The federal officials say the romaine lettuce E. coli outbreak has ended, but E. coli lawyers say some questions remain unanswered. The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) issued their final reports on the outbreak yesterday, but neither report contained any new information about the origins of the contamination.

In its last update before the final report was issued, the FDA named one farm as a potential source of contamination. But both FDA Commissioner Scott Gottlieb, M.D. and FDA Deputy Commissioner Frank Yiannas said other farms were likely to be named as traceback analysis showed no single farm explained all of the illnesses. Specifically, the FDA update said its investigators had identified clusters of illness linked to five restaurants in four states that were supplied by 11 distributors, nine growers, and eight farms. All of them potential sources of contaminated romaine lettuce. The final report revealed no additional names.

Ryan Osterholm
Attorney Ryan Osterholm

“There are 62 people who got sick from eating this lettuce. Twenty-five people were hospitalized, two of them developed a type of kind failure called hemolytic uremic syndrome (HUS), where are there answers?” asked E. coli lawyer Ryan Osterholm, a lead attorney on Pritzker Hageman’s E. coli Team.

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Incomplete E. coli Investigation

On December 13, 2018, federal officials identified Adam Bros. Farm in Santa Barbara County, California as one potential source of contamination after CDC tests on samples taken from a reservoir on the farm were positive for the outbreak strain of E. coli O157:H7. At that time, 59 people in 15 states had been sickened and the FDA and the CDC said lettuce from other farms could also be implicated.

Roughly one month later, the outbreak has grown to include three more cases and one additional state. The CDC’s final report issued January 9, 2019 states 62 people in 16 states were sickened. Almost half of the case-patients, 46 percent, required hospitalization. And two of them developed HUS, a potentially fatal complication that affects between 5 percent and 10 percent of E. coli patients. The last reported onset-of-illness date was December 4, 2018. About two weeks after Adam Bros. stopped shipments of romaine. According to the FDA, the number of cases reported from each state is as follows: CA (12), CT (1), DC (1), FL (1), GA (1), IL (2), LA (1), MA (1), MD (1), MI (7), NH (6), NJ (13), NY (7), OH (1), PA (5), RI (1) and WI (1). Illnesses were also reported in Canada.

The outbreak was first announced by the CDC on November 20, 2018, when 32 people in 11 states had been identified and one person was already suffering from HUS. The CDC  accompanied the announcement with a dire warning to consumers, restaurants and retailers to throw away all romaine lettuce.

The warning was a departure from the CDC and FDA’s approach in handling an E. coli outbreak that had ended months earlier. The deadly E.coli outbreak linked to romaine lettuce grown in Yuma, AZ  sickened more than 200 people and five of them died. The FDA was never able to identify a common brand, farm, grower, supplier or distributor in that outbreak either. It did identify the region where the lettuce was grown, and consumers not to eat and restaurants and retailers not to sell romaine lettuce unless they knew it was grown elsewhere.

Problems abounded. Consumers discovered that the packaging on most romaine lettuce does not state where it was grown. Some stores issued recalls, some didn’t. Some restaurants stopped serving romaine, some didn’t. And some romaine producers issued statements saying their products were not implicated in the outbreak, including one company based in Yuma, AZ. No one wanted a repeat of this scenario.

And yet, just days after the CDC’s warning to “throw it all away” the FDA announced it had narrowed down the growing region where the tainted romaine originated and consumers, retailers and restaurants should avoid romaine grown in that area. And to help make that determination process easier, producers would begin putting growing region information on the labels. In the weeks that followed both agencies cautioned that not all of the packages would have these labels yet. The FDA’s final report seems to suggest some may never have them. The agency now calls this crucial step a “recommendation” and said that after talking with producers and distributors the labels with harvest date and location will be voluntary.

Romaine Lettuce E coli Outbreak