Another seven people have contacted E. coli after eating romaine lettuce, the CDC has revealed.
That brings the total sickened by the current outbreak to 59, including 23 people that have been hospitalized – two of whom have developed a type of kidney failure called hemolytic uremic syndrome (HUS).
In a media call on Thursday afternoon, the CDC said it has identified one of the farms where the outbreak came from: the Adam Brothers farm in Santa Barbara, California.
But they warned that is likely not the only source, and officials are warning the public not to buy, sell or eat romaine lettuce from three California counties: Monterey, San Benito and Santa Barbara.
In the current outbreak, 59 have been sickened, including 23 people hospitalized – two of whom have developed a type of kidney failure called hemolytic uremic syndrome
Illnesses related to the current outbreak began on October 5 with the most recent occurring on November 11.
The states where cases have been identified include: California, Connecticut, District of Columbia, Florida, Illinois, Louisiana, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island and Wisconsin.
There have been no deaths, but 23 hospitalizations including two for HUS.
This is a condition in which there is an abnormal destruction of blood platelets and red blood cells.
According to the Mayo Clinic, the damaged blood cells can clog the kidney’s filtering system, resulting in life-threatening kidney failure.
‘The investigation remains quite active and recently identified additional cases,’ said Dr Stephen Ostroff, senior advisor to the FDA Commissioner, on the media call.
‘It is premature to say the outbreak is over but we believe the likely-contaminated product is well off the market at this point.’
Health officials only identified one farm that has been traced back to the outbreak, the Adam Brothers farm, which specifically grows produce.
The CDC and the FDA confirmed the romaine lettuce grown on the farm came into contact with an agricultural reservoir that was found to have the bacteria in it.
‘We still have to assess how the reservoir became contaminated,’ said Dr Ian Williams, chief of the Outbreak Response and Prevention Branch at the CDC.
‘But it can from domesticated animals, from wild animals, things being used on the farm like fertilizer. These are just potential ways it could happen.’
He added that there are likely multiple distributors and processors and farms responsible for the outbreak.
Romaine harvesting recently began shifting from California’s Central Coast to winter growing areas, primarily Arizona, Florida, Mexico and California’s Imperial Valley.
Those winter regions weren’t yet shipping when the illnesses began.
The labeling arrangement was worked out as the produce industry called on the FDA to quickly narrow the scope of its warning so it wouldn’t have to waste freshly harvested romaine.
An industry group noted the labels are voluntary, and that it will monitor whether to expand the measure to other leafy greens and produce.
The FDA said the industry committed to making the labeling standard for romaine and to consider longer-term labeling options for other leafy greens.
Robert Whitaker, chief science officer of the Produce Marketing Association, said labeling for romaine could help limit the scope of future alerts and rebuild public trust after other outbreaks.
‘Romaine as a category has had a year that’s been unfortunate,’ Whitaker said.
Even though romaine from the Yuma, Arizona, region is not implicated in the current outbreak, it was blamed for an E. coli outbreak this spring that sickened more than 200 people and killed five.
Contaminated irrigation water near a cattle lot was later identified as the likely source.
Leafy greens were also blamed for an E. coli outbreak last year. US investigators never specified which salad green might be to blame for those illnesses, which happened around the same time of year as the current outbreak.
But officials in Canada identified romaine as a common source of illnesses there.
The produce industry is aware the problem is recurring, said Jennifer McEntire of the United Fresh Produce Association.
‘To have something repeat in this way, there simply must be some environmental source that persisted,’ she said. ‘The question now is, can we find it?’
Growers and handlers in the region tightened food safety measures after the outbreak this spring, the industry says. Steps include expanding buffer zones between cattle lots and produce fields.
The Adam Brothers farm (pictured) in Santa Barbara, California, was named as one of the culprits after its romaine lettuce came into contact with agricultural reservoir that had E. coli
But McEntire said it’s not known for sure how the romaine became contaminated in the Yuma outbreak. Another possibility, she said, is that winds blew dust from the cattle lot onto produce.
McEntire said the industry is considering multiple theories, including whether there is something about romaine that makes it more susceptible to contamination.
Compared with iceberg lettuce, she noted its leaves are more open, thus exposing more surface area.
Since romaine has a shelf life of about 21 days, health officials said last week they believed contaminated romaine could still be on the market or in people’s homes.
Food poisoning outbreaks from leafy greens are not unusual. But after a 2006 outbreak linked to spinach, the produce industry took steps it believed would limit large scale outbreaks, said Timothy Lytton, a Georgia State University law professor.
The outbreak linked to romaine earlier this year cast doubt on how effective the measures have been, he said.
But Lytton also noted the inherent risk of produce, which is grown in open fields and eaten raw.