miércoles, 21 de noviembre de 2018

FDA warns against eating romaine lettuce due to E. coli multistate outbreak | Fox News

FDA warns against eating romaine lettuce due to E. coli multistate outbreak | Fox News

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A THANKSGIVING WARNING ABOUT ROMAINE LETTUCE: The Food and Drug Administration (FDA) on Tuesday said the public should not eat romaine lettuce as a result of a multistate E. coli outbreak ... At least 32 people have gotten sick and 13 have been hospitalized as a result of an outbreak believed to be connected to romaine lettuce, according to the FDA. So far, 11 states have reported cases, the latest onset of which was dated Oct. 31. "People should not eat romaine lettuce until more is known about the source of the contaminated lettuce and the status of the outbreak," the federal agency said. The FDA, which is investigating the matter with the Centers for Disease Control and Prevention (CDC) and state and local agencies, said they're also working alongside officials in Canada, where a similar outbreak was discovered. - Reported by Elizabeth Zwirz
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Published Date: 2018-11-20 21:32:07
Subject: PRO/AH/EDR> E. coli EHEC - USA (28): O157, romaine lettuce
Archive Number: 20181120.6156581
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Tue 20 Nov 2018
Source: CDC [edited]

Outbreak of _E. coli_ Infections Linked to Romaine Lettuce
CDC, public health and regulatory officials in several states, Canada, and the FDA are investigating a multistate outbreak of Shiga toxin-producing _Escherichia coli_ O157:H7 (_E. coli_ O157:H7) infections.

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on _E. coli_ bacteria isolated from ill people by using techniques called pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS). CDC PulseNet manages a national database of these DNA fingerprints to identify possible outbreaks. WGS gives a more detailed DNA fingerprint than PFGE. WGS performed on _E. coli_ bacteria from ill people in this outbreak showed that the strains were closely related genetically. This means that the ill people were more likely to share a common source of infection.

As of 20 Nov 2018, 32 people infected with the outbreak strain of _E. coli_ O157:H7 have been reported from 11 states.

State: [reported cases]
California: 10
Connecticut: 1
Illinois: 2
Massachusetts: 2
Maryland: 1
Michigan: 7
New Hampshire: 2
New Jersey: 3
New York: 2
Ohio: 1
Wisconsin: 1
Total: 32

Illnesses started on dates ranging from 8 Oct 2018 to 31 Oct 2018. Ill people range in age from 7 to 84 years, with a median age of 24. 66 percent of ill people are female. Of 26 people with information available, 13 (50 percent) were hospitalized, including 1 person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Illnesses that occurred after 30 Oct 2018, might not yet be reported due to the time it takes between when a person becomes ill with _E. coli_ infection and when the illness is reported. This takes an average of 2 to 3 weeks.

Investigation of the Outbreak
Epidemiologic evidence indicates that romaine lettuce is a 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. 11 (79 percent) of 14 people interviewed reported eating romaine lettuce. This percentage is significantly higher than results from a survey of healthy people in which 47 percent 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.

Whole genome sequencing (WGS) results showed that the _E. coli_ O157:H7 strain isolated from ill people in this outbreak is closely related genetically to the _E. coli_ strain isolated from ill people in a 2017 outbreak linked to leafy greens in the United States and to romaine lettuce in Canada. The current outbreak is not related to a recent multistate outbreak of _E. coli_ O157:H7 infections linked to romaine lettuce. People in the spring outbreak were infected with _E. coli_ O157:H7 bacteria with a different DNA fingerprint.

FDA and states are working to trace back romaine lettuce that ill people ate in the current outbreak. At this time, no common grower, supplier, distributor, or brand of romaine lettuce has been identified. CDC is advising that consumers not eat any romaine lettuce, and restaurants and retailers not sell any, until we learn more about this outbreak and the source of the contaminated lettuce.

This investigation is ongoing, and CDC will provide more information as it becomes available.

Communicated by:
ProMED-mail Rapporteur Mary Marshall

[ProMED thanks Glenn Snow for submitting the post as well. - Mod. LL

HealthMap/ProMED map available at:
United States: http://healthmap.org/promed/p/106]

See Also

E. coli EHEC - USA (27): (UT) 20181028.6113669
E. coli EHEC - USA (26): O26, ground beef, alert, recall 20180920.6041171
E. coli EHEC - USA (25): (WA) raw milk 20180909.6016693
E. coli EHEC - USA (24): (FL) O26, grocery chain ground beef, alert, recall 20180831.5998786
E. coli EHEC - USA (23): (OK) possible recreational water exposure 20180801.5941698
E. coli EHEC - USA (22): (WA) restaurants 20180708.5893948
E. coli EHEC - USA (21): (TN) O157, 2 clusters, 2 sources 20180706.5891482
E. coli EHEC - USA (20): O157, romaine lettuce, water source 20180702.5882323
E. coli EHEC - USA (19): (UT, AZ) O157, 2017 20180616.5858104
E. coli EHEC - USA (18): (TN) raw milk, more cases 20180614.5856110
E. coli EHEC - USA (17): (OR) O111, daycare center 20180613.5854733
E. coli EHEC - USA (16): (TN) raw milk 20180607.5844304
E. coli EHEC - USA (15): O157, romaine lettuce, more cases, fatal 20180604.5837662
E. coli EHEC - USA (14): (WA) sandwich shops 20180527.5820803
E. coli EHEC - USA (13): O157, romaine lettuce, increasing cases, fatality 20180517.5799620
E. coli EHEC - USA (12): O157, romaine lettuce, increasing cases, fatality 20180510.5791677
E. coli EHEC - USA (11): (OK) day care center 20180502.5780250
E. coli EHEC - USA (10): O157, romaine lettuce, fatality 20180502.5780249
E. coli EHEC - USA (09): O157, romaine lettuce 20180427.5771229
E. coli EHEC - USA (08): (CA) military outbreak, undercooked beef, 2017 20180425.5769489
E. coli EHEC - USA (07): O157, romaine lettuce 20180425.5769488
E. coli EHEC - USA (06): O157, romaine lettuce 20180421.5761217
E. coli EHEC - USA (05): O157, romaine lettuce 20180418.5756056
E. coli EHEC - USA (04): O157, romaine lettuce 20180413.5745944
E. coli EHEC - USA (03): O157, expansion of NJ outbreak 20180411.5738813
E. coli EHEC - USA (02): (NJ) poss. restaurant chain link, RFI 20180405.5728398
E. coli EHEC - USA: O157, leafy greens 20180110.5550773

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