Wisconsin officials have found E. coli O157:H7 in an unopened bag of pre-washed, chopped romaine collected from an ill person’s home.  Laboratory testing is pending to determine if the E. coli matches a strain causing one of the ongoing multi-state outbreaks linked to romaine lettuce.

The Wisconsin findings are part of the investigation into a multistate outbreak of E. coli O157:H7 infections. The E. coli O157 bacteria was found in a bag of chopped Fresh Express brand “Leafy Green Romaine” lettuce with a use-by date of 11/14/2019 and a lot code of Z301 A05B.

The source of the romaine identified on the packaging was Salinas Valley, CA. While the bacteria was found in a bag of Fresh Express brand romaine, it is important to note that not all of the sick people in Wisconsin who are included in this outbreak have reported consuming Fresh Express brand salads. At this time, no single product, brand, or variety of salad has been reported by all ill individuals. Some did report eating the Fresh Express romaine. The investigation is ongoing to determine the source of contamination and whether additional products are linked to illnesses.

The Wisconsin Department of Health Services (DHS) advises consumers not to consume any products containing romaine lettuce from Salinas Valley, CA, regardless of brand. While some romaine-containing products were recalled on Nov. 21, romaine from Salinas Valley is still available on many store shelves. Public health officials at state and federal levels are saying it is important to look at product labels for any mention of Salinas Valley, CA, and avoid purchasing such products.

The Wisconsin department also advises consumers to check their refrigerators for any lettuce mixes containing romaine from the Salinas Valley and throw them away. Produce drawers and refrigerator surfaces should be cleaned thoroughly after throwing out the product.

Officials report that as of Dec. 9, Wisconsin  has 33 confirmed cases included in this multistate outbreak. Available epidemiologic, laboratory and traceback evidence indicate that romaine lettuce from the Salinas, CA, growing region is the likely source of this outbreak.

Illnesses in Wisconsin residents started on dates ranging from Nov. 7-19. Two cases of the hemolytic uremic syndrome (HUS), a type of kidney failure, have been reported and 14 people have been hospitalized. At this time, 97 percent of ill people reported eating leafy greens in the week before becoming sick; 88 percent of them report consuming or possibly eating romaine lettuce in the week before they became sick. Food safety and regulatory officials are still working to identify the potential source of contamination and determine how it happened.

Specific advice to consumers, restaurants, and retailers can be found on the CDC outbreak website(link is external) or the DHS Outbreak webpage.

About E. coli infections
Anyone who has eaten any of the implicated products and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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