4 More People Have Died In The E. Coli Outbreak Linked To Romaine Lettuce

The death toll from a multistate outbreak of E. coli has risen to five, but it's safe to eat romaine lettuce again. Here's what you need to know.

The mysterious E. coli outbreak linked to romaine lettuce is not over just yet, with four additional deaths and dozens of new cases, the CDC announced Friday.

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So far, a total of 197 people have gotten sick and five people have died after becoming infected with E. coli O157:H7, according to the most recent update from the US Centers for Disease Control and Prevention (CDC), which was published on Friday. Since the last case count on May 16, four more deaths were reported — these were in Arkansas, California, Minnesota, and New York. There were also 25 additional cases reported and the outbreak now spans across 35 states.

However, most of the new cases are people who got sick two or three weeks ago, when the contaminated romaine lettuce was still available for sale and in people's homes, the CDC reported. There can be a lag in reporting these cases and deaths to the CDC from local health departments. A portion of the people who became sick did not report eating any romaine lettuce, but instead came into direct contact or cared for someone who was sick with E. coli.

Escherichia coli (E. coli) are bacteria commonly found in the digestive tracts of humans and animals. Most types of E. coli are harmless, but some strains are pathogenic, meaning they can cause diarrhea or other illnesses. The strain in this outbreak is called E. coli O157:H7 and it's particularly bad because the bacteria produce a potentially life-threatening toxin. These toxin-carrying bacteria are called Shiga toxin-producing E. coli, or STEC.

Most strains cause severe diarrhea and cramping, but some can cause urinary tract infections, respiratory illness and pneumonia, and kidney problems, according to the CDC. You can get exposed to E. coli from contaminated water or food, or through contact with sick people or their fecal material.

Nearly half of the people who have gotten sick with E. coli have been hospitalized, which is an unusually high hospitalization rate.

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Shiga toxin-producing E. coli typically cause diarrhea or bloody stools, stomach cramps, and vomiting. Most cases are mild, but some can become severe or life-threatening and require hospitalization. Supportive care and hydration are the only treatment — antibiotics are not used to treat STEC, according to the CDC.

Out of 187 sick people in the outbreak with available information, 89 have been hospitalized (48%), the CDC reported. Of those who were hospitalized, 26 developed hemolytic uremic syndrome, a type of kidney failure that occurs in about 5–10% of people diagnosed with E. coli O157.

People of any age can become infected with E. coli, including STEC. But pregnant women, newborns, young children, older adults, and people with weak immune systems have the highest risk of getting sick and developing severe or potentially fatal complications.

The tainted romaine was grown in the Yuma, Arizona region, but the last harvest was in mid-April, so it is unlikely that any of this lettuce is still available for sale.


According to the US Food and Drug Administration (FDA), the contaminated romaine lettuce was sourced from areas in and around the Yuma region. However, the illnesses caused by this outbreak have not yet been traced to a single grower, harvester, processor, or distributor. The FDA is still investigating this outbreak and searching for answers.

The good news? The growing season for lettuce is over and the last shipments of romaine from Yuma were harvested on April 16. The lettuce thought to be contaminated with E. coli is long past its 21-day shelf life, according to the FDA, so is no longer available in stores or restaurants.

It is safe to eat romaine lettuce again.

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Although the case counts and deaths have increased in the most recent CDC report, most of these occurred several weeks ago and it's likely that there was a lag in reporting. The FDA has announced that the lettuce and lettuce products in question are no longer on shelves, and the CDC has removed their warning not to buy any romaine. So you can go back to enjoying your salads.

If you are experiencing symptoms of E. coli, talk to your doctor and report any infections to your local health department.

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The symptoms of O157:H7 E. coli infection will vary from person to person, and some people might not feel sick at all. In those who do develop symptoms, they usually start to feel sick three or four days after exposure. The most common symptoms are diarrhea (which can be bloody), severe stomach cramps, and vomiting.

You should contact your health care provider if you have severe, persistent, or bloody diarrhea or are vomiting so much that you can't keep any liquids down. If you get a positive diagnosis of E. coli, make sure you contact your local or state health department to report the illness.

You can prevent infection with E. coli by practicing proper hand-washing, especially after using the bathroom and before preparing or eating food. You should also avoid consuming raw or undercooked meats, poultry, and eggs and follow other food safety practices to avoid cross-contamination while preparing food.