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Wednesday, August 8, 2018

FDA Investigation into E.coli Outbreak Linked to Romaine Lettuce Finds Cattle Feeding Operation as Potential Source

The FDA continues their investigation into the E. coli outbreak, but are looking at a Concentrated Animal Feeding Operation as a potential source.  This CAFO is stated as being able to hold up to 100,000 head of cattle.

E. coli and 100,000 pooping cattle....that may be a good place to be concerned about especially if there is access from that operation to the canal system.  But the release was short on information specifically the distances from the CAFO to the canal system, and then down to the farming area?  Can cattle ever get to the water?  Can rain water runoff make its way into the CAO? 

Had anyone raised a concern about the locale of the CAFO to the canal system?  Has anyone tested the water if there were a concern?  As a main component of produce safety, water quality and the potential for contamination should have been evaluated.  And as part of that, the potential contamination by farm animals should also have been evaluated.  While testing can be unreliable, a risk analysis of a nearby CAFO should have been undertaken.    But at this point, it is hard to glean this information that FDA has released.

In this outbreak, 210 were infected across 36 states with 96 hospitalizations and five deaths.  In a June 28th news release, FDA and CDC reported that the E. coli strain was found in the irrigation canal.

https://www.fda.gov/food/recallsoutbreaksemergencies/outbreaks/ucm604254.htm
FDA Investigating Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce from Yuma Growing Region
August 6, 2018

The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local partners, are investigating a multistate outbreak of E. coli O157:H7 illnesses linked to romaine lettuce from the Yuma growing region.

Update

On July 31 and August 1, 2018, the FDA participated in a meeting of the Leafy Greens Food Safety Task Force that was formed in response to the serious outbreak of E. coli O157:H7 associated with romaine lettuce that occurred earlier this year. During the meeting FDA shared preliminary hypotheses from the Environmental Assessment in Yuma to facilitate conversations with state and local officials, industry and local growers on the hypotheses and associated actions necessary to prevent such an outbreak from occurring again.

As FDA has previously stated, samples of canal water have tested positive for the outbreak strain of E. coli. FDA continues to consider that contaminated water coming into contact with produce, either through direct irrigation or other means, is a viable explanation for the pattern of contamination. But other hypotheses were discussed as well. FDA notes that the canal is close to a Concentrated Animal Feeding Operation (CAFO), a facility with a large number of cattle on the premises. The CAFO can hold in excess of 100,000 head of cattle at any one time and the FDA traceback information showed a clustering of romaine lettuce farms nearby.

Our experts continue to work on examining potential links between the CAFO, adjacent water, and geologic and other factors that may explain the contamination and its relationship to the outbreak. Additional sampling activities will be conducted to further explore and narrow down hypotheses in the near future. Our findings will be detailed in a finalized environmental assessment report.

We urge other government and non-government entities, produce growers in the region, and those engaged in managing the canal systems to work with FDA and marshal and deploy resources to achieve our collective food safety goal. Broad engagement from the surrounding community is critical to developing and implementing remediation measures to reduce the potential for another outbreak. We believe local in-depth knowledge and actions are critical in helping resolve this issue in order to protect public health.

The Environmental Assessment report will be made publicly available when complete.

Fast Facts
  • •The FDA is investigating a multistate outbreak of E. coli O157:H7 illnesses linked to romaine lettuce sourced from the winter growing areas in and around the Yuma growing region. Suspect product is no longer being harvested or distributed from this area and is no longer available in stores or restaurants, due to its 21-day shelf life.
  • •As of June 27, the CDC reports that 210 people in 36 states have become ill. These people reported becoming ill in the time period of March 13, 2018 to June 6, 2018. There have been 96 hospitalizations and five deaths.
  • •The traceback investigation indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor. While traceback continues, the FDA will focus on trying to identify factors that contributed to contamination of romaine across multiple supply chains. The agency is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching consumers. 
  • •On May 31, 2018 the FDA released a blog with updated information on the traceback investigation (for additional information, visit FDA Update on Traceback Related to the E. coli O157:H7 Outbreak Linked to Romaine Lettuce).
  • •The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak. To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli 0157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.
  • •The FDA is continuing to investigate this outbreak and will share more information as it becomes available.
  • •Consumers who have symptoms of STEC infection should contact their health care provider to report their symptoms and receive care. Although many infections resolve in 5-7 days, they can result in serious illness, including a potentially serious condition called hemolytic uremic syndrome.
  • •The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections from November to December 2017 linked to leafy greens consumption. People in the previous outbreak were infected with a different DNA fingerprint of E. coli O157:H7 bacteria.
What is the Problem and What is being Done About It?

The FDA and the CDC, along with state and local health officials, are investigating an outbreak of Shiga toxin-producing E. coli O157:H7 infections.

There are 210 cases in 36 states: Alabama (3) Alaska (8), Arkansas (1), Arizona (9), California (49), Colorado (3), Connecticut (2), Florida (3), Georgia (5), Idaho (12), Illinois (2), Iowa (1), Kentucky (1), Louisiana (1), Massachusetts (4), Michigan (5), Minnesota (12), Mississippi (1), Missouri (1), Montana (9), Nebraska (1), New Jersey (8), New York (11), North Carolina (1), North Dakota (3), Ohio (7), Oklahoma (1), Oregon (1), Pennsylvania (24), South Dakota (1), Tennessee (3), Texas (4), Utah (1), Virginia (1), Washington (8), and Wisconsin (3). The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to leafy greens. People in the previous outbreak were infected with a different DNA fingerprint of E. coli O157:H7 bacteria.

The most recent information collected by the FDA, in conjunction with federal, state, and local partners, indicates that the romaine lettuce that ill people ate was likely grown or originated from the winter growing areas in or around the Yuma region. This region generally supplies romaine lettuce to the U.S. during November-March each year.

The FDA is working closely with federal, state, and local partners on an ongoing traceback investigation to determine the source of romaine lettuce supplied to ill consumers. In a typical traceback effort, CDC and the FDA identify clusters of people who became ill, especially in different geographical regions and work to trace the food eaten by those made ill to a common source. For this outbreak investigation, we have been able to identify romaine lettuce as the common food source. Romaine products that would have caused illness were no longer available at exposure locations, making it difficult to determine production lots of concern. In addition, we have found that a single production lot may contain romaine from multiple ranches, which makes the traceback more challenging. We are working with federal and state partners and companies as quickly as possible to collect, review and analyze hundreds of records in an attempt to traceback the source of the contaminated romaine lettuce.

To date, the available information indicates that romaine lettuce from the Yuma growing region is the source of the current outbreak of E. coli O157:H7 infections, and was supplied to restaurants and retailers through multiple processors, grower/shipper companies, and farms. The information we have collected indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor. While traceback continues, FDA will focus on trying to identify factors that contributed to contamination of romaine across multiple supply chains. The agency is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching consumers. (for additional information, visit FDA Update on Traceback Related to the E. coli O157:H7 Outbreak Linked to Romaine Lettuce).

The traceback investigation is ongoing and additional information will be provided as it becomes available.


Timeline

On April 4, 2018 FDA learned about a cluster of E. coli O157:H7 infections in two states.

On April 5, 2018 a new cluster was reported in multiple states.

In the following weeks, the FDA, CDC, and state partners worked together to collect additional information and conduct traceback activities to identify a food item of interest.

On April 10, 2018 the FDA publicly communicated about the outbreak, but was unable to identify a food source. The agency recommended that consumers practice safe food handling and preparation and to consult a health care provider if they think they might have symptoms of E. coli infection.

Interviews with ill people allowed health partners to identify chopped romaine from the Yuma growing region as the likely source of contamination on April 13, 2018.

April 16, 2018 was the final day of romaine harvesting in the Yuma growing region, however at the time chopped romaine had just been identified as the likely source allowing the traceback investigation to begin and at this point, nospecific farms in the Yuma region had been identified. FDA did not receive confirmation of the final harvest date until May 2, 2018.

On April 19, 2018, Alaska health partners announced that eight persons with E. coli O157:H7 infections from a correctional facility have been confirmed as part of the outbreak. These individuals ate whole-head romaine lettuce from the Yuma growing region. Following this announcement the FDA advised consumers to avoid all romaine lettuce from the Yuma growing region.

In the following weeks FDA continued its traceback investigation, part of which was able to trace the Alaskan correctional facility back to a single farm, which was released on April 27, 2018.

On May 2, 2018 the FDA received confirmation from the Arizona Leafy Greens Marketing Agreement that romaine lettuce was no longer being produced and distributed from the Yuma growing region, reducing the potential for exposure to contaminated product. At that time, due to the 21-day shelf life, we could not be certain that romaine lettuce from that region was no longer in the supply chain.

On May 31, 2018 the FDA released a blog with updated information on our ongoing traceback investigation (for additional information, visit FDA Update on Traceback Related to the E. coli O157:H7 Outbreak Linked to Romaine Lettuce).

From June 4 - June 8, 2018 sampling for the environmental assessment was conducted in the Yuma growing region.

On June 28, 2018 the CDC announced that the outbreak has ended. In addition, the FDA and CDC announced preliminary sample results from the environmental assessment of the Yuma growing region.

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