While two people have died and more than 13 states and parts of Canada have been affected with the recent outbreak of E. coli. So far, the CDC and FDA have not released any official press release. Some restaurants have voluntarily stopped serving romaine lettuce due to the E. coli outbreak and Sobeys, a national store chain in Canada, has stopped sale of romaine lettuce temporarily.

The CDC did release a media statement on Thursday, December 28, 2017, stating that DNA tests confirm a relationship between the US and Canadian outbreaks. Though the Public Health Agency of Canada has identified romaine lettuce as the source of the outbreak in Canada, neither the US or Canada has advised individuals to stop eating romaine lettuce, officially.

If romaine lettuce is the source of an E. coli Outbreak, many media outlets are asking “Why haven’t the CDC or FDA done anything?”

Just because they haven’t officially published anything doesn’t mean that the CDC and/or FDA aren’t taking the threat seriously. The CDC and FDA are very slow to publish anything in an official capacity until they have facts that have clearly identified a culprit due to the significant financial impact it can have on businesses if they make an announcement precipitously. For example, if the CDC told Americans not to eat romaine lettuce, only to find that it wasn’t the lettuce that had caused a problem in the US but some other source, producers and sellers of romaine might have lost sales that they could not recover, due to an invalidated scare.

So, how do the CDC and FDA investigate outbreaks?

The FDA has established a network called the Coordinated Outbreak Response and Evaluation Network, otherwise known as CORE. This network helps the FDA to work closely with the CDC and other health responders to manage responses to outbreaks, share data, and review outbreaks to ensure that post-response activities including reports on findings, causes, and remediation methods are fully evaluated and reported.

CORE has three response groups, the Signals and Surveillance Team, Response Teams, and Post-Response Teams. The Signals and Surveillance Team is responsible for early detection of potential outbreaks and researches ways to predict or identify past or present indicators that might be leading to a future outbreak. It is likely that the signals team has already identified the outbreak and handed it over a response team, since so many people are ill from the E. Coli romaine lettuce related outbreak at this point.

A party involved in the CORE response team are likely who coordinated the comparison of the Canadian E. Coli outbreak to the US E. Coli outbreak and provided the information for the CDC statement that there are similarities enough between the two that they suspect some type of linkage. The response team, while not reporting to the public at this point, is likely interviewing those who contracted the illness in an attempt to identify a common cause. Until they can definitely link the illnesses to a specific cause, they cannot publish any public suggestion of what product or products need to be removed from public circulation. If they are able to trace it back they will publish advisory statements at that time.

Once an outbreak has been handled, the Post-Response team evaluates what happened, and where possible publishes reports of findings, measures taken to prevent future outbreaks, and how they traced it back. Examples of successful past reports that the two E. coli outbreaks related to food in 2017 include tracking an E. coli outbreak to a batch of General Mills flour, and another where it was tracked back to SoyNut Butter.

Tracking an outbreak back to the source can be very time consuming, but helps the FDA know if any changes need to be made in food safety guidelines, such as how food is handled or processed in the factories, or if the problem was due to a violation of existing guidelines. Looking at how the CORE team traced the outbreak for the General Mills Flour E. Coli outbreak, it is actually very commendable that CORE was so successful in tracking them. CORE was able to trace back the illness to people eating at least five different dried baking mixes, back to flour packaged at two factories, and ultimately back to general mills as the flour producer.

At this point, the outbreak has occurred to recently so CORE has not yet been able to report if they have identified any particular source for the current outbreak.

I have romaine lettuce at home. The CDC and FDA have not suggested I not eat it, but I’m worried. What should I do?

The CDC may not be suggesting that US citizens stop eating lettuce, but some people like to live by the old adage, “It’s better to be safe, than sorry.”

Did you know, romaine lettuce can be eaten cooked? If you have some romaine lettuce you’ve already bought, you might be debating whether you should toss it in light of the recent E. Coli outbreak. Romaine is a hearty leafy vegetable. It can be substituted in place of cabbage in dishes such as soups. E. coli has been shown to die when exposed to hot water at 160°F degrees for 15 seconds. Water boils at 212°F, so cooking any soup containing Romaine for at least 5 minutes to fully cook the romaine will also kill any bacteria in it.

Due to the recent outbreak, if you do have romaine lettuce in your home, regardless of whether you choose to cook it or simply throw it away, any surfaces it has touched should be cleaned with bleach, including the drawers in your refrigerator, counter tops, and cutting boards. Any utensils used that came in contact with raw romaine lettuce should also be washed at high temperatures in a sink full of hot, bleachy water.