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/Multiprovince Outbreak of E. coli O157:H7 Linked to Romaine Lettuce, United States and Canada

On November 20, 2018 the CDC announced a multistate outbreak of E. coli O157:H7 linked to consumption of romaine lettuce. At the time of the announcement, investigators suspected romaine lettuce grown in California. As of November 9, 2018 there were 62 people infected with the outbreak strain of E. coli O157:H7. Sixteen states and the District of Columbia reported illnesses. Illnesses started on dates ranging from October 8, 2018 to December 4, 2018. Twenty-five people were hospitalized, including two people who developed Hemolytic Uremic Syndrome (HUS). As of December 13, 2018 the Public Health Agency of Canada had identified 28 ill people infected with the same strain of E. coli O157:H7 in British Columbia, Ontario, Quebec and New Brunswick. Ten of the Canadian case patients had been hospitalized and two had developed HUS. Canadian cases experienced symptom onset between mid-October and mid-November, 2018. No deaths were reported in the United States or Canada. On November 26, 2018 the CDC and FDA narrowed the scope of the warning and narrowed the warning to romaine lettuce harvested from the Central Coastal growing regions of northern and central California. CDC analyzed water and sediment samples from Adam Bros. Farming, Inc. farm in Santa Barbara County California, which was one of the 8 farms identified in traceback. The outbreak strain of E. coli O157:h7 was found in sediment within an agricultural water reservoir located on the farm. Whole genome sequencing results showed that the E. coli O157:H7 found in the agricultural water reservoir was closely related genetically to the E. coli O157:H7 isolated from ill people. On December 13, 2018 Adam Bros Farming, Inc. recalled red leaf lettuce, green leaf lettuce and cauliflower products harvested on November 27 to November 30, 2018 because of possible contamination with E. coli O157:H7. By that date, romaine lettuce was no longer available. Spokane Produce, Inc. of Spokane, Washington recalled sandwiches and other products under the Northwest Cuisine Creations and Fresh and Local Label.

  • Outbreak began:
  • October 2018
  • Affected Country:
  • US
  • Affected States/Territories:
  • California, New York, Wisconsin, Maryland, Michigan, New Hampshire, Ohio, Pennsylvania, Massachusetts, Rhode Island, District of Columbia, Florida, Georgia, Illinois, Louisiana, New Jersey, Not Applicable
  • Organism(s):
  • E. coli O157:H7
  • Vehicle(s):
  • Romaine Lettuce
  • Molecular Results Available:
  • Yes
  • Test Results:
  • EXHX01.4071/EXHA26.0531
  • Location(s):
  • Retail
  • Brand Name(s):
  • Adam Bros. Farming, Inc.
  • Total ill:
  • 90
  • Number ill by Case Definition Known:
  • Yes
  • Number Laboratory Confirmed Cases:
  • 90
  • Number Probable Cases:
  • 0
  • Number Possible Cases:
  • 0
  • Anyone Hospitalized:
  • Yes
  • Number Hospitalized:
  • 35
  • Any Deaths:
  • No
  • Number Dead:
  • 0

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