FDA Updates the Trace Back Areas for the E. coli Contaminated Romaine Lettuce

FDA provided an update on 11/28/19 to detail the counties that are involved in the trace back analysis.  According to the report, "current evidence indicates this romaine was harvested in the Central Coast growing regions of northern and central California.
The specific California counties FDA is including in this region are:

• Monterey
• San Benito
• San Luis Obispo
• Santa Barbara
• Santa Cruz
• Ventura

There have not been any new cases since the last update on 11/26/18.

https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm626330.htm
FDA Investigating Multistate Outbreak of E. coli O157:H7 Infections Likely Linked to Romaine Lettuce Grown in California

Case Counts
Total Illnesses: 43
Hospitalizations: 16
Deaths: 0
Last illness onset: October 31, 2018
States with Cases: CA (11), CT (1), IL (2), MA (2), MD (1), MI (7), NH (2), NJ (9), NY (5), OH (1), RI (1), WI (1)

FDA Now Advises to Avoid Romaine Lettuce from Northern and Central CA

Updated 11/27/18
FDA updated its recommendation on Romaine lettuce - "If romaine lettuce does have this labeling information, we advise avoiding any product from the Central Coast growing regions of northern and central California. Romaine lettuce from outside those regions need not be avoided.  Romaine lettuce that was harvested outside of the Central Coast growing regions of northern and central California does not appear to be related to the current outbreak. Hydroponically- and greenhouse-grown romaine also does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these sources."

Of course, it is important to make sure that packages of Romaine indicate harvest information, including the date and location.  The industry has agreed to voluntary labeling to ensure compliance.

There are now 43 cases with 16 hospitalizations across 12 states.

FDA News Release
https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm626330.htm
FDA Investigating Multistate Outbreak of E. coli O157:H7 Infections Likely Linked to Romaine Lettuce Grown in California
Update: November 26, 2018

Florida Retailer Recalls Ground Beef After Linked to E. coli Illnesses

Publix Super Markets Inc., a Florida based retail grocery store chain is recalling an undetermined amount of ground beef products made from chuck (purchased by consumers from June 25, 2018, through July 31, 2018) that may be contaminated with Escherichia coli O26.   FSIS was notified of an investigation of E. coli O26 illnesses with 18 case-patients predominantly from Florida and having onset dates ranging from July 5 to July 25, 2018.  "Traceback information indicated that case-patients consumed ground chuck products purchased at various Publix Super Markets that was supplied by a yet-to-be determined source."

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2018/recall-072-2018-release
Publix Super Markets Inc. Recalls Ground Chuck Products Due To Possible E. coli O26 Contamination
Class I Recall 

072-2018
Health Risk: High 

Aug 30, 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

Florida Establishment Recalls Raw Ground Beef After Internal Testing Finds STEC E. coli

Win Opportunity Knocks, doing business as Ottomanelli Wholesale Meats Inc., a St. Petersburg, Fla. establishment, is recalling approximately 6,020 pounds of fresh and frozen, raw ground beef products that may be contaminated with Shiga toxin-producing E. coli (STEC) O45, O103 and O145,

The problem was discovered when FSIS was notified that the product was tested by the establishment and found positive for E. coli under their sampling program.

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2018/recall-064-2018-release
Win Opportunity Knocks Recalls Fresh and Frozen, Raw Ground Beef Products Due to Possible E. Coli O45, O103 and O145 Contamination
Class I Recall
064-2018
Health Risk: High
Jul 18, 2018

CDC Updates Case Numbers for E. coli Outbreak Associated with Romaine Lettuce

The CDC released an update of the number of cases of E. coli infection associated with the Romaine Lettuce Outbreak.   There are now 197 ceases with 89 being hospitalized and 5 deaths.  This is reported as one of the largest E. coli outbreaks.  These cases still fall in the window for the Yuma AZ grown romaine, which is reported as being completely out of the supply chain.  The reason additional cases are being reported is the lag from eating to illness to reporting on the federal level.  The last case starting on May 12.

There is still no further information on the source or contributing factors.

https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce

Case Count of E. coli Infection Continues to Increase in Outbreak Associated with Romaine Lettuce

There are now 149 reported cases of E. coili infection associated with romaine.  Cases were reported from 29 different states.  There have been 64 hospitalizations and one death.

The romaine lettuce is no longer being harvested from the suspected areas of Yuma AZ.  While one farm has been linked to a set of illnesses in Alaska and this through consumption of whole heads, product from this farm does not seem to be linked to the vast majority of cases which were linked to chopped romaine.

https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce
Posted May 9, 2018 1:45 PM EST

E. coli Outbreak in Romaine - 121 Now Ill, One Farm Identified for Alaska Cases, but FDA Still Investigating Entire Distribution Chain

There are now 121 cases of E. coli infection from romaine lettuce with 52 hospitalizations and one death. Cases have occurred in 25 different state throughout the country.

FDA has identified one farm linked to whole head romaine lettuce involved with cases in Alaska, but have not yet identified where the contamination occurred. "The FDA has identified one farm as the source of the whole-head romaine lettuce that sickened several people at a correctional facility in Alaska. However, the agency has not determined where in the supply chain the contamination occurred. 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 the Alaska correctional facility where it was served." The farm was identified as Harrison Farms of Yuma AZ.

FDA further states that harvesting of romaine lettuce from Yuma is done and product would not be past its shelf-life. "All of the lettuce in question from this farm was harvested during March 5-16 and is past its 21-day shelf life. Because the growing season in the Yuma region is at its end, the farm is not growing any lettuce at this time."

CDC Outbreak Update
https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce
Posted May 2, 2018 2:30 PM EST

At A Glance
Case Count: 121   (https://www.cdc.gov/ecoli/2018/o157h7-04-18/epi.html)
States: 25    (https://www.cdc.gov/ecoli/2018/o157h7-04-18/map.html)
Deaths: 1
Hospitalizations: 52
Recall: No

CDC: 4/25 Update on E. coli Outbreak Associated with Romaine Lettuce

There are now 84 cases of E. coli infection with 42 hospitalizations related to the romaine lettuce from Yuma AZ.  Cases have occurred in 19 different states.   CDC recommends against eating any form of romaine lettuce unless you can verify that it is from an area other than Yuma.

How hard is it to determine where your romaine is from?  Probably not easy. 
Unfortunately, this will be a big impact on all those who farm or process romaine.

https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce

CDC Includes All Forms of Romaine Lettuce from Yuma AZ in E. coli Outbreak

The CDC is now including all forms of romaine lettuce from Yuma AZ.  it was initially focused on chopped romaine in the E. coli outbreak.  They suggest that if you purchase romaine lettuce, you ensure that the product is not from Yuma.

There are now 53 cases of E.coli infection in 16 states with 31 hospitalized.

https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Multistate Outbreak of E. coli O157:H7 Infections Linked to Romaine Lettuce
Posted April 20, 2018 4:00 PM EST

At A Glance

• Case Count: 53(https://www.cdc.gov/ecoli/2018/o157h7-04-18/epi.html)
• States: 16(https://www.cdc.gov/ecoli/2018/o157h7-04-18/map.html)
• Deaths: 0
• Hospitalizations: 31
• Recall: No

What's New?

• Based on new information, CDC is expanding its warning to consumers to cover all types of romaine lettuce from the Yuma, Arizona growing region. This warning now includes whole heads and hearts of romaine lettuce, in addition to chopped romaine and salads and salad mixes containing romaine. 
• Do not buy or eat romaine lettuce at a grocery store or restaurant unless you can confirm it is not from the Yuma, Arizona, growing region.
• Unless the source of the product is known, consumers anywhere in the United States who have any store-bought romaine lettuce at home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick. Product labels often do not identify growing regions; so, throw out any romaine lettuce if you’re uncertain about where it was grown. This includes whole heads and hearts of romaine, chopped romaine, and salads and salad mixes containing romaine lettuce. If you do not know if the lettuce is romaine, do not eat it and throw it away.
• Restaurants and retailers should not serve or sell any romaine lettuce from the Yuma, Arizona growing region.
• The expanded warning is based on information from newly reported illnesses in Alaska. Ill people in Alaska reported eating lettuce from whole heads of romaine lettuce from the Yuma, Arizona growing region.

CDC Reports Ongoing Outbreak E. coli STEC Infections with 17 Cases So Far, Food Not Yet Identified

The CDC reports that there is an ongoing outbreak of E. coli O157:H7 infections.  To date, there have been 17 cases in 7 states, with those states located across the country.  A source food or establishment has not yet been identified.
Connecticut  2
Idaho  4
Missouri  1
New Jersey  6
Ohio  1
Pennsylvania  2
Washington  1
Total  17

While finding the source in this type of cross-country outbreak is probably not easy, the ability to track and match the bacterial strains for each of the cases is incredible, especially when you consider that many of the states only have one or two cases.

https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html
Investigation Notice: Multistate Outbreak of E. coli O157:H7 Infections
Posted April 10, 2018 6:00 PM EST

Oregon Meat Processor Recalling Ground Meat for Potential E. coli Contamination

A Clackamas, Ore. establishment, Interstate Meat Distributors, Inc.,  is recalling approximately 14,806 pounds of ground beef and pork products that may be contaminated with E. coli O157:H7. "The problem was discovered when the firm notified FSIS Inspection Program Personnel (IPP) that the firm’s sample of beef trim was positive for E. coli O157:H7 based on results by their third party lab. "

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2018/recall-019-2018-release
Interstate Meat Distributors, Inc., Recalls Ground Beef and Pork Products due to Possible E. Coli O157:H7 Contamination
Class I Recall 

019-2018
Health Risk: High 

Mar 3, 2018

What is the Likelihood That Salmonella is On Your Chicken...or Beef...or Pork

USDA FSIS released their yearly sampling results that indicate the prevalence, or percent positive samples, for raw meat products.  As FSIS points out, "These calculations may vary significantly from the actual prevalence of the population, but FSIS cannot make a more precise calculation with the data currently available."  It is important to note that this does not evaluate the amount present, only if any are present.

Beef - In ground meat, Salmonella was present in just over 2% of the samples while pathogenic E. coli was present in 0.05% of samples.  While the prevalence of E. coli is low, there is still a risk of it being present, and considering the seriousness of the illness (and the fact that Salmonella could be present as well) it still remains important to cook meat to the proper temperature.

Pork - While there is extremely low to no risk for pathogenic E. coli, there is a higher risk of Salmonella being present in pork compared to beef.  For cuts, the prevalence of Salmonella is over 7%, but in comminuted pork meat (ground, stuff used in sausages), the prevalence is 22 percent.  Cook those brats to the right temperature.

Chicken - as the chicken moves from whole to parts to ground, the prevalence increases for both Salmonella and Campylobacter.   For whole chickens, there is a prevalence of 5.8% for Salmonella and 1.9% for Campylobacter.  In mechanically separated meat, the prevalence is almost 76% for Salmonella and 23% for Campylobacter.

Turkey - the stated prevalence is lower than that for chicken with whole birds at 0.56% for Salmonella and 0.16% for Campylobacter.  Much of difference between whole turkey and chicken may be due in part to how they are sampled, with a sponge being used for turkeys and a whole bird rinse used for chickens.

In the end, the risk is there, so it remains important to properly cook raw meat and poultry products.  And of course, to use a thermometer to verify.

E. coli (STEC) Outbreak in US and Canada Under Investigation

CDC, several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Shiga toxin-producing E. coli O157:H7 infections where 17 people have become ill in 13 states.   A possible link may exist to an outbreak in Canada.  While the Canadian Public Health Agency has identified romaine lettuce as the source of the outbreak in Canada, no particular product has been identified in the U..

https://www.cdc.gov/media/releases/2017/s1228-e-coli-outbreak.html
CDC Investigating Multistate Outbreak of E. coli O157:H7 Infections
For Immediate Release: Thursday, December 28, 2017
Contact: Media Relations
 (404) 639-3286

Outbreak of E. coli Affects Hundreds of Marine Recruits

About 300 marine recruits were stricken with E. coli infection this past week, and of that, 85 are still ill.  The outbreak occurred at Marine Corps Depot San Diego along with some personnel at Camp Pendleton,  The investigation continues as to the cause.

Fox 5 News - San Diego
http://fox5sandiego.com/2017/11/02/dozens-of-marine-recruits-remain-sick-from-e-coli/
Dozens of Marine recruits remain sick from E. coli
Posted 8:51 PM, November 2, 2017, by City News Service

CA Company Recalls Taboule Salad after Sample E. coli STEC Positive

Haig’s Delicacies of Hayward, CA is recalling 342 cases of Taboule Salad because it may be contaminated with Escherichia coli O157:H7 bacteria (E. Coli O157:H7).  The potential for contamination was noted after routine testing by the company detected the presence of E. coli O157:H7.  No illnesses have been reported to date.

FDA Recall Notice
https://www.fda.gov/Safety/Recalls/ucm583041.htm
Haig’s Delicacies LLC Recalls Lot of Taboule Salad Because of Possible Health Risk
For Immediate Release
October 30, 2017

Produce Grown in Greenhouse Recalled Due to Potential E. coli Issue

BrightFarms, a company that grows produce in greenhouses, is initiating a voluntary recall of packaged produce sold in Roundy's Supermarkets due to the potential presence of E. coli at its Rochelle, Illinois greenhouse farm.   BrightFarms chose to take this action out of an abundance of caution after receiving routine lab results and discovering that certain product may have been compromised.

FDA Recall Notice
https://www.fda.gov/Safety/Recalls/ucm581532.htm
BrightFarms Announces Voluntary Regional Recall of Produce Due to Potential Presence of E. coli
For Immediate Release
October 20, 2017

Nut Butter Recalled in March for E. coli Contamination Still in Marketplace

FDA issued a news release to remind the public and retailers that the I.M. Healthy Soy Nut Butter Products have been recalled and must not be available for sale.  These products were recalled back in March after being linked to a dozen cases of E. coli O157:H7 infection.  The problem is that these products are still being sold, both online and in retail stores.  The packer was suspended.

The occurrence of recalled product, and dangerous product at that, still being in the marketplace shows the difficulty of recall compliance in smaller retailers and online venues where niche product like this is likely to sell.

FDA Outbreak Notice

https://www.fda.gov/food/recallsoutbreaksemergencies/outbreaks/ucm544964.htm
FDA Reminds Public that All I.M. Healthy Soy Nut Butter Products Are Recalled
October 13, 2017

PA Establishment Recalls Ground Beef for E. coli O157:H7

A PA establishment is recalling approximately 700 pounds of ground beef products that may be contaminated with E. coli O157:H7.  "The problem was discovered on Oct. 2, 2017 when the firm notified FSIS that the firm’s sample of ground beef had tested positive for E. coli O157:H7 by a third party lab. There have been no confirmed reports of adverse reactions due to consumption of these products."

Yes, this organism is still a risk in ground beef with dire consequences for those who become infected from eating undercooked contaminated hamburgers.  A reminder to use those thermometers.

USDA Recall Notice
https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2017/recall-106-2017-release
Clair D. Thompson & Sons, Inc. Recalls Ground Beef Products Due To Possible E. Coli O157:H7 Contamination
Class I Recall 106-2017
Health Risk: High Oct 4, 2017

FSIS Issues Updated Compliance Guideline for Control of Pathogenic E. coli (STEC) in Non-intact Beef

FSIS released an updated 2017 Compliance Guidance on Minimizing the Risk of Shiga Toxin-Producing Escherichia coli (STEC) in Raw Beef (including Veal) Processing Operations.  This guideline updates and combines information from both the 2008 Sampling Beef Products forEscherichia coli O157:H7 (August 12, 2008) and •Sanitation Guidance for Beef Grinders (January 2012).  "This guideline incorporates current Agency thinking on the use of antimicrobial treatments, establishment sampling programs, and other measures in the establishment’s HACCP system."

This guidance states "FSIS is revising [the previous guidance documents] because it has seen that many small and very small establishments have had difficulty in designing and supporting their HACCP system (e.g., HACCP plan, Sanitation Standard Operating Procedure, or other prerequisite program) in a manner to prevent, eliminate, or reduce STEC to an acceptable level."

The guidance applies to non-intact beef products including: "ground beef; beef that an establishment has injected with solutions; beef that is vacuum tumbled with solutions; beef that an establishment has mechanically tenderized by needling, cubing, pounding devices (with or without marinade); beef that an establishment has reconstructed into formed entrees; and diced beef less than ¾ inch in any one dimension."