Right before thanksgiving, the CDC announced a multistate outbreak of Escherichia coli O157:H7 bacteria (aka E. coli O157:H7), linked to romaine lettuce. A quarter of the cattle in the United States carry E. coli O157:H7 in their guts without being sick from it. These bacteria are found not only in fecal matter of cattle and some other animals, but also in the environment surrounding animal activities. An earlier outbreak of E. coli O157:H7 this year was linked to consumption of contaminated romaine lettuce growing next to a cattle farm! It is thought that a canal used to irrigate the lettuce, was contaminated with E. coli O157:H7 bacteria from this cattle farm, causing 210 reported infections, 96 hospitalizations and five deaths. The current outbreak shows 43 cases and 16 hospitalizations, spread across 12 states, as of this writing. If you have any romaine lettuce in your refrigerator, discard it immediately, along with any foods it came in contact with, and then clean your refrigerator.
If you suspect that you may have consumed contaminated romaine lettuce, here is what you should watch out for. Within one to ten days, symptoms could begin slowly with mild bellyache and diarrhea that worsens over several days to severe stomach cramps, bloody diarrhea and vomiting. There may be fever (under 101˚F). Most of the time, individuals recover in a week. The very young, elderly, or immunocompromised, risk severe illness and hemolytic uremic syndrome (HUS), which can be deadly. About a week after initial symptoms, HUS can manifest symptoms of decreased frequency of urination, fatigue, loss of pink color in cheeks and inside the lower eyelids. Individuals with HUS may suffer kidney failure or even die, but most will recover within a few weeks.
Other ways in which you could come in contact with E. coli O157:H7 include:
- unpasteurized (raw) milk,
- unpasteurized apple cider,
- soft cheeses made from raw milk,
- water that has not been disinfected,
- contact with cattle, or
- contact with feces of infected people,
- this last happening as a direct result of poor hand hygiene.
Sometimes, the activity preceding E. coli O157:H7 food poisoning is pretty obvious –
- changing diapers,
- working on a cattle farm, or
- touching animals or the environment in petting zoos.
Other times, it is not so obvious –
- eating an undercooked hamburger or
- contaminated romaine lettuce, or
- swallowing lake water while swimming.
We may not always foresee potential E. coli O157:H7 food poisoning. Along with stringent hygiene on farms, and prevention of cross contamination of meat and produce with fecal matter, there are certain basic steps all of us can follow to reduce infections, the most important of which is hand hygiene. Wash your hands thoroughly after using the bathroom, assisting someone with using the bathroom, changing diapers, or petting animals.
Adopt the four basic steps to food safety: clean, separate, cook and chill.
CLEAN – wash hands, fruits and veggies, but not meat, poultry or eggs, as it could splash bacteria from these foods onto areas in your kitchen. Wash all kitchen surfaces, cutting boards and utensils used, with hot, soapy water.
SEPARATE poultry, seafood, eggs and all meats from other foods, while cooking, while shopping, and while storing in the refrigerator. Bacteria such as Salmonella, Clostridium perfringens and Campylobacter grow in the guts of poultry. Consequently, these bacteria can contaminate raw poultry and anything that comes in contact with raw poultry, including hands, produce, and cutting boards, among other kitchen aids.
To kill stowaway bacteria, COOK poultry to an internal temperature of 165°F; cook beef steaks and roasts to at least 145°F and rest for 3 minutes before consumption; cook ground beef and pork to at least 160°F.
CHILL perishable groceries within two hours of shopping, or within one hour, if the temperature is 90°F or greater. Once cooked, hot foods should be kept at a temperature of 140°F or above. Do not keep cooked foods at temperatures between 40°F and 140°F for over two hours – ample time for bacteria to cause food poisoning!
For more information on each one of the safety steps, visit foodsafety.gov.
Nov. 28, 2018 update: The FDA and CDC have narrowed down the source of the E. coli O157:H7 outbreak to romaine lettuce harvested from the Central Coastal growing regions of northern and central California. If you are unsure where the romaine lettuce is from, do not eat it. Check your bag or box of romaine lettuce for a label indicating the area of harvest. The specific California counties identified in the investigation are: Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, and Ventura.