BISMARCK, N.D. – The North Dakota Department of Health (NDDoH) reports North Dakota’s first case of E. coli infection associated with romaine lettuce originating from the Yuma, Arizona growing region. The NDDoH has been working with the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and other state and local health officials in this national investigation. A second case in ND possibly associated with the outbreak is still under investigation.
“The FDA has stated they cannot be certain that romaine lettuce from the Yuma region is no longer in the supply chain due to the 21-day shelf life,” said Laura Cronquist, epidemiologist with the NDDoH. “Food service establishments and retailers should not sell or serve any romaine lettuce, including chopped, whole heads or hearts, that originate from Yuma, Arizona. Consumers should not eat or buy romaine lettuce unless they can confirm it is not from the Yuma growing region.”
To reduce the risk of a E. coli infection, people should:
• Wash fresh produce before consuming it.
• Cook foods to the correct temperature.
• Avoid cross-contamination by keeping ready to eat foods separate from raw meats and poultry.
• Use separate cutting boards for fresh produce and raw meats and poultry.
• Clean and disinfect food preparation work surfaces.
• Wash hands with soap and running water before preparing food, after handling raw meats, and after using the bathroom or changing diapers.
The most common symptoms of E. coli include diarrhea, bloody diarrhea, abdominal pain, nausea and vomiting. Symptoms typically begin three to four days after exposure to the bacteria, but can take as long as 10 days. Treatment with antibiotics is not recommended. Most cases resolve on their own, but severe cases and cases involving complications may require hospitalization. The CDC estimates that around 5-10 percent of people with E. coli infections develop a complication known as hemolytic uremic syndrome (HUS), which affects the red blood cells and can cause kidney failure. Although anyone can develop HUS, this complication is more likely to occur in younger children, older adults, and those with impaired immune systems or other underlying health conditions. Indications that a person may be developing HUS include, decreased frequency of urination, feeling very tired, and loss of pink color in cheeks and inside the lower eyelids.
As of May 2, 121 cases from 25 states have been reported to the CDC, not including the case from North Dakota, which will be added to the outbreak summary in the next update. Fifty-two cases have been hospitalized and there has been one death. Cases range in age from 1 to 88 years, with a median age of 29.
To learn more about the outbreak of E. coli infections linked to romaine lettuce, please visit the CDC’s website at www.cdc.gov/ecoli/2018/o157h7-04-18/index.html or contact Laura Cronquist, North Dakota Department of Health, at 701.328.2378.