In the lettuce E. coli O145 outbreak, we have long suspected that illnesses were confined to three states only—New York, Ohio, and Michigan–despite a recall that extended to 23 states. That was wrong though, as the CDC reported today. A Tennessee resident was today confirmed today as having been infected by E. coli O145 in the outbreak as well. So, unless the Tennessee resident was actually infected in New York, Michigan, and Ohio—which the CDC likely would have indicated in its update today on the E. coli O145 outbreak—we can assume that the contaminated lettuce did, in fact, reach the state of Tennessee in addition to New York, Michigan, and Ohio.
The question that today’s lettuce outbreak news raises is one that has been asked, in other forms, before. Every new layer to this outbreak—i.e. each time another person is identified as an outbreak victim (now 23 confirmed, and 7 probable)—the number of actual outbreak victims increases on the order of possibly 30 times every number that has been announced to date. See Mead article.
But maybe even that isn’t putting the romaine lettuce E. coli O145 outbreak in proper context. The E. coli O145 strain of bacteria is a non-O157 STEC that is not regularly tested for, either by the federal government or food producers in our food supply, or by doctors, hospitals, and laboratories who are treating sick people. This makes even detecting outbreaks of bugs like E. coli O145 a difficult task, much less gaining any reasonable sense for how big the outbreak truly is. Almost certainly, the only reason why Michigan and Ohio have so many confirmed cases is because area health providers were put on notice of the possibility of an E. coli O145 outbreak before the true scope of the outbreak, or the extent of Freshway Foods recall, was even known.