3 Arizonans among E. coli cases traced to romaine from Yuma

Three Arizonans are among a growing list of people sickened in an E. coli outbreak that health officials say originated with chopped romaine lettuce from the Yuma area.

The Arizona Department of Health Services confirmed Wednesday that two people in Maricopa County and another in Pinal County became ill from the strain of E. coli blamed for dozens of illnesses in 16 states.

“We are notifying Arizona because we are taking it seriously,” department spokesman Wes Parrell said. “We want people to know this is here. This is serious.”

Two of the three Arizona residents were hospitalized, Parrell said. Although their condition is unknown, no deaths have been linked to the foodborne bacteria, he said.

The Centers for Disease Control and Prevention, the lead public health agency investigating the outbreak, on Wednesday updated the number of ill-

nesses to 53 from 35. The CDC statement said since its Friday update cases had been reported in five additional states, Alaska, Arizona, California, Louisiana, and Montana.

The CDC did not include the three Arizona cases in its bulletin Friday, which warned consumers to throw out storebought chopped romaine lettuce.

The agency said at the time 22 people were hospitalized from eating the tainted greens. On Wednesday, the CDC said nine more people have been hospitalized, bringing the total to 31. Five people have suffered kidney failure.

The CDC did not identify any growers, suppliers, distributors or brands associated with the outbreak.

“Information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona, growing region could be contaminated with E. coli,” the CDC said in the update. “At this time, no common grower, supplier, distributor, or brand has been identified.”

The CDC did not respond to requests for comment Wednesday.

The CDC said people began getting sick March 13 and illnesses continued being reported through April 6. Victims range in age from 10 to 85, the CDC said.

Illnesses that occurred after March 29 might not yet be reported because of the gap when someone gets sick and when it is reported to public health agencies. The CDC said reporting can take up to three weeks.

It is unknown how the Arizona victims came in contact with the tainted lettuce, or whether it was from a grocery store or a restaurant.

Parrell said doctors report the cases and samples are sent to the state lab, which tests the bacteria to determine if it shares DNA with the outbreak strain. In this case, it did.

The test results were sent to the CDC, which investigates the links between people and sources. Parrell said the CDC has not provided any information about how victims came in contact with the tainted lettuce, or commonalities between victims.

Parrell emphasized the seriousness of the outbreak.

“This is important,” he said. “We don’t want anyone to get sick.”

Until Wednesday, most of the E. coli outbreak cases appeared clustered in Connecticut, New York, New Jersey, Pennsylvania and Ohio. Cases also were reported in Idaho, Illinois, Michigan, Missouri, Virginia and Washington.

Wherever you live in North America, if you are eating a salad at home or in a restaurant from January through March, chances are the lettuce came from the Yuma area.

Yuma is the nation’s largest supplier of winter greens — lettuce, cabbage, spinach, kale, spring mix and more.

Now that it’s April, most romaine lettuce comes from California. That lettuce is not affected by the outbreak, according to a joint statement from industry leaders, including the Produce Marketing Association.

“We are cooperating fully with government and working closely to further identify the specific source of this outbreak,” it said, noting that the advisory affects only chopped, bagged lettuce and not whole heads or hearts of romaine. E. coli is the shortened name of a bacteria called Escherichia coli found in the environment, foods, and intestines of people and animals, according to the CDC. It can cause diarrhea, urinary tract infections, pneumonia and kidney failure. Some strains of E. coli aren’t dangerous, but others can be fatal.

It takes an average three to four days to get sick after eating food infected with E. coli, but it can as many at eight.

Most people experience diarrhea, severe stomach cramps and vomiting and recover within one week. Anyone taken ill should contact a doctor if diarrhea “lasts more than 3 days or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine,” according to the CDC.

Children younger than 5, older adults and people with weakened immune systems are more likely to develop hemolytic uremic syndrome.

“Symptoms of HUS can include fever, abdominal pain, pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and decreased urination,” according to the CDC. People experiencing such symptoms should seek emergency medical care.

Ten years ago, no uniform standards existed for leafy greens coming out of the field. It was up to the industry to police itself.

An E. coli outbreak in 2006 changed the leafy-green industry’s approach to food safety. Three people died and 205 were sickened in 26 states.

An investigation by the Food and Drug Administration ultimately traced the outbreak to Dole brand baby spinach farmed in California. But before the source could be confirmed, and as more victims went to emergency rooms across the country, the FDA sent a message: Don’t eat spinach.

The FDA didn’t specify a brand or a region or a date. It simply warned consumers that spinach wasn’t safe. Overnight, grocery stores purged their shelves and restaurants altered their menus. And the spinach industry lost an entire crop.

Produce growers, who had long resisted government oversight and the need for industrywide safety standards, found themselves facing calls for state and federal regulation and demands for public accountability.

Their response was a voluntary program called the Leafy Green Marketing Agreement, which required members to adopt rigorous food-safety standards, inspections and audits.

The program, developed with the help of university scientists, agricultural specialists, food-safety industry experts and government oversight agencies, created protocols for every aspect of the process. It covered pesticides, irrigation, field workers, equipment, storage and transportation.

The agreements were supported by produce buyers and retailers who aimed to ensure customers that their commodities were safe. Grocery chains signed agreements to buy only from LGMAcertified growers.

Companies that grow and ship leafy greens were forced to join or they quickly found themselves without buyers for their produce.

The professional agreements, audits and safety procedures haven’t fully eliminated E. coli and other pathogens.