Today the CDC and FDA announced that a total of 17 people infected with the outbreak strain of E. coli O157:H7 have been reported from 8 states: Washington, Idaho, Montana, California, Colorado, Arizona, Wisconsin, and Maryland.
Illnesses started on dates ranging from September 24, 2019, to November 8, 2019. Ill people range in age from 3 to 72 years, with a median age of 16. Fifty-six percent of ill people are female. Of 17 ill people with information available, 7 hospitalizations have been reported, including 2 people who developed hemolytic uremic syndrome (HUS), a type of kidney failure. No deaths have been reported.
The Maryland Department of Health identified 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 salad had a “Best By” date of October 31, 2019. WGS is currently underway in Maryland for this sample to determine if it is closely related genetically to the E. coli found in people in 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. Ill people in Maryland reported eating Ready Pac Foods Bistro® Chicken Caesar Salad. In initial interviews, ill people in other states have not reported eating this particular salad.
FDA is tracing back the supply of the romaine lettuce in the salad and has identified possible farms in Salinas, California. Preliminary information indicates that romaine lettuce used in the product that tested positive was harvested in mid-October and is no longer within current expiration dates.
In late October the FDA announced that an E. coli O157:H7 outbreak, involving 23 illnesses, was likely associated with romaine lettuce. CDC notified the FDA of this illness cluster in mid-September 2019 and the agency promptly initiated a traceback investigation.
The FDA, CDC, along with state and local partners, investigated the illnesses associated with the outbreak. A total of 23 people infected with the outbreak strain of E. coli O157:H7 were reported from 12 states: Arizona (3), California (8), Florida (1), Georgia (1), Illinois (2), Maryland (1), North Carolina (1), Nevada (1), New York (1), Oregon (1), Pennsylvania (2) and South Carolina (1). Eleven people were hospitalized, and no deaths were reported. Illnesses started on dates ranging from July 12, 2019 to Sept. 8, 2019.
Investigators were sent to visit farms located in California’s central coast region which were identified through the traceback investigation. They collected and tested many environmental samples, and the outbreak strain was not identified. While romaine lettuce is the likely cause of the outbreak, the investigation did not identify a common source or point where contamination occurred.
E. coli O157:H7 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:
Date | Vehicle | Etiology | Confirmed Cases |
States/Provinces |
July 1995 | Lettuce (leafy green; red; romaine) | E. coli O157:H7 | 74 | 1:MT |
Sept. 1995 | Lettuce (romaine) | E. coli O157:H7 | 20 | 1:ID |
Sept. 1995 | Lettuce (iceberg) | E. coli O157:H7 | 30 | 1:ME |
Oct. 1995 | Lettuce (iceberg; unconfirmed) | E. coli O157:H7 | 11 | 1:OH |
May-June 1996 | Lettuce (mesclun; red leaf) | E. coli O157:H7 | 61 | 3:CT, IL, NY |
May 1998 | Salad | E. coli O157:H7 | 2 | 1:CA |
Feb.-Mar. 1999 | Lettuce (iceberg) | E. coli O157:H7 | 72 | 1:NE |
Oct. 1999 | Salad | E. coli O157:H7 | 92 | 3:OR, PA, OH |
Oct. 2000 | Lettuce | E. coli O157:H7 | 6 | 1:IN |
Nov. 2001 | Lettuce | E. coli O157:H7 | 20 | 1:TX |
July-Aug. 2002 | Lettuce (romaine) | E. coli O157:H7 | 29 | 2:WA, ID |
Nov. 2002 | Lettuce | E. coli O157:H7 | 13 | 1:Il |
Dec. 2002 | Lettuce | E. coli O157:H7 | 3 | 1:MN |
Oct. 2003-May 2004 | Lettuce (mixed salad) | E. coli O157:H7 | 57 | 1:CA |
Apr. 2004 | Spinach | E. coli O157:H7 | 16 | 1:CA |
Nov. 2004 | Lettuce | E. coli O157:H7 | 6 | 1:NJ |
Sept. 2005 | Lettuce (romaine) | E. coli O157:H7 | 32 | 3:MN, WI, OR |
Sept. 2006 | Spinach (baby) | E. coli O157:H7 and other serotypes | 205 | Multistate and Canada |
Nov./Dec. 2006 | Lettuce | E. coli O157:H7 | 71 | 4:NY, NJ, PA, DE |
Nov./Dec. 2006 | Lettuce | E. coli O157:H7 | 81 | 3:IA, MN, WI |
July 2007 | Lettuce | E. coli O157:H7 | 26 | 1:AL |
May 2008 | Romaine | E. coli O157:H7 | 9 | 1:WA |
Oct. 2008 | Lettuce | E. coli O157:H7 | 59 | Multistate and Canada |
Nov. 2008 | Lettuce | E. coli O157:H7 | 130 | Canada |
Sept. 2009 | Lettuce: Romaine or Iceberg | E. coli O157:H7 | 29 | Multistate |
Sept. 2009 | Lettuce | E. coli O157:H7 | 10 | Multistate |
April 2010 | Romaine | E. coli O145 | 33 | 5:MI, NY, OH, PA, TN |
Oct. 2011 | Romaine | E. coli O157:H7 | 60 | Multistate |
April 2012 | Romaine | E. coli O157:H7 | 28 |
1:CA Canada |
June 2012 | Romaine | E. coli O157:H7 | 52 | Multistate |
Sept. 2012 | Romaine | E. coli O157:H7 | 9 | 1:PA |
Oct. 2012 | Spinach and Spring Mix Blend | E. coli O157:H7 | 33 | Multistate |
Apr. 2013 | Leafy Greens | E. coli O157:H7 | 14 | Multistate |
Aug. 2013 | Leafy Greens | E. coli O157:H7 | 15 | 1:PA |
Oct. 2013 | Ready-To-Eat Salads | E. coli O157:H7 | 33 | Multistate |
Apr. 2014 | Romaine | E. coli O126 | 4 | 1:MN |
Apr. 2015 | Leafy Greens | E. coli O145 | 7 | 3:MD, SC, VA |
June 2016 | Mesclun Mix | E. coli O157:H7 | 11 | 3:IL, MI, WI |
Nov. 2017 | Leafy Greens | E. coli O157:H7 | 67 | Multistate and Canada |
Mar. 2018 | Romaine | E. coli O157:H7 | 219 | Multistate and Canada |
About Marler Clark
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 $650 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.
Additional Resources