U.S. Markets closed

Here Are the E. Coli Symptoms to Watch Out For, Just in Case You Ate Contaminated Romaine Lettuce Recently

Sarah Jacoby
It starts with bloody diarrhea and somehow gets worse.

Update:

The Centers for Disease Control (CDC) is advising folks to avoid eating any and all romaine lettuce while they get to the bottom of an E. coli outbreak that has infected 32 people in 11 U.S. states and 18 people in Canada, and for which the repeat offender leafy green is the most likely culprit.

Investigators have yet to pinpoint the source—or even a common grower, supplier, distributor, or brand—hence the abundantly cautious blanket warning.

"Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick," reads the alert. "This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad." Restaurants and retailers are being similarly advised not to serve or sell any romaine lettuce products.

The CDC, Food and Drug Administration (FDA), state and local agencies, and The Public Health Agency of Canada (PHAC) and Canadian Food Inspection Agency, are all working together to determine the source of the outbreak. Currently, the FDA is conducting its traceback investigation and conducting lab analysis on lettuce samples that may be linked to the outbreak. So far, they detected the Shiga toxin-producing Escherichia coli O157:H7 strain in the people who have fallen ill, according to the CDC.

Does all of this sound way too familiar? Well, you're right: There was an E. coli outbreak linked to romaine lettuce in April 2018 (check out the original report below).

The CDC said they know that this strain is not genetically linked to the E. coli outbreak that occurred earlier this year. It actually bears the same DNA fingerprint as the strain seen in an outbreak of E. coli O157:H7 in fall 2017 that was linked to leafy greens in the U.S. and romaine in Canada.

To date, 13 people have been hospitalized in the U.S., with their illnesses beginning between October 8 and October 31. One person has developed a type of kidney failure called hemolytic uremic syndrome, the CDC reports, but there have been no deaths. However, since it takes two to three weeks for illnesses to be reported, there may be more cases occurring.

The CDC advises anyone feeling ill to see their doctor immediately. They also recommend washing and sanitizing any fridge shelves or drawers where you recently stored romaine. Check out our original article below with more information on signs and symptoms of E. coli to watch out for, plus what to do if you come down with symptoms.

Original report: April 20, 2018

First, there was a salmonella-related recall of 200 million eggs earlier this week. And now, people are being instructed to steer clear of a popular salad green. The Food and Drug Administration (FDA) announced that it's investigating an outbreak of Escherichia coli (E. coli) that's been linked to romaine lettuce, which can cause symptoms like bloody diarrhea.

Since March 13, the outbreak has caused 53 illnesses and 31 hospitalizations across 16 states, according to the Centers for Disease Control and Prevention (CDC). Although investigators have traced the outbreak to chopped romaine from the Yuma, Arizona, growing region, they haven't pinpointed a specific brand, grower, supplier, or distributor yet.

As of April 20 2018, the CDC expanded its warning to consumers to avoid all types of romaine from the Yuma, Arizona growing region, not just the chopped variety originally included.

That means that, in addition to any chopped romaine or salad mixes containing romaine you may have bought recently, you should avoid eating any whole heads of romaine or romaine hearts from that region for the time being. And you should steer clear from eating romaine at a restaurant unless you can confirm that the romaine is not from the Yuma growing area.

The update is in response to new information about the outbreak coming from people at a correctional facility in Alaska who became sick. Their illnesses were traced back to romaine grown in the Yuma area.

Most types of E. coli are actually harmless. But the type involved with this outbreak is known to cause particularly severe infections.

According to the CDC, this outbreak is associated with Shiga toxin–producing E. coli O157:H7, which causes infections that may bring on the following symptoms:

  • Diarrhea (often bloody)
  • Severe stomach cramps
  • Vomiting

Symptoms usually start between two and eight days after eating the contaminated food and, among healthy adults, usually last for about a week.

However, in some cases, the infection can go on to cause a serious complication known as hemolytic uremic syndrome (HUS), which is a form of kidney failure. Young kids, elderly adults, and people with compromised immune systems are most likely to develop HUS. According to the CDC, symptoms of HUS include:

  • Abdominal pain
  • Fever
  • Pale skin tone
  • Fatigue and irritability
  • Small, unexplained bruises
  • Decreased urination
  • Bleeding from the nose and mouth

Most people with E. coli infections get better with minimal treatment (including rest and staying hydrated), although the FDA does recommend getting in touch with your doctor to be sure you know what you're dealing with (and it's always a good idea to see a doctor if you are experiencing bloody diarrhea).

But if you suspect you may have developed HUS, it's important to get medical care ASAP. And if you have symptoms of severe dehydration—dark pee, dizziness, and fatigue, for example—due to diarrhea and/or vomiting, seek medical attention.

For now, the CDC recommends avoiding all types of romaine from the Yuma, Arizona growing region.

If you're eating out, the CDC suggests confirming where the restaurant got their romaine. If you can't get information about the source of the romaine to confirm it's not from Yuma, don't eat it.

Beyond this advice, following basic food safety rules can help prevent an infection. That includes washing your hands frequently, especially after going to the bathroom or changing diapers, before and after preparing or eating food, and after contact with animals or their environments. Use hand sanitizer if soap and water aren't available.

It's also important to freeze or refrigerate perishable foods quickly and to separate raw foods (like uncooked meat)—including using separate cutting boards—from ready-to-eat foods, to avoid spreading a possible infection from one food item to another.

So, unfortunately, it's in your best interest to avoid chopped romaine for now and opt for another one of your favorite greens. Your salad could probably use some shaking up, anyway.

Related: