On February 5, 2004, the FDA wrote a letter to the lettuce and tomato industries to voice its concern about the frequent outbreaks linked to those products. In the letter, the FDA counted 14 such outbreaks since 1996 that it had investigated. Among other things, the letter stated:
In view of continuing outbreaks associated with fresh lettuce and fresh tomatoes, we strongly encourage firms in your industries to review their current operations in light of the agency’s guidance for minimizing microbial food safety hazards in fresh lettuce and fresh tomatoes, as well as other available information regarding pathogen reduction or elimination on fresh produce. We further encourage these firms to consider modifying their operations accordingly, to ensure that they are taking the appropriate measures to provide a safe product to the consumer. Since the available information concerning some of the recent outbreaks does not definitively identify the point of origin of the contamination, we recommend that firms from the farm level through the distribution level undertake these steps.
On September 30, 2005, a year and a half after the FDA’s 2004 letter to the lettuce industry, the Minnesota Department of Health issued a press release stating that 11 Minnesota residents had been infected by E. coli O157:H7 from contaminated Dole romaine lettuce. Two days later, the FDA issued a nationwide public health alert regarding Dole pre-packaged salads. Further investigation indicated that 22,321 cases of potentially contaminated Dole romaine lettuce had been sent to market from a processing facility in central California. Ultimately, at least 32 people were sickened in the outbreak.