The lettuce E. coli outbreak has caused at least 19 confirmed illnesses, and likely many more.  Michigan appears to be at the epicenter of the outbreak, with 10 illnesses among the 19 confirmed illnesses counted by the CDC and FDA.  The Michigan arm of the lettuce E. coli outbreak is centered in Washtenaw County.  Also, a lawsuit was filed today in the outbreak on behalf of an Ohio resident.  

Of course, Michigan residents, unfortunately, should know the drill by now.  They’ve been hit by lettuce E. coli outbreaks in the past, including multiple residents of Washtenaw County.  On September 15, 2008, Ingham County Health Department (ICHD) was notified that nine students of Michigan State University (MSU) were seen in the emergency department over the weekend with gastrointestinal symptoms of abdominal pain, diarrhea, and bloody diarrhea. Lab cultures had confirmed that at least two of them were positive for E. coli O157:H7. The ICHD then launched an investigation with help from the Michigan Department of Community Health (MDCH), and both the United States & Michigan Department of Agriculture (MDA). Other Public Health agencies and health care providers were notified to contact ICHD if they had patients with similar symptoms and onsets of illness.

Over the ensuing days it became clear that the outbreak was not limited to MSU. While at MSU, the reported number of E. coli O157:H7 cases had risen to 18 (3 confirmed, 15 probable), there were also a reported 12 cases at Lenawee County Jail (5 confirmed, 7 probable). In fact, by September 29, a total of 26 confirmed cases of E. coli O157:H7 with the same genetic fingerprint had been reported to MDCH, from eight Michigan counties, including Washtenaw County. Additionally, nine individuals in Illinois and three from the Province of Ontario had also been identified with the same genetic strain of E. coli O157:H7.

By this point in the 2008 investigation, there was also strong epidemiological evidence linking the outbreak to institutional size, bagged iceberg lettuce. Two separate case-control studies had been conducted by MDCH at MSU and the Illinois Department of Public Health, and both implicated iceberg lettuce as the source of contamination. As a result, the MDA coordinated a traceback investigation of iceberg lettuce and found that the common supplier of all iceberg lettuce to MSU, the Lenawee County Jail, a restaurant in Illinois, as well as other foodservice locations identified by ill individuals, was Fresh-Pak Inc., distributed under the name, “Aunt Mid’s.” Ultimately, further traceback confirmed that Aunt Mid’s had been supplied the contaminated lettuce by Santa Barbara Farms, a California company. 

Ultimately, the number of confirmed illnesses in the 2008 lettuce outbreak in Michigan, Illinois, and Ontario was 34. This included: nine students from MSU (Ingham County), five inmates at the Lenawee County Jail, three students at the University of Michigan and another in Washtenaw County, five in Macomb County, five in Wayne County, three in Kent County, and one each in St. Clair, Oakland, and Genesee Counties.