Update: As of 4 p.m. today, the CDC expanded its warning to consumers to include all types of romaine from the Yuma, Arizona growing region, not just the chopped variety originally included.
That means that, in addition to any chopped romaine or salad mixes containing romaine you may have bought recently, you should avoid eating any whole heads of romaine or romaine hearts from that region for the time being. And you should steer clear from eating romaine at a restaurant unless you can confirm that the romaine is not from the Yuma growing area.
The update is in response to new information about the outbreak coming from people at a correctional facility in Alaska who became sick. Their illnesses were traced back to romaine grown in the Yuma area.
First, there was a salmonella-related recall of 200 million eggs earlier this week. And now, people are being instructed to steer clear of a popular salad green. The Food and Drug Administration (FDA) announced that it's investigating an outbreak of Escherichia coli (E. coli) that's been linked to romaine lettuce, which can cause symptoms like bloody diarrhea.
Since March 13, the outbreak has caused 53 illnesses and 31 hospitalizations across 16 states, according to the Centers for Disease Control and Prevention (CDC). Although investigators have traced the outbreak to chopped romaine from the Yuma, Arizona, growing region, they haven't pinpointed a specific brand, grower, supplier, or distributor yet.
The CDC is keeping an updated map online with information about which states have been affected by the outbreak. So far, there have been illnesses reported in Alaska, Arizona, California, Connecticut, Idaho, Illinois, Louisiana, Michigan, Missouri, Montana, New Jersey, New York, Ohio, Pennsylvania, Virginia, and Washington.
Most types of E. coli are actually harmless. But the type involved with this outbreak is known to cause particularly severe infections.
According to the CDC, this outbreak is associated with Shiga toxin–producing E. coli O157:H7, which causes infections that may bring on the following symptoms:
- Diarrhea (often bloody)
- Severe stomach cramps
Symptoms usually start between two and eight days after eating the contaminated food and, among healthy adults, usually last for about a week.
However, in some cases, the infection can go on to cause a serious complication known as hemolytic uremic syndrome (HUS), which is a form of kidney failure. Young kids, elderly adults, and people with compromised immune systems are most likely to develop HUS. According to the CDC, symptoms of HUS include:
- Abdominal pain
- Pale skin tone
- Fatigue and irritability
- Small, unexplained bruises
- Decreased urination
- Bleeding from the nose and mouth
Most people with E. coli infections get better with minimal treatment (including rest and staying hydrated), although the FDA does recommend getting in touch with your doctor to be sure you know what you're dealing with (and it's always a good idea to see a doctor if you are experiencing bloody diarrhea).
But if you suspect you may have developed HUS, it's important to get medical care ASAP. And if you have symptoms of severe dehydration—dark pee, dizziness, and fatigue, for example—due to diarrhea and/or vomiting, seek medical attention.
For now, the CDC recommends avoiding store-bought chopped romaine lettuce and throwing away any that you already bought.
If you're eating out, the CDC suggests confirming where the restaurant got their romaine. If you can't get information about the source of the romaine to confirm it's not from Yuma, don't eat it.
Beyond this advice, following basic food safety rules can help prevent an infection. That includes washing your hands frequently, especially after going to the bathroom or changing diapers, before and after preparing or eating food, and after contact with animals or their environments. Use hand sanitizer if soap and water aren't available.
It's also important to freeze or refrigerate perishable foods quickly and to separate raw foods (like uncooked meat)—including using separate cutting boards—from ready-to-eat foods, to avoid spreading a possible infection from one food item to another.
So, unfortunately, it's in your best interest to avoid chopped romaine for now and opt for another one of your favorite greens. Your salad could probably use some shaking up, anyway.