A multistate outbreak of E coli O157:H7 infections has been served at catering events, restaurants, and schools.
Safe Food Handling
Image credits: FDA
The outbreak linked to iceberg and romaine lettuce blend (referenced as E coli O157:H7 outbreak #1280) is actively under investigation by the FDA and CDC, along with state and local partners. The investigation has identified this particular lettuce blend, served at catering events, restaurants, and a school, as the source of the outbreak. As of now, 69 cases of E coli O157 infections have been reported across 10 states. The FDA's traceback investigation has pinpointed the iceberg and romaine lettuce blend as the likely cause, sourced from a common supplier. Although the affected product identified so far appears to be past its shelf life and is no longer available on the market.
Despite this, the investigation is ongoing, and there doesn't seem to be any current risk to public health. The FDA has emphasized that consumers do not need to avoid iceberg or romaine lettuce at this time. Although, the investigation may reveal additional details as it progresses.1
These current E coli outbreaks linked to the lettuce and previous cases such as organic carrots, and McDonalds onions have been recalled due to contamination with E coli O121. This strain of E coli can cause severe foodborne illness, including stomach cramps, diarrhea (often bloody), and vomiting. Symptoms typically appear 3 to 4 days after exposure and can lead to serious complications like kidney failure (hemolytic uremic syndrome, or HUS).1
In an exclusive interview last month with Nicole M Iovine, MD, PhD, an infectious disease physician and chief hospital epidemiologist at the University of Florida, Lovine provided Contagion with additional insight into the specific strain of E coli responsible for this outbreak and its potential for severe complications, “This particular type of E coli is carrying a gene that produces a toxin, and that toxin is pretty dangerous. It can lead to kidney failure, even to the point of someone needing dialysis,” she said.
The toxin produced by this strain is especially problematic because antibiotics can worsen the infection. “If you give a person antibiotics, the bacteria can actually sense the presence of the antibiotics. It takes it as a danger signal, and the bacteria responds by revving up production of that toxin to really high levels. So, you actually make people worse when you give antibiotics for this particular strain.”
This phenomenon complicates treatment, as physicians often rely on antibiotics for gastrointestinal bacterial infections. “Most of the time, giving them an antibiotic is what you want to do, but for this particular strain, that will make the disease process worse,” Iovine explained.
As the stool culture results for identifying the specific pathogen take several days to come back, this delay can result in the patient receiving antibiotics before the correct diagnosis is made. “By the time you get those results, it’ll take a few days. So, what often happens is people do get antibiotics, and this can lead to worse outcomes, for sure,” she noted.
The outbreak of E coli O157:H7 linked to iceberg and romaine lettuce has been traced to a past-shelf-life product, with no ongoing public health risk identified.
E coli O157:H7 can cause severe symptoms, including bloody diarrhea and kidney failure, and antibiotics may worsen the infection.
Young children, the elderly, and immunocompromised individuals are at higher risk for severe outcomes from foodborne illnesses and should take extra precautions.
Vulnerable Populations: Extra Precaution Needed
Lovine also discussed the heightened risks for certain vulnerable populations, who are more likely to experience severe outcomes from foodborne illnesses, “These individuals need to be especially vigilant and take extra care to practice all possible measures to ensure their food is safe,” she advised. “If they get infected with any kind of foodborne illness, the outcomes can be more severe. This applies particularly to individuals who are under the age of five, those over the age of 65, and people whose immune systems are suppressed—either because they are on medications or undergoing treatments like chemotherapy for cancer.”
By following these guidelines, individuals can better protect themselves from potentially dangerous pathogens like E coli, reducing the impact of foodborne illness outbreaks. The FDA continues to work with the supplier to confirm if any further products might be involved, and additional updates will be provided as more information becomes available.
