Dozens of people in Michigan, Ohio, and New York are part of an E. coli O145 outbreak traced to the consumption of contaminated lettuce sold by Freshway Foods.

Students from Ohio State University, the University of Michigan, and Daemen College in Buffalo, New York, have fallen ill as part of the E. coli outbreak, which was first reported in mid-April.  The U.S. Food and Drug Administration (FDA) announced yesterday that at least 12 people have been hospitalized due to the severity of their E. coli O145 infections, including three with potentially life-threatening hemolytic uremic syndrome, a complication of E. coli infection that can lead to kidney failure and central nervous system impairment.  

FDA stated in a press release yesterday that the results of a traceback investigation indicated that the implicated shredded Romaine lettuce distributed to the three academic institutions by Freshway Foods originated from one processing facility.  An unopened package of Freshway Foods brand Romaine lettuce tested positive for E. coli O145 bacteria on May 5 in a New York state lab.  

Attorney Bill Marler, who has been contacted by several individuals who believe they are part of the outbreak, commented on the announcement that Freshway Foods Romaine lettuce had been identified as the source.  “E. coli O145 is not that common.  Food service distribution of a product contaminated with E. coli O145 is the missing link that health investigators have been looking for.”

Freshway Foods is recalling products containing Romaine lettuce with a use by date of May 12 or earlier due to potential contamination with E. coli O145.  The products were sold to wholesalers and food service outlets under the Freshway and Imperial Sysco brands.

The public health investigation will continue, as FDA attempts to trace the lettuce to its original source.  In past outbreak situations, such as the 2006 spinach E. coli O157:H7 outbreak, investigators have been able to identify not only the farm that sold contaminated produce, but the field in which it was grown.  “It does not seem likely that where the lettuce was grown, or how it made its way to Freshway, will be determined–at least at this point,” Marler wrote on his blog.

While the trace-back investigation may be complicated, there is some confusion as to where the lettuce went after it left the Freshway Foods plant. 

The company states in its recall notification, “The recalled romaine lettuce products were sold to wholesalers and food service outlets in the following states east of the Mississippi river: Alabama, Connecticut, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, West Virginia, and Wisconsin.

The recalled romaine products were also sold for distribution to in-store salad bars and delis for Kroger, Giant Eagle, Ingles Markets, and Marsh stores in the states listed.”

Doug Powell, associate professor of food safety at Kansas State University, voiced his frustrations over the company statement yesterday on the Barf Blog: “Amy pointed out, since when [is] Kansas east of the Mississippi river?  Someone else e-mailed me to say the same thing about Missouri.  I called Freshway Foods and asked, why are Kansas and Missouri on the list, since they are west of the Mississippi … The U.S. Food and Drug Administration press release about the outbreak repeated the same geographical nosestretcher.  Given the states listed, should Dillons supermarket, in Manhattan (Kansas), owned by Kroger, be dumping their salad bar? The dude said, uh, good point, thanks, someone will get back to you.”

When Powell’s call was returned, “The nice lady said, we distribute a few other products into Missouri and Kansas but not romaine lettuce. … Oh, we do send romaine lettuce to a couple of distributors in Kansas City, Missouri.”

His response was, “Sigh.”

Caroline Smith-DeWaal, Food Safety Director for the Center for Science in the Public Interest (CSPI), responded to the outbreak announcement by urging Congress to bring Senate Bill 510, the FDA Food Safety Modernization Act, to the floor for a vote, stating, “While consumers wait for Congress to pass food safety legislation, the plants that process and bag lettuce and the farms that grow it are operating under an industry honor system which clearly failed in this case. The FDA can’t tell us when it last had inspectors in the plant where this lettuce was processed.  Congress urgently needs to give the FDA the resources and authority from the farm forward, transforming it from a reactive agency to an agency focused on preventing contamination.

“Freshway is conducting this recall on a voluntary basis, because–even with the presence of this serious food safety hazard–FDA lacks the ability to order a recall.  Giving the FDA mandatory recall authority is another reason why the Senate should bring S. 510, the FDA Food Safety Modernization Act, to the floor without further delay.”

Traceability and FDA’s lack of recall authority are repeat issues discussed during nearly every E. coli outbreak traced to produce.  Something different about this outbreak is the pathogen itself–E. coli O145, a pathogenic strain of E. coli that is not considered an adulterant in food.

Marler, who has been representing victims of E. coli outbreaks since 1993, speculated on his blog, “Given the time of the year, the most likely area for growing Romaine Lettuce is Arizona–likely Yuma. The investigation is likely hampered by the failure of health departments throughout the United States from actually testing ill persons stools for E. coli O145.”  Although he did not comment on the pending food safety legislation today, he has been an ardent supporter of the FDA Food Safety Modernization Act since it was introduced.