A multi-state outbreak of E coli According to an update from the Centers for Disease Control and Prevention, O157 infections linked to romaine lettuce on Wendy’s burgers have more than doubled since last week.
The number of cases now stands at 84 and includes four states: Indiana (6), Michigan (53), Ohio (23) and Pennsylvania (2). That’s higher than last week’s number of 37 cases from the same four states. At least 38 of the sick people are currently hospitalized. Eight of those people, all in Michigan, have developed a serious and potentially life-threatening type of kidney failure called hemolytic uremic syndrome (HUS), the CDC reports. No deaths have been reported. So far, patients range in age from 5 to 94, with a median age of 24.
Because of reporting delays, the CDC warns that “the actual number of sick people in this outbreak is likely to be higher than the reported number, and the outbreak may not be limited to the states with known diseases.”
The prime suspect in the outbreak remains, as before, romaine lettuce that Wendy’s used exclusively on burgers and sandwiches (the fast food chain uses various leafy greens for its salads). The CDC notes that of the 62 affected people interviewed, 52 (84 percent) said they had eaten at Wendy’s in the week before becoming ill.
deadly lettuce
In a statement last week, Wendy’s said it is fully cooperating with the CDC’s investigation. “While the CDC has not yet confirmed that a specific food is the source of that outbreak, we have taken the precaution of discarding and replacing the sandwich lettuce in some restaurants in that region,” Wendy’s said. “The lettuce we use in our salads is different and unaffected by this promotion. As a company, we are committed to maintaining our high standards of food safety and quality.”
As Ars has reported, Escherichia coli O157:H7, produces Shiga toxin, which is toxic to cells and can stop a cell’s protein production. Shigatoxin can cause serious illness, including hemolytic uremic syndrome (HUS), which affects eight people in this outbreak. In HUS, the toxin enters the blood and leads to the mechanical breakdown of red blood cells and acute kidney injury. Although no deaths have been reported in this outbreak, HUS can be fatal, and E coli outbreaks associated with spoiled lettuce have been deadly before.
The CDC notes that “researchers are working to confirm whether romaine lettuce is the source of this outbreak, and whether romaine lettuce served at Wendy’s restaurants was served or sold at other companies.” And the agency notes that it “is not recommend that people not eat at Wendy’s restaurants or that people stop eating romaine lettuce.”
But, E coli-contaminated romaine wouldn’t be a surprising confirmation. Lettuce – and salads in general – have been the cause of a series of similar outbreaks in recent years. And while it’s not always clear exactly how the gut bacteria get into lettuce, the culprit is often manure contamination from livestock in fields.
Shiga toxin-producing E coli are shed from the entrails of animals, especially cattle. In a traceback study of a 2018 E coli outbreak with contaminated romaine lettuce, researchers concluded that manure runoff from an upstream, densely populated livestock farm of more than 100,000 cows contaminated canal water that may have been used to irrigate lettuce crops. That 2018 outbreak sickened at least 210 people in 36 states, sent 96 to hospitals, caused kidney failure in 27 and killed five.
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