Romaine lettuce

The Centers for Disease Control and Prevention is advising consumers, restaurants, and retailers not to eat, serve, or sell any romaine lettuce as it investigates an outbreak of E. coli O157:H7 infections linked to romaine. Read the investigation announcement: https://www.cdc.gov/ecoli/2018/o157h7-11-18/index.html.

Key Points

  • CDC, public health and regulatory officials in several states and Canada, and the U.S. Food and Drug Administration are investigating a multistate outbreak of  coli O157:H7 infections.
  • Thirty-two illnesses have been reported from 11 states, including 13 people who have been hospitalized. One person developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.
  • Epidemiologic evidence from the United States and Canada indicates that romaine lettuce is a likely source of the outbreak.
  • Illnesses started on dates ranging from Oct. 8, 2018 to Oct. 31, 2018.
  • Ill people in this outbreak were infected with  colibacteria with the same DNA fingerprint as the E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada. The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce.

Advice to Consumers, Retailers and Restaurants

  • CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak. This investigation is ongoing and the advice will be updated as more information is available.
  • 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.
    • 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.
    • If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.
  • Restaurants and retailers should not serve or sell any romaine lettuce, including salads and salad mixes containing romaine.
  • People with symptoms of an E. coli infection, such as severe stomach cramps, diarrhea (often bloody), and vomiting, and think you might have gotten sick from eating romaine lettuce, should talk to their doctor and report their illness to the health department.
  • This investigation is ongoing and CDC will provide more information as it becomes available.

Advice to Clinicians

  • Antibiotics are not recommended for patients with  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.