The federal government today expanded its romaine lettuce warning to include all types of romaine lettuce from the Yuma, AZ, growing region, including whole heads and hearts of romaine in addition to chopped, because of an ongoing E. coli outbreak. No specific brands, growers or processors have been named.

On April 13, the warning against romaine from the Yuma, AZ, only included pre-chopped romaine and salads containing pre-cut romaine. At that time 35 people from 11 states had been confirmed with the outbreak strain of E. coli O157:H7, according to the Centers for Disease Control and Prevention. Of the sick people, 22 had required hospitalization.

The CDC’s expanded warning today did not go as far as Consumer Reports, a non-profit organization, did in recent days, urging people to avoid eating any form of romaine lettuce from any region because of the “potentially fatal consequences” until the government declares it “definitely safe.”

Romaine lettuce to date has sickened 53 people with E. coli in 16 states. No deaths have yet been attributed to the outbreak, but 31 of those infected have required hospitalization. Five of the victims developed a type of kidney failure called hemolytic uremic syndrome (HUS).

When it went public with the outbreak on April 10, CDC reported a specific food source had not been identified. Three days later the agency told consumers to throw away any pre-chopped romaine lettuce they had on hand, even if people had eaten some of it and not become ill. The CDC warning at that time also directed consumers to not eat any romaine served by restaurants or buy any chopped romaine sold in grocery stores unless they were assured it was not grown in Yuma. 

Yuma-grown romaine is typically available from November through late March or mid-April. Scott Horsfall, CEO of the California Leafy Greens Marketing Agreement, says shipments of romaine lettuce from the Yuma region have ceased. He says romaine production out of California is not associated with the outbreak.

“We know that government investigators are doing all they can to pinpoint the exact source of the outbreak,” Horsfall has said. “In the meantime, people may be confused about what leafy greens are safe to eat.”

The LGMA said the romaine that made people sick during the March 13 to April 6 period means the romaine was likely harvested and shipped in early March. There’s been no recall by lettuce growers or processors because the exact brands responsible for the illnesses are not known However, the LGMA doubts that any romaine harvested and shipped in early March would still be on store shelves.

The far-flung outbreak has reached as far away as a remote state prison outside Nome, AK. State officials on Thursday announced eight confirmed E. coli cases at Anvil Mountain Correctional Center that they believe are linked to whole heads of romaine from the Yuma area.   

Food Safety News has learned the romaine was likely delivered to the correctional facility during the final week of March. Prison officials believe it was all consumed during the first week of April. Inmates who became ill first experienced symptoms on April 5, 6, 9 and 15. The Anvil Mountain facility used whole heads of romaine lettuce from the Yuma, Arizona growing region.

The Alaskan departments of Health and Social Services, Environmental Conservation, and Corrections are working together to investigate and control the outbreak. None of the Alaskan victims required hospitalization and all are recovering, according to prison officials.

Country Foods, located three hours from Nome by air, is the food supplier for the Anvil Mountain prison.

New advice for consumers
The CDC’s latest recommendations for consumers include:

• Do not buy or eat romaine lettuce in any form from a grocery store or restaurant unless you can confirm it is not from the Yuma, AZ, growing region.
• Unless the source of the lettuce is known, consumers anywhere in the United States who have any store-bought romaine lettuce at home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick. Food contaminated with E. coli usually does not look or smell bad.
• Product labels often do not identify growing regions; so, throw out any romaine lettuce if you’re uncertain about where it was grown. This includes whole heads and hearts of romaine, chopped romaine, pre-packaged salads, and salad mixes containing romaine lettuce. If you do not know if the lettuce is romaine, do not eat it and throw it away.
•  Restaurants and retailers should not serve or sell any romaine lettuce in any form from the Yuma, AZ, growing region.
• The expanded warning is based on information from the illnesses in Alaska . Ill people in Alaska reported eating lettuce from whole heads of romaine lettuce from the Yuma, Arizona growing region.

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