By: Heather Williams

Want to know something more chilling than a fictional deranged clown? STEC E. coli in produce, namely lettuce.

Not convinced? Let me tell you how the current outbreaks plaguing the United States and Canada are definitely more hair-raising than any character the infamous Stephen King could write.

Dual Outbreaks, Same Pathogen 

Two border countries, the United States and Canada, are experiencing E. coli outbreaks.  Both presumably linked to romaine lettuce. In Canada, 41 people have become ill linked with the outbreak, and one has died.  In the United States, 17 have become ill linked with the outbreak.  Two of those have developed a complication known as hemolytic uremic syndrome (HUS), and one has died.  At this time, no recall has been issued in either country, as the exact source has yet to be identified.  Though the Public Health Agency of Canada has recommended citizens to opt for other lettuces and avoid romaine. The Canadian grocery chain, Sobeys, has voluntarily pulled romaine lettuce from their shelves while the investigations continue. This means the perpetrator is likely still at large, lurking on the shelves of stores or even your home.

So, what does this mean for you?

How can you fight back?

In this time of food uncertainty, we have armed you with a list of FAQs on what should you know about E. coli, and what you can do to protect yourself and your family from this foodborne illness. And most importantly, to know when to panic and when to eat the salad.


  • What is E. coli?

Escherichia coli, better known as E. coli is a large and diverse group of bacteria.  It is also the most studied bacteria we know about today.  It was discovered by a German bacteriologist Theodor Escherich in 1885.  E. coli can be found living in the intestines of both people and animals.

  • Is All E. coli Bad?

Not all E. coli are bad.  In fact, most E. coli are naturally found in the healthy human intestinal tract as part of the digestion mechanics of our body.  Some non-pathogenic E. coli are in the food we eat and sometimes the water we drink.  These non-pathogenic strains of E. coli cause no harm to humans.

  • Are There Harmful Forms of E. coli?

When you hear E. coli, even though I have told you not all E. coli are bad, you might be thinking foodborne illness.  And you wouldn’t be wrong.  There are several forms of E. coli that can cause illness.  Illness is generally diarrheal illness, but sometimes can even reach beyond the intestinal tract into other parts of the body and bloodstream.  The most well known harmful E. coli is known as Shiga toxin-producing E. coli O157:H1.

  • What is Shiga Toxin-Producing (STEC) E. coli?

Shiga toxin-producing E. coli is the most notorious E. coli of all.  When you hear about an E. coli outbreak, chances are this is the responsible party.  Shiga toxin-producing E. coli or STEC is responsible for about 100,000 illnesses each year, accounting for 3,000 hospitalizations and 90 deaths in the United States.  The most reported STEC in the United States can be tracked to the strain E. coli O157:H7.  This accounts of about 73,000 of the estimated 100,000 infections each year.  A 2005 study indicated that this illness is responsible for an annual cost of $405 million (in 2003 dollars).  This includes $30 million for medical expenses, $5 million in lost productivity, and $307 million in premature deaths.

  • What are the Symptoms of STEC?

While symptoms can vary from person to person, symptoms generally include diarrhea (often bloody), severe stomach cramps, and vomiting.  If a fever is present, it is generally not very high and usually less than 101 ºF.  Illness onset is around 3 to 4 days from eating something contaminated with the harmful bacteria, though the illness can begin anywhere from 1 to 10 days from exposure.  Most normally healthy individuals recover within 5 to 7 days of infections.

  • Who Gets STEC?

While people of any age can consume the pathogen and become infected with STEC, some are more likely than others to develop more serious complications.  The very young, the very old, and those with a compromised immune system are more likely to become infected with STEC.  The very young and the elderly are at risk to develop a severe illness known as Hemolytic Uremic Syndrome or HUS, though even healthy older children and younger adults can become ill.

  • What is HUS?

HUS, or hemolytic uremic syndrome is a potentially life-threatening complication affecting the kidneys as a result of STEC infection.  About 5 to 10% of those diagnosed with STEC end up with HUS.  People with HUS should be hospitalized, otherwise they could experience kidney failure and other serious health problems.  Though most people with HUS can recover within just a few weeks, some may suffer permanent damage and not recover.

  • What are the Symptoms of HUS?

Symptoms of HUS develop about 7 days after initial STEC symptoms appear, often as diarrheal symptoms are improving.  Someone with HUS may experience a decrease in the frequency of urination, a very tired feeling, and pallor of the cheeks and lower eyelids.

  • When Should I Contact a Health Care Provider?

It is a good idea to contact your health care provider and seek medical attention if you experience diarrhea for more than 3 days or diarrhea accompanies by high fever or blood in the stool.  If you are vomiting so much that you cannot keep any liquids down and you pass very little urine, you are likely becoming dehydrated and should seek medical attention.  If you experience any of the symptoms of HUS, you should contact your health care provider.  Dehydration is a dangerous side-effect of this illness and can cause additional organ issues if not handled appropriately.

  • How Are Infections Spread?

STEC is spread through fecal to oral transmission.  This is a polite way of saying that you get sick from eating infected poop.  Though you may not realize it, poop is sort of all around us.  Food may be contaminated with microscopic fecal matter from the slaughter process, the things around us may be contaminated with microscopic transfer of fecal matter on objects touched by someone who is infected that did not wash their hands after using the bathroom.

Man Your Battle Station

The easiest way to prevent the spread of STEC from person to person is to wash your hands, but there are several other tips to keep yourself safe from infection.

  • WASH YOUR HANDS and wash them often. Always wash your hands after changing diapers, after using the bathroom, and before preparing food or eating food.  Wash your hands after coming in contact with animals and their environments.
  • Cook meats to an appropriate temperature. USE A MEAT THERMOMETER to ensure internal temperature meets appropriate temperature.  Remember color and temperature to the touch is not a reliable indicator of doneness.
  • Avoid UNPASTERURIZED products such as dairy products and juices. These food products have not been heat treated to remove bacteria that it could have come in contact with during the production process.
  • Do not SWALLOW WATER when playing or swimming in ponds, streams, lakes, swimming pools, or even the seemingly innocent kiddie pools.
  • Prevent CROSS-CONTAMINATION by washing hands, utensils, cutting boards, and counters after touching raw meat. Always store cooked and ready-to-eat foods away from raw foods.

Let Them Eat Lettuce?

Produce is good for you. There is no question about that. It is when it is contaminated that it becomes a health issue.

Food safety lawyer Jory Lange stated that, “I’m telling my family and friends not to eat any romaine lettuce, for now.”  Mr. Lange explained that, “There may be a common source of infection in the U.S. and Canadian E. coli outbreaks.  The CDC’s preliminary test results show that the U.S. and Canadian E. coli outbreaks are genetically closely related.  Right now, the CDC is interviewing the Americans affected by this outbreak to determine what they ate before they got sick.  Meanwhile, Canadian health officials continue to recommend that people avoid eating romaine lettuce during this ongoing outbreak investigation.  While the CDC continues its investigation, it seems prudent to follow the Canadian health official’s recommendation to avoid eating romaine lettuce, for now.”

UnsafeFoods will continue to monitor the dual E. coli outbreaks and report as more information becomes available.  E. coli lawsuit or questions for an e. coli lawyer?