Foodborne Illness Outbreak Database

This database provides summaries of significant food and water related outbreaks occurring since 1984 caused by E. coli, Salmonella, Hepatitis A, Campylobacter and other pathogens. Read more »

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2018 Multistate Outbreak of E. coli O157:H7 Linked to Romaine Lettuce

In April 2018 local, state and federal public health and agriculture agencies announced an outbreak of E. coli O157:H7 linked to romaine lettuce from the Yuma, Arizona growing region. On June 28, 2018 the CDC declared the outbreak over. A total of 210 people were diagnosed with E. coli O157. Ninety-six people were hospitalized including 27 people who developed Hemolytic Uremic Syndrome (HUS). Five people died. Cases were reported from 36 states. Illness onset dates ranged from March 13, 2018 to June 6, 2018. WGS analysis of isolates from 184 ill people identified antibiotic resistance to chloramphenicol, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. These findings did not affect treatment guidance since antibiotics are not recommended for patients with E. coli O157 infections. Epidemiologic, laboratory and traceback evidence linked the outbreak to consumption of romaine lettuce from the Yuma growing region. The FDA and state and local regulatory officials traced the lettuce to many farms in the Yuma growing region. CDC laboratory testing identified the outbreak strain of E. coli O157:H7 in water samples taken from a canal in the Yuma region. Whole genome sequencing showed that the E. coli O157:H7 found in canal water was closely related genetically to the E. coli O157:H7 found in ill people. The Public Health Agency of Canada identified 8 people in several Canadian provinces infected with the same DNA fingerprint of E. coli O157:H7. Canadian illnesses were reported by 5 provinces: British Columbia, Alberta, Saskatchewan, Quebec, and Ontario. One of the Canadian cases were hospitalized and no deaths were reported.

  • Outbreak began:
  • March 2018
  • Affected Country:
  • US
  • Affected States/Territories:
  • California, Arizona, New York, Minnesota, Wisconsin, Oregon, Utah, Colorado, Iowa, Washington, Michigan, North Carolina, Ohio, Pennsylvania, Virginia, Arkansas, Alaska, Idaho, Montana, North Dakota, South Dakota, Massachusetts, Alabama, Florida, Georgia, Illinois, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, New Jersey, Oklahoma, Tennessee, Texas
  • Organism(s):
  • E. coli O157:H7
  • Vehicle(s):
  • romaine lettuce
  • Molecular Results Available:
  • Yes
  • Test Results:
  • EXHX01.0047/EXHA26.0626
  • Location(s):
  • Restaurants, Home
  • Brand Name(s):
  • Product Subject to Recall:
  • No
  • Total ill:
  • 210
  • Number ill by Case Definition Known:
  • Yes
  • Number Laboratory Confirmed Cases:
  • 210
  • Number Probable Cases:
  • 0
  • Number Possible Cases:
  • 0
  • Anyone Hospitalized:
  • Yes
  • Number Hospitalized:
  • 96
  • Any Deaths:
  • Yes
  • Number Dead:
  • 5

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