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Canada declares outbreak over; CDC, FDA still investigating

U.S. officials say leafy greens most likely cause; victim interviews ongoing to find specific source

Canadian officials said today an E. coli outbreak linked to romaine lettuce is over, but U.S. officials are continuing to investigate the deadly foodborne illness outbreak that they believe is linked to leafy greens.

Both countries’ public health officials posted updates on the outbreak today stressing that there is little remaining danger to the public because the most recent victim became sick Dec. 12, 2017.

“Leafy greens typically have a short shelf life, and since the last illness started a month ago, it is likely that contaminated leafy greens linked to this outbreak are no longer available for sale,” according to today’s media statement from the U.S. Centers for Disease Control and Prevention.

Between the two countries, 66 people have been infected with the outbreak strain of E. coli O157:H7, with each country reporting one death. In the United States, there are 24 confirmed victims across 15 states. In Canada there are 42 victims across five provinces.

“Illnesses started on dates from Nov. 15 through Dec. 12, 2017,” the CDC reported today. “Among the 18 ill people for whom CDC has information, nine were hospitalized, including one person in California who died. Two people developed hemolytic uremic syndrome, a type of kidney failure.”

Many of the sick people reported eating romaine lettuce in various forms from grocery stores, restaurants and other locations. The Public Health Agency of Canada began advising people in the five implicated provinces to consider not eating romaine until further notice. The agency ended that advisory today.

To view a larger version of this information graphic, please click on the image. Source: CDC

In the U.S., the CDC did not make any recommendations to the public about avoiding any foods in its initial Dec. 28, 2017, media statement on the outbreak or in today’s update.To date, only half of the U.S. victims have been interviewed by outbreak investigators.

“The likely source of the outbreak in the United States appears to be leafy greens, but officials have not specifically identified a type of leafy greens eaten by people who became ill,” the CDC reported today.

“State and local public health officials continue to interview sick people in the United States to determine what they ate in the week before their illness started. Of 13 people interviewed, all 13 reported eating leafy greens. Five of nine ill people specifically reported eating romaine lettuce.”

Little transparency during outbreak
Neither country released any information about produce growers, suppliers or any other entities in the farm-to-fork continuum in connection to the outbreak.

No recalls have been initiated, but some retailers and restaurants temporarily pulled romaine lettuce from shelves and menus. Consumer Reports recommended that consumers avoid romaine lettuce until the outbreak cause was determined.

The Canadian Food Inspection Agency — which is similar to the U.S. Food and Drug Administration — tested samples of romaine lettuce as part of the outbreak investigation. Today the Canadian officials revealed that all food samples tested negative.

In the U.S., the FDA, which had not posted any public information about the outbreak until today, is assisting the CDC, but has virtually nothing to report.

“The FDA’s outbreak investigation team is working with CDC and state and local officials to determine what ill people ate, where they bought it, and the distribution chain — all with the goal of reaching where these foods were produced, to see if there’s any common food or point where the food might have become contaminated.”

Industry, watchdog reactions
The statements today spurred very different reactions from produce industry groups and consumer advocates.

A coalition of produce marketing and lobbying groups — United Fresh Produce Association, Arizona and California LGMAs, Canadian Produce Marketing Association, Produce Marketing Association and Western Growers — welcomed the statements as vindication.

“In collaboration with our association colleagues we’d like to share the following update to last week’s communications regarding the E. coli O157:H7 foodborne illness outbreak that has impacted many (of our) members,” the produce groups’ release said.

“… the undersigned organizations call your attention to the following details:

“Public health agencies in both the United States and Canada are informing consumers that there are no concerns about consuming any particular food, while they continue their investigations into what caused this E. coli O157:H7 outbreak that began in November.

“Based on these statements, both governments have concluded that the food responsible for this foodborne illness outbreak is no longer in the market.

“The industry associations are committed to working with government agencies in both the United States and Canada to assist with the ongoing investigations.”

There is a very different view at Consumers Union, which is the policy and mobilization division of Consumer Reports. Food safety advocates there “continue to think it prudent to avoid romaine lettuce for now,” according to Jean Halloran, director of Food Policy Initiatives at Consumers Union.

In a media statement, Halloran urged the CDC and Canadian officials to share their raw data on the outbreak and called on the FDA to request and review internal bacterial testing data from producers of romaine lettuce in order to pinpoint the source of the E. coli bacteria that has triggered the illnesses.

“This is a dangerous strain of E. coli that can cause severe illness and even death,” said Halloran’s statement. “Health officials need to take more aggressive steps to protect the public. In order to ensure that this threat to consumers’ health won’t continue or happen again, the government needs to identify the source.”

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