A total of 167 people infected with the outbreak strain of E. coli O157:H7 were reported from 27 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases page. The Public Health Agency of Canada also reported several illnesses that were closely related genetically to illnesses in the United States.

Illnesses started on dates ranging from September 20, 2019, to December 21, 2019. Ill people ranged in age from less than 1 to 89 years, with a median age of 27. Sixty-four percent of ill people were female. Of 165 ill people with information available, 85 (52%) hospitalizations were reported, including 15 people who developed hemolytic uremic syndrome (HUS), a type of kidney failure. No deaths were reported.

WGS analysis of bacterial isolates from 159 ill people did not predict antibiotic resistance in 157 of the isolates, but predicted resistance in 2 isolates. One isolate contained a resistance gene for ampicillin, and a second isolate contained resistance genes for ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline. WGS analysis of five bacterial isolates from a lettuce sample did not predict antimicrobial resistance. Standard antibiotic resistance testing of clinical isolates by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently underway. These findings do not affect treatment guidance since antibiotics are not recommended for patients with E. coli O157 infections.

Epidemiologic, laboratory, and traceback evidence indicated that romaine lettuce from the Salinas Valley growing region in California was the likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Ninety-four (83%) of 113 people interviewed reported eating romaine lettuce. This percentage was significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy people in which 47% reported eating romaine lettuce in the week before they were interviewed. Ill people reported eating different types of romaine lettuce in several restaurants and at home.

The Maryland Department of Health identified the outbreak strain of E. coli O157:H7 in an unopened package of Ready Pac Foods Bistro® Chicken Caesar Salad collected from a sick person’s home in Maryland. The Wisconsin Department of Health Services  identified the outbreak strain of E. coli O157:H7 in an unopened bag of Fresh Express® Leafy Green Romaine collected from an ill person’s home in Wisconsin. The Salinas Valley growing region in California was the main source of the romaine lettuce in both products.

FDA and states traced the source of some of the romaine lettuce eaten by ill people. Information gathered indicated that the romaine lettuce of interest was harvested from the Salinas Valley growing region in California. For more information about the traceback investigation, visit the FDA website.

Contaminated romaine lettuce from the Salinas Valley growing region in California is no longer available for sale. As of January 15, 2020, this outbreak appears to be over.

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 $800 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.