized for observation and treatment, according to the CDC.
Updated on May 2 with a report of the first death and additional illnesses associated with the outbreak.