CDC, public health and regulatory officials in several states, and FDA are investigating a multistate outbreak of Shiga toxin-producing E. coli O157:H7 infections. As of December 9, 2019, a total of eight people infected with the outbreak strain of E. coli O157:H7 have been reported from three states. Illnesses started on dates ranging from November 5, 2019, to November 15, 2019. Ill people range in age from 21 to 91, with a median age of 32. Among ill people, 63%  are female. Three of the eight ill people have been hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

This investigation includes illnesses in Canada. In Canada, as of December 8, 2019, there are 16 confirmed cases of E. coli O157 illness linked to this outbreak in the following provinces: Ontario (10), Quebec (1), New Brunswick (3), Nova Scotia (1), and Newfoundland and Labrador (1). Individuals became sick between November 5 and November 22, 2019. Four individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 11 and 73 years of age. The majority of cases (62%) are female.

This outbreak is caused by a different strain of E. coli O157:H7 than the current outbreak linked to romaine lettuce from the Salinas, California, growing region.

Information collected to date indicates that Fresh Express Sunflower Crisp chopped salad kits are a likely source of this outbreak.

State and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before their illness started. Of seven ill people with information available, all seven (100%) reported eating any leafy green in the week before their illness started. Six ill people reported eating or maybe eating a Fresh Express Sunflower Crisp chopped salad kit.

The investigation is ongoing to determine which ingredient in the salad was contaminated. Romaine lettuce is one of the ingredients in the salad kit, but we do not know yet if this outbreak is related to a current outbreak linked to romaine lettuce from the Salinas, California, growing region. Preliminary information indicates that romaine lettuce in the salad kits eaten by some of the sick people likely came from the Salinas growing region. CDC is concerned that these kits may still be in some homes. If you have any of these salad kits in your home, throw them away.

In late 2018, I posted (slightly edited) about cross-border E. coli outbreaks linked to leafy greens, specifically romaine lettuce:

Total Sick – 350
Hospitalized – 162
Kidney Failure – 31
Deaths – 7

In 2017 in Canada, a total, of 42 cases of E. coli O157 illness were reported in five eastern provinces: Ontario (8), Quebec (15), New Brunswick (5), Nova Scotia (1), Newfoundland and Labrador (13). Seventeen individuals were hospitalized. One individual died. Individuals who became ill were between the ages of 3 and 85 years of age. The majority of cases (74%) were female.

In 2017 in the United States, 25 people infected with the outbreak strain of STEC O157: H7 had been reported from 15 states. Ill people ranged in age from 1 to 95 years, with a median age of 26. Among ill people, 67% were female. Nine ill people were hospitalized, including two people who developed the hemolytic uremic syndrome. One death was reported from California.

In the Spring of 2018 in Canada, there were eight Canadian illnesses of E. coli O157 with a similar genetic fingerprint to illnesses reported in the U.S. investigation.

In the United States as of June 27, 2018, 210 people infected with the outbreak strain of E. coli O157: H7 were reported from 36 states. Ill people ranged in age from 1 to 88 years, with a median age of 28. Sixty-seven percent of ill people were female. Of 201 people with information available, 96 (48%) were hospitalized, including 27 people who developed the hemolytic uremic syndrome. Five deaths were reported from Arkansas, California, Minnesota (2), and New York.

In Canada, as of November 23, 2018, there had been 22 confirmed cases of E. coli illness investigated in Ontario (4), Quebec (17), and New Brunswick (1). Eight individuals were hospitalized, and one individual suffered from the hemolytic-uremic syndrome. Individuals who became ill were between 5 and 93 years of age. The cases are evenly distributed among male and female individuals.

In November 2018, 66 people infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7 were reported from 12 states. Illnesses started on dates ranging from October 8, 2018 to October 31, 2018. Sixteen people were hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. Epidemiologic and traceback evidence from the United States and Canada indicates that romaine lettuce harvested from the Central Coastal growing regions of northern and central California is a likely source of the outbreak.

E. coli outbreaks associated with lettuce, specifically the “pre-washed” and “ready-to-eat” varieties, are by no means a new phenomenon. In fact, the frequency with which this country’s fresh produce consuming public has been hit by outbreaks of pathogenic bacteria is astonishing. Here is just a sample of E. coli outbreaks based on information gathered by the Center for Science in the Public Interest, Kansas State University, and the Centers for Disease Control and Prevention:

I need to update my chart.

Additional Resources

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli outbreaks and hemolytic uremic syndrome (HUS). The E. coli lawyers of Marler Clark have represented thousands of victims of E. coli and other foodborne illness infections and have recovered over $700 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our E. coli lawyers have litigated E. coli and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products.  The law firm has brought E. coli lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s.  We have proudly represented such victims as Brianne Kiner, Stephanie Smith and Linda Rivera.

If you or a family member became ill with an E. coli infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli attorneys for a free case evaluation.

• About E. coli – a complete online resource with information on symptoms and risks of E. coli infection
• Marler Clark E. coli Lawsuits and Litigation
• A downloadable Family Health Guide on E. coli (PDF)
• About Hemolytic Uremic Syndrome