More romaine victims reported — FDA says look to industry for change; industry says additional study needed

The FDA says shipping records show at least 10 distributors, 11 farms and 12 growers in the romaine lettuce supply chain are implicated in an ongoing E. coli outbreak that has now sickened almost 80 people in the U.S. and Canada.

In updates yesterday, the U.S. Food and Drug Administration, Centers for Disease Control and Prevention, and the Public Health Agency of Canada (PHAC), continued to warn the public and businesses against eating or selling romaine unless they know for sure it is not from previously specified regions of California.

Neither health nor food safety officials on either side of the international border named any of the farms or other entities they have identified as having grown or handled the romaine in question. The FDA reported current evidence indicates the suspect romaine was harvested in the Central Coast growing regions of northern and central California.

Both the United States and Canada are seeing increasing numbers of people confirmed with infections from the outbreak strain of E. coli O157:H7. Neither country has reported any confirmed deaths in relation to the outbreak.

As of Dec. 6, the U.S. CDC reported 52 patients across 15 states. Canadian officials reported 27 people in four provinces have fallen ill. The outbreak strain is proving particularly virulent, having a U.S. hospitalization rate of 42 percent. Nine of the patients in Canada have been admitted to hospitals. Two people in each country have developed kidney failure.

In the United States, illness onset dates range from Oct. 5 to Nov. 18. The sick people range in age from 1 year old to 84 years old. Public health officials expect additional outbreak illnesses to be confirmed.

“Illnesses that occurred after Nov. 14 might not yet be reported due to the time it takes between when a person becomes ill with E. coli infection and when the illness is reported,” the CDC reported. “Twenty-four — 83 percent — of 29 people interviewed reported eating romaine lettuce. Ill people reported eating different types of romaine lettuce in several restaurants and at home.”

Testing
This week’s updates and warnings say all romaine from Canada is safe and some grown in the United States is safe. Green-light romaine includes that grown in greenhouses, hydroponic operations, or any areas other than the seven California counties identified by outbreak investigators. Those counties are Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz and Ventura.

“Traceback information from four restaurants in three different states so far has implicated 10 different distributors, 12 different growers, and 11 different farms as potential sources of contaminated lettuce,” the FDA reported yesterday. “ The information indicates that the outbreak cannot be explained by a single farm, grower, harvester, or distributor.”

Federal and state investigators began on-site work Nov. 23, three days after the CDC and FDA announced the new outbreak and warned the public to avoid all romaine regardlesswhere it came from, what form it was in, or where it was sold. The on-site ivestigations include farms and lettuce cooling facilities.

An FDA spokesman told Food Safety News on Wednesday that the agency and its investigation partners have been collecting a variety of samples for lab testing, including soil, water, and swab samples from surfaces and equipment. Thursday’s agency update reported samples of romaine lettuce and scat samples.

“To date, E. coli O157:H7 has not been found in any of the lettuce, soil or scat samples,” the FDA reported.

Test results are still pending on water samples and the swabs of surfaces and equipment.

Talking the talk
Government and industry have been talking about E. coli and romaine for literally all of 2018, with the current outbreak marking the third time since November 2017 that the leafy green has been associated with E. coli infections.

Task force discussions earlier this year, in the wake of a deadly E. coli O157:H7 outbreak linked to romaine from the Yuma, AZ, growing area, resulted in new, self-imposed safety measures for growers. Those measures include cleaning harvesting equipment and allowing more space between growing fields and adjacent feed lots. 

One of the country’s largest cattle feed lots, which can habdle more than 100,000 head at a time, is adjacent to the Yuma romaine growing area. Water in an open canal that is used for romaine irrigation in that area snakes past concentrated animal feeding operations. Investigators working on this spring’s outbreak have said the most likely source of the E. coli was dust from feeding areas blowing into the canal water.

With the new outbreak this fall, industry has promised additional task force talks, according to FDA Commissioner Scott Gottlieb. This past week Gottlieb announced a voluntary labeling program that industry has been asked to use as a precurser to other measures determined by the industry task force. The labeling program, if companies decided to use it, involves indicating harvest regions and dates on packaging.

Neither Gottlieb’s statement last week nor the FDA’s update this week included any information on whether the government and industry had discussed test-and-hold or irradiation as possible methods to mitigate outbreaks or contamination.

An FDA spokeperson said the best insight into those topics was covered in Gottlieb’s statement Nov. 27.

“… the leafy greens industry has agreed to establish a task force to find solutions for long term labeling of romaine lettuce and other leafy greens for helping to identify products and to put in place standards for traceability of product,” Gottlieb said in his announcement. “The task force will also examine information from this outbreak to identify measures that led to its occurrence and how to prevent ongoing safety problems with romaine lettuce. One outcome could be to extend the commitment for labeling for origin and date of harvest to other leafy greens.”

Produce industry leaders say the task force and its objectives are not set. The California and Arizona Leafy Greens Marketing Agreement (LGMA)organizations are taking the lead. 

Jennifer McEntire of the United Fresh Produce Association was leader for the traceability group of the LGMA task force earlier this year. She told Food Safety News this week that work is ongoing. However, she could not provide a timeline for meetings, reports or recommendations. 

“This group evaluated current traceback programs in the produce industry and their impact on traceability during outbreak events and will assess the challenges encountered in investigating outbreaks due to traceability issues,” McEntire said. “This topic extends beyond the leafy greens industry and the discussion may go on after the work of the task force is completed.”

Scott Horsfall, head of the California LGMA said he agreed with McEntire’s assessment of the situation.

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