By: Kerry Bazany

Most of the US population has now heard about the most recent E.coli outbreaks in the United States and Canada. However, when I recently shared that information with a few of my friends, they were surprised to hear that the FDA has not recommended avoidance or recall of romaine lettuce.

The Food Safety and Inspection Service (FSIS) within the U.S. Department of Agriculture inspects and regulates meat, poultry, and processed egg products produced in federally inspected plants. FSIS is responsible for ensuring that these products are safe, wholesome, and accurately labeled. All other food products are regulated by the Department of Health and Human Services’ Food and Drug Administration (FDA). By definition, a food recall is “a voluntary action by a manufacturer or distributor to protect the public from products that may cause health problems or possible death. A recall is intended to remove food products from commerce when there is reason to believe the products may be adulterated or misbranded”. (Source:

As of this date, the particular US outbreak associated with romaine lettuce has no confirmed source, even though the strains in Canada and the US seem to be genetically linked. Therefore, no recall was issued. It can take several weeks, from initial reports of foodborne illness symptoms for an official recall by the FDA because of traceback analysis procedures and various protocols.

You Don’t Need to be a Scientist to Know That E.coli is Dangerous

Unfortunately, the battle with E.coli has been lengthy, as evidenced by a long list of outbreaks. However, this latest outbreak has all the markings of being a potentially deadly strain.  This particular E.coli bacterium is known as STEC E.coli O157:H7 (herein referred to as O157:H7), and it is particularly virulent because of the toxin that is shed by the bacteria: toxins that can result in life-threatening hemolytic-uremic syndrome (HUS). This strain is potentially deadly to the elderly, young infants and children, and those with compromised immune systems.

Aside from the recent outbreak, E.coli made one of its appearances in April 2012 when it contaminated romaine lettuce grown and distributed by Amazing Coachella, Inc., the parent company of Peter Rabbit Farms in California. Twenty eight individuals became sick from eating the lettuce that was served at Jungle Jim’s Restaurant in Canada, and tested positive for O157:H7. Yet more incidences of O157:H7 were first identified in the region near St. Louis, Missouri as well in surrounding collar counties, which made 58 people sick from this pathogen. Upon investigation, it was discovered that these individuals had eaten items from salad bars at Schnuck’s grocery stores. Subsequently, Illinois state health officials stated that an investigation was under way that might be linked to the illnesses in Missouri. According to the investigation, “Traceback analysis determined that a common lot of romaine lettuce, from a single farm, was used to supply Schnuck’s grocery stores’ salad bars.”

In 2006, another one of our favorite salad items, spinach, was contaminated by O157:H7. This outbreak succeeded in making 199 people sick, and hospitalized 31 due to HUS. Three people died. The outbreak was traced to organic, bagged fresh spinach grown on a farm in San Benito County, California. The CDC at that time believed that the bacteria originated from irrigation water contaminated with fecal matter from cattle. Though preliminary, it is thought that the current romaine lettuce contamination may be linked to a similar scenario in which runoff water from cattle fields seeped into the surrounding lettuce fields.

In addition, international outbreaks other than the recent Canadian outbreak are not uncommon. As recently as July 2016, Public Health England (the United Kingdom’s equivalent of the FDA), advised consumers to thoroughly wash lettuce leaves after 151 people fell ill, with 62 needing hospital care, and two individuals dying from their illness. It is believed that the source of the contamination arose from a mix of lettuces imported from the Mediterranean.

Trends in Raw Vegetable-Borne E.coli Contamination

In a 2015 investigative study conducted by Research Gate, multiple researchers examined the data recorded from 2004-2012 in the US and the European Union. Their focus delineated the process of contamination by various pathogens and the produce vehicles that were involved. It is well known that a diet inclusive of raw vegetables is part of a healthy lifestyle. Yet the rise in the consumption of raw vegetables presents as a double-edged sword: nutrient-rich vegetables and leafy greens versus being susceptible to foodborne pathogens. But breathe easier: part of the study’s findings concluded that the consumption of raw vegetables on a consistent basis still outweighs the possibility of contracting a foodborne illness. Additionally, this study stated that norovirus, followed by salmonella, were the greatest causes of multi-state produce outbreaks. Further, E.coli was identified as the second leading cause of multi-state outbreaks, and appeared frequently in lettuces. “The occurrence of food-related infections due to fresh produce calls for better control interventions and the need for improved prevention strategies worldwide, since food can be contaminated at any point in the food chain, and interventions must be applied where appropriate at every step.” (Kozak et al, 2013). Part of the difficulty in ascertaining best practices results from globalization and international trade; both of which can increase the risk of produce containing pathogens due to lower safety standards. The study did not elaborate specifically on the transmission of the E.coli bacterium, other than to conjecture that, like salmonella, it could be linked to the source of water feeding the lettuce fields, possibly contaminated by livestock feces.

A Final Word

It cannot be understated, and rather it must be highlighted, the danger associated with this potentially deadly strain of E.coli that has received much media attention lately. What makes this strain noteworthy is its capability of causing hospitalization and fatalities. In truth, no one wants to actually cook their lettuce for several reasons, so in conclusion, it is best at this time to avoid purchasing romaine lettuce, as Consumer Reports has strongly recommended. In other words, be safe and do not wait for the FDA to issue a recall. The eventual source of this recent outbreak will be discovered. The old adage “better safe than sorry” certainly applies here.