Romaine Outbreak: What Restaurants Need to Know

The U.S. Food and Drug Administration, the Centers for Disease Control and Prevention (CDC), along with state and local partners, are investigating a multistate outbreak of E. coli O157:H7 likely linked to romaine lettuce.

At this time, the FDA recommends that consumers do not eat romaine lettuce and discard any product until we know more. Retailers, restaurants and other food service operators should not serve romaine lettuce until more is known about this outbreak. If consumers are experiencing symptoms of an E. coli O157:H7 infection, they should immediately seek the care of a health care professional.

Federal health officials are working on gathering information and tracing back romaine lettuce reportedly consumed by people located in various parts of the country who became ill with E. coliO157:H7 to determine the source of contamination. U.S. agencies are also coordinating with the Public Health Agency of Canada (PHAC), which is also investigating a similar outbreak in Canada and providing similar advice to Canadian consumers. While the strain of E. coli O157:H7 seen in this outbreak is different than the one identified in the large outbreak in Spring 2018 linked to romaine from the Yuma growing region, it does appear to be similar to the strain that caused a smaller outbreak linked to leafy greens that occurred in the fall of 2017 in both the U.S. and Canada. Since these prior outbreaks were identified, the FDA has been working closely with the leafy greens industry and other state and federal partners to implement safety practices that can help further reduce the risk of these types of outbreaks. As a direct response to the outbreaks we have seen, the agency will also begin a special effort to sample and test romaine lettuce for contamination throughout the market.

Retailers, restaurants and other food service operators should not serve romaine lettuce until more is known about this outbreak.

"The quick and aggressive steps we're taking today are aimed at making sure we get ahead of this emerging outbreak, to reduce risk to consumers, and to help people protect themselves and their families from this foodborne illness outbreak. This is especially important ahead of the Thanksgiving holiday, when people will be sitting down for family meals. We want to get this information out to consumers early. While we've made progress, it's still early in this investigation and work remains to pinpoint the source of contamination that contributed to this outbreak and allow us to employ more targeted measures to reduce future risk," said FDA Commissioner Scott Gottlieb, M.D. "While we don't have enough traceback information to request a recall from specific suppliers, we're working to prevent unnecessary foodborne illness. Consumers can avoid eating and discard any romaine lettuce. Industry can also contribute greatly to containing and stopping this outbreak by voluntarily withdrawing any romaine products from the market and by withholding the distribution of romaine until we can ensure the outbreak is over or we can identify a specific source of contamination. This isn't the first romaine outbreak we have seen in the recent past, and we will continue to take steps to identify the root causes of these events and take action to prevent future outbreaks. We're committed to working with our partners to implement additional safety practices so that we'll be better positioned to prevent outbreaks like this from occurring. In the meantime, we'll continue to take action around this outbreak to help protect American consumers from eating potentially contaminated romaine lettuce as our current investigation unfolds."

Michael Droke, a partner at the international law firm Dorsey & Whitney devoted to the areas of agriculture and cooperative law, and in the food and agriculture industries, said a recall of this magnitude especially during the holiday week will impact not only romaine, but other leafy green vegetables such as spinach. Retailers will be pulling romaine and possibly all other lettuce/leafy greens from their shelves (a process called quarantining) until the source is found. Droke says while this recall appears to be voluntary, the FDA's mandatory recall authority it was given this month under the Food Safety Modernization Act (FSMA) is an additional nudge for retailers to move swiftly on their own.

"The Food Safety Modernization Act (FSMA) overhauled the nation’s food safety systems for the first time in over a generation," said Drake. "Among other changes, the food safety law gave the Federal Food and Drug Administration (FDA) mandatory recall authority for foods if there is a reasonable probability that the food is adulterated or misbranded, and that the food could cause serious illnesses or death.  Put another way, the FDA was given authority to force a recall even if the retailer, supplier, or producer wanted to avoid it.  The FDA must allow the responsible party to conduct a voluntary recall before ordering a mandatory recall.  Prior to the FSMA, the FDA could only rely on manufacturers to voluntarily recall certain potentially harmful food products."

"The FSMA mandatory recall authority gives teeth to the FDA’s enforcement right.  This agency's guidance helps employers understand when that authority will be used, and will encourage companies to voluntary recall products to avoid a mandatory sanction.  Food and ingredient companies should prepare in advance for the need to recall their products to minimize the risk of a mandatory order," Droke said.. 

Consumers are at greater risk for foodborne illness eating a fresh salad than if they ordered a burgers and fries.

In a recent Modern Restaurant Management (MRM) magazine article, Aaron Cohen,  Co-Founder and VP of Business Development, CoInspect, noted that the demand for fresher foods is a big reason that we’ve seen such a huge increase in foodborne illnesses at restaurants recently. While produce and other fresh foods are healthier for consumers to eat, they (unfortunately)

carry more food safety risk.

"People are eating healthier, but are getting food poisoning more frequently," he wrote. "Consumers are at greater risk for foodborne illness eating a fresh salad than if they ordered a burgers and fries. Since spring 2018, there have been multiple, widespread contamination issues (and subsequent recalls) around produce at restaurants and retailers. Adding to the problem: fresh produce has more stops along the supply chain, which means more opportunities for contamination." He also offered a number of food safety protocols restaurants should follow. 

A group of produce industry associations  is relying on producers and retail/restaurant customers to support the government health agency advisories and is urging an industry-wide voluntary withdrawal of all romaine currently in marketing channels and held in inventory.

The associations include:

• Arizona Leafy Greens Marketing Agreement
• California Leafy Greens Marketing Agreement
• Produce Marketing Association
• United Fresh Produce Association
• Western Growers
• Yuma Safe Produce Council
• Yuma Fresh Vegetable Association

In a statement, they said:

"We believe a withdrawal of romaine lettuce is the fastest way to clear up the supply chain of any romaine that could be responsible for illnesses and to make a hard, convincing and clean break from harvesting and shipping romaine lettuce until this outbreak is declared over or the source of the implicated produce can be identified. Additionally, we are calling on handlers to clean and sanitize any equipment that may have been used in recent weeks to prevent cross-contamination of product during future harvest, processing and distribution activities.In order to be sure that any romaine lettuce that may have been responsible for illnesses is completely gone, we are urging full compliance with the government’s request for a voluntary withdrawal of all romaine."

"A group of food safety experts from the produce industry is coming together as quickly as possible to closely examine information that may help pinpoint the specific source of the outbreak utilizing the extensive traceback information maintained by leafy greens producers. The goal of this effort is to learn any information about the geographic region or specific farms that may be tied to this outbreak. Government agencies have indicated the E. coli isolate involved in this outbreak has been closely related by Whole Genome Sequencing data to two past outbreaks linked to leafy greens in 2016 and 2017."

"No one wants to get to the bottom of how these outbreaks are occurring faster than the producers of leafy greens. We absolutely must do everything possible to stop recurring outbreaks. We owe this to those whose lives have been tragically impacted by this outbreak and to all our consumers who trust us to grow safe food for their families. It should be noted this outbreak and the consumer advisories are limited to romaine lettuce only and do not impact other leafy greens products such as iceberg, green leaf or spinach."

Arizona Leafy Greens Marketing Agreement
California Leafy Greens Marketing Agreement
Produce Marketing Association
United Fresh Produce Association
Western Growers
Yuma Safe Produce Council
Yuma Fresh Vegetable Association

Anyone with questions about food safety can call the FDA at 1-888-SAFEFOOD or consult the FDA's website.