CDC Food Safety Alert: E. Coli Outbreak Linked to Romaine Lettuce | Hacker News Reader

CDC Food Safety Alert: E. Coli Outbreak Linked to Romaine Lettuce

cdc.gov

148 pointssycdan89 comments

It seems like no one learned anything after the last one 5 months ago: https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html

IIRC the first outbreak was from farmers in Yuma watering their fields with water that had been contaminated by runoff from a large cattle farm upstream.

(The article says the two aren't related, but it seems like more than a coincidence unless romaine lettuce is more succeptible to contracting and retaining e. coli somehow..)

Consumer Reports had a more thorough article than the short write up by the CDC. I find it frustrating the CDC blanket points the fjnger at lettuce without disclosing root cause. People confuse the fact that plants are not the source, animal feces is (most likely in this case). Just as s it was last time...

https://www.consumerreports.org/food-safety/what-growers-are...

The CDC is saying to avoid romaine lettuce until we learn more about the outbreak, with a promise to update the advice as more information becomes available.

That seems quite an appropriate way to proceed and does not imply that the lettuce itself is the cause.

The way it is presented gives zero background and conflates the issue. You realize the CDC did this last year as well? Did you hear about it? Probably not.

It's also interesting there is little to no showcase if the turkey issue right before US Thanksgiving: https://www.nola.com/news/2018/11/just-in-time-for-thanksgiv...

> I find it frustrating the CDC blanket points the fjnger at lettuce without disclosing root cause.

Uh, they disclose the root cause, the specific strain of STEC.

You are upset they aren't highlighting an intermediate level between the root cause and the actual actionable consumer information.

More that people will form the wrong conclusion - vegetables are naturally prone to e. coli - because they didn't point out that thus had to come from an outside source.

No need to speculate if we've not nailed which source, but we can _highlight_ the current lack of actionable info rather than let people assume one.

CDC alerts have a fairly narrow, action-driving purpose; every extraneous word increases the number of people that tune it out, with negative public health consequences.

Complaining that they aren't adding information that—true as it is—is irrelevant to the task at hand to the alert is, quite literally, asking to make the immediate public health issue worse, and for more people to die.

But it's still correct to be wary of plants, the fact that you typically eat them raw makes them the most common source of infection.

Plant based infection ranks highly because of the risks from rice, and those risks are present even if you cook it correctly and properly reheat left-overs.

Growing lettuce in your garden bears very few risks. Buying lettuce from a store also carriers very free risks if you know the source. Plants are significantly less risk than any red meat or white meat.

The way the CDC presents this makes it appear, to the uniformed, that this is a plant borne illness - of which it is not. It's almost certain it is human created through misuse of fecal matter disposal or fertilizer.

You're missing the point.

You cook meat the vast majority of the time. This massively reduces the risk of foodborne illness.

Lettuce on the other hand, is eaten raw. As a sibling comment mentioned, at best lettuce gets a rinse, if that.

So while the source isn't actually the lettuce itself, lettuce is the perfect carrier. This is why produce is the source of half of US food poisonings, while meat and poultry only cause 22[0]. You can get pedantic about the original source, but from the end consumer's perspective this does not matter one iota. It doesn't really matter much whether or not the ecoli on your lettuce grew there, or was deposited by cow feces, it matters that there's ecoli on your freaking lettuce.

0. https://www.vox.com/2015/3/6/8158289/food-poisoning

I'm not missing the point at all because it's highly unlikely that home food prep adequately cooks food. It's a well known fact more people take on risk of eating undercooked meat and shellfish by choice. And this is part of my original point. You're conflating things that aren't true because of a failure to understand the root cause.

Maybe this can help you educate yourself: http://extension.colostate.edu/topic-areas/nutrition-food-sa...

Ecoli doesn't "grow" on food as you claim. I think you're missing substantial understanding of the subject matter. And your source? Far taken out of context. Try recent findings from historical data compilation by the CDC in 2018:

https://www.cdc.gov/mmwr/volumes/67/ss/ss6710a1.htm

So, your statistic is wrong as of latest compilation of CDC data.

"Amongst 1,281 outbreaks in which the food reported could be classified into a single food category, fish were the most commonly implicated category (222 outbreaks [17%]), followed by dairy (136 [11%]) and chicken (123 [10%]). The food categories responsible for the most outbreak-associated illnesses were chicken (3,114 illnesses [12%]), pork (2,670 [10%]), and seeded vegetables (2,572 [10%]). Multistate outbreaks comprised only 3% of all outbreaks reported but accounted for 11% of illnesses, 34% of hospitalizations, and 54% of deaths."

Again - what you cited is not true.

And a quick overview of common contaminants linked to foods - you'll find meats most prevalent and cross contamination by meats to other foods as the highest risk:

https://www.mayoclinic.org/diseases-conditions/food-poisonin...

That may be true, but people also know there’s generally a risk to eating undercooked meat. Restaurants and food products tell you, if you undercook this, you might get sick. People don’t assume there’s a risk to eating lettuce.

I am pretty much always going to throw a cut of meat on the grill or in a pan on the stove. This action brings the food up to a temperature where it tends to kill/denature a lot of the bad bugs in the food.

I'm likely to just rinse off an apple or lettuce, which may or may not successfully clean the food.

This action brings the food up to a temperature where it tends to kill/denature a lot of the bad bugs in the food.

Unfortunately that's not enough, because cooking temperatures don't always denature the toxins that the bugs produce, which is what the real problems come from.

While true, for the most part toxic subsistences won't build up to dangerous levels before the food reaches a point where it is obviously spoiled. The problem with E. Coli is that it starts self-reproducing in your gut, so even a small dose can turn deadly over time. This is also why simple washing is not always sufficient, as it can be difficult to completely eradicate a biofilm on a delicate leaf without destroying the food in the process.

> Unfortunately that's not enough, because cooking temperatures don't always denature the toxins that the bugs produce, which is what the real problems come from.

Isn't the problem that the "bugs" produce the toxins while thriving inside your body? If you kill them through cooking, they won't be producing anything while inside you when dead.

This problem is most commonly found in rice.

Cooking the rice doesn't kiil the bugs. Not chilling the rice quickly enough allows the bugs to produce toxins. Reheating the rice doesn't destroy the toxin.

https://www.nhs.uk/common-health-questions/food-and-diet/can...

>This action brings the food up to a temperature where it tends to kill/denature a lot of the bad bugs in the food.

That action may bring it up to a safe temperature. The fact that people die from e. coli poisoning from undercooked meat all the time shows that this is not foolproof.

>I'm likely to just rinse off an apple or lettuce, which may or may not successfully clean the food.

Which is an absolute non-issue if that food hasn't been sprayed with feces in the first place, as the parent poster pointed out. You can't get e. coli from unwashed vegetables unless someone has sprayed animal (including human) feces on it first.

"Tends to kill". So you're saying you always cook all meats at or above recommended internal temperatures? Most people don't enjoy meat overcooked / well done - and that is the conflicting reference point here. Do you eat your steak even medium-well? Then it's not guaranteed to be free from food borne illness and not cooked according to safe food handling instructions by said CDC.

Apples are far less likely to ever carry pathogens because they're harvested from a tree, off the ground and tree farms are not fertilized with feces. And even if they are in proximity you're failing to understand that if a tree has a contaminated water source the entire tree acts as a filter prior to the fruit - a lettuce does not.

Again, misinformation and misunderstanding of the root cause showcase highly in your comment which was my criticism of the original disclosure by the CDC.

Even well done steak is not guaranteed to be free of food borne illness. You really need to know two variables - temperature and time, and one objective - kill rate. Time is the reason that it is safer to eat a sous vide rare pork chop than a grilled rare pork chop.

Also, it’s far more delicious that way.

Isn't it more susceptible? The structure of Romaine is such that contaminants can fairly easily get "inside", but are not easily washed away.

The way the leaves are bunched together makes it hard to clean. And secondly it is not cooked before eating.

That's a property of most (all?) lettuces, but here we are with two romaine-related instances in 5 months.

Interestingly enough, bean sprouts are eaten raw, are not (thoroughly) cleaned before eating, and must be, by definition, held at an unsafe temperature to sprout.

They also cause a bunch of foodborne illness. I think it's a pretty clear connection.

I blanch bean sprouts before freezing them for storage and then toss them in something I’m frying or boiling. Seems to work for me.

So you eat them not raw.

I might toss a few onto something I’m having by chance right then but I typically by them in advance of when I need them and don’t want to have them rot in the fridge

Sure, but why not other types of lettuce like red leaf lettuce, green leaf lettuce, iceberg lettuce, or butter lettuce?

Apparently Romaine is grown in exactly two places, one for summer and one for winter.

I believe the word 'regions' would be more appropriate.

Planet Money just did an episode on this issue which ended with the opinion that it was highly likely to happen again, guess they were right.

https://www.npr.org/sections/money/2018/08/24/641739640/epis...

The other day, my wife introduced me to yet another difference between Chinese cuisine and US cuisine: She cooked the Romaine lettuce she got from her coworker. She just cooked it like you'd cook Bok Choy. It was quite good!

My wife also rinses everything we get from the store. No one is to be trusted with your family's food. Absolutely everything is rinsed, including things most Americans would really rather not. One day, I had to work a bit to convince her to not rinse the steel cut oats!

>Absolutely everything is rinsed

Don't rinse raw meat. It makes things worse!

https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety...

Spoilers: Its not making things worse. It just provides an avenue for cross contamination, which you should be accounting for when preparing meat anyways.

In my experience, it makes the roasted meat worse. A lot of roasted meat works better if you dry out the outer layers with salt. Rinsing does the opposite.

I mean, unless I'm eating it completely raw (where is hope to practically know the cow by name) then washing the outside before cooking it seems like a complete waste of time.

The thought was to do it prior to seasoning to provide better coverage (after drying). Recipes switched to having you just pat the meat dry with paper towels to avoid the cross contamination vector.

Many restaurants in China serve cooked lettuce as a side, I found it quite odd at first but it's really tasty and with some soy sauce easy to eat by itself. Cooking lettuce in the western world will probably raise a few eyebrows.

I’ve gone to a few restaurants in the US that do a cooked version of a caesar salad that’s quite good. I’ve made it myself, too. Grill whole heads of romaine until they’re blackened and wilting, then dress and shave parmesean on them.

Well ... don’t do that now, I guess. But once the red alert is over, it’s pretty tasty.

Gordon Ramsay has something to say about cooked salads, and it’s hilarious.

I'm used to eating cooked collards, mustard greens, turnip greens, spinach, and kale but I don't know why it has never crossed my mind you could do the same with something like romaine or lettuce. I imagine it wouldn't be too different.

I’ve halved romaine lettuce and grilled it before with olive oil, salt and pepper topped with a light Vinaigrette. Quite tastey but difficult to grill. I’ve done it twice.

My wife’s eyebrows were raised both times. She thought it was weird but didn’t think it tasted bad.

It's a pretty standard hot pot ingredient in the U.S.

Rinsing is good at /gorse/ cleaning, getting the really big obvious, bad to chew, things off.

The cooking is the part that actually sanitizes the food.

A soup of puréed romaine is quite good as well.

I always cut and rinse lettuce, is that uncommon? Sounds interesting. I need to try stir frying romaine.

You can't rinse off what's physically inside the plant.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404196/

You took that comment out of context. The parent implied that it was unusual for people to cut and rinse vegetables (I was replying it was not unusual for me). I never said that would resolve the E. Coli problem.

Reminder that if you're getting your lettuce from a local farm at the farmers market, you probably don't have to worry about this. This outbreak is from some industrial romaine lettuce growing and processing operation.

(Yes, it's possible for local produce to be contaminated with E. coli as well. I have no idea if it's more or less likely on average. But it shouldn't be involved in this outbreak, so go ahead and make your salad.)

Be sure you actually know this local farm is real. Lots of stalls at farmer's markets are just buying the same produce as grocery stores and selling it at a higher price while lying about where it came from.

http://www.tampabay.com/projects/2016/food/farm-to-fable/far...

https://www.cbc.ca/news/business/farmers-markets-lies-market...

If people are wondering why vegetables can be infected with something like E. Coli, the reason is that animal waste is often used as fertilizer, or animals live near the crop's water supply and then gets sprayed all over the vegetable crops.

It's not just animal waste. http://time.com/3974244/cilantro-feces/

To be fair, humans are animals. But yes, waste from human and non-human animals have contaminated crops throughout history.

It seems like this happens all the time. I really wonder what the implications of this will be to companies like Chipotle, who use Romaine Lettuce exclusively. Personally, I am more of a fan of Iceberg, but it just makes me wonder why E. Coli is much more common in Romaine than in Iceberg. Any thoughts?

> wonder why E. Coli is much more common in Romaine than in Iceberg. Any thoughts?

Romain grows in sprouts while iceberg grows round, effectively in its own shell

> Personally, I am more of a fan of Iceberg,

The U.S. shifted from Iceberg to more Romaine as a way to have more flavor, nutrition in their lettuce than mostly water.

Is there a reason that Chipotle doesn't just switch to some other type of lettuce? Surely the minor difference in what's essentially a filler ingredient doesn't compare to the financial loss that yet another e.coli outbreak with Chipotle's name on it would incur.

Would other types of lettuce be any less susceptible to E. coli?

IIRC the past few outbreaks have only been for romaine lettuce. Iceberg and green leaf seem to be have relatively fewer incidents, though I'm not sure if this is due to something about the supply source, the way it's used, or the way it's grown.

My guess is that more folds make it harder to clean properly.

I wonder if there could be a good tech solution where lettuce samples would be tested s part of the packaging pipeline.

I think the fundamental problem is that these bacteria are detected by growing a sample, which takes a day or longer.

Forcing workers to drag a "porta potty" through lettuce fields so farmers don't have to pay for the restroom breaks could be causing this.

http://crownservicesco.com/wp-content/uploads/2016/09/Ag-and...

If I was a farm worker I wouldn't be too upset about not having to go perhaps a long ways to use a restroom and be able to clean my hands afterwards.

If you were a farm worker who was paid piece rates rather than hourly, you might be less happy about that

Why? Not having to walk across a field saves them time, so they can spend more time harvesting, so they make more money.

Outrage notwithstanding, the last couple of these have been caused by water contaminated with animal feces.

Lettuce grows outdoors, in the soil. Animals have access to it for weeks or months. Dust happens around it. It is quite likely sprayed with fertilizer or pesticide at some point. Then it is cut by hand. Then it goes to the store where it is fondled by employees and the passing public.

So it's a good idea to wash it (and all produce) very thoroughly and not depend on some process to clean if for you. That means in the case of lettuce separating the leaves. It might be overkill but I usually put a drop or two of bleach in wash water, dunk chopped greens, rinse them well in clean water, then spin them in a centrifugal spinner. Something like this (these things are great) https://www.amazon.com/OXO-Good-Grips-Salad-Spinner/dp/B0000...

Also they sell specific vegetable washes although a little bleach or hydrogen peroxide works well enough for me. Generally I don't eat raw produce at restaurants.

For the record, I worked on a lettuce farm years ago and food safety is very important, but it's a mass produced out door farm operation with manual handling of product. To say nothing of transport and retail. It's better to wash things yourself and be sure. I think in many parts of the world this is better understood, but for some reason in the US we have this disembodied view of where food comes from.

Tens of millions of people shouldn't eat Romaine lettuce because 30 people got sick in October?

Well you can if you want

Not really. Just got back from some holiday grocery shopping and in all 3 stores I've been to the clerks were removing the romaine from the shelves. That's how I found out about this.

I had the unfortunate luck of reading the breaking news as I was eating a caesar salad at a restaurant. The restaurant didn't seem to be aware of the news.

I guess you were also for people carrying phone bombs (Note 7) in their pockets?

In order to prevent additional illness.

There are about 100 deaths from car accidents each day and there’s no ban on driving.

Yep, that about sums it up.

The offending strain in both the current outbreak, and a major outbreak in June, is E. coli O157:H7, which is a less common strain typically associated with cattle or other livestock.[1] CDC analysis (also helpfully linked by craftyguy) of the previous outbreak of this strain, which hospitalized or killed people in 36 states, found that the source was contaminated canal water used for irrigation near Yuma AZ.[2] A large CAFO (Confined Animal Feeding Operation) exists upstream nearby.[3] You can see it from space in satellite imagery. It is interesting to view the orientation of this CAFO to Gila River, and to zoom in to the level of individual cattle to get a sense of it's scale and topographic orientation.

Determining the source of water contamination is outside of the scope of office of CDC. EPA is responsible for this, but I can find no evidence of investigation of the source canal contamination. Perhaps EPA is becoming more “business friendly.”

[1] https://en.wikipedia.org /wiki/Escherichia_coli_O157:H7#Natural_habitat

[2] https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html

[3] https://www.google.com/maps/place/McElhaney+Cattle+Company/@...

Edit: FDA published an environmental assessment on Nov. 1. They also attributed contaminated canal water as a possible cause. That assessment included "limited" samples (I can't figure out what kind of samples) from the CAFO, which found no matching e coli strain. The authors state that the assessment occurred several weeks after the growing season ended.

"It is uncertain how the outbreak strain of E. coli O157:H7 was introduced into this 3.5-mile stretch of irrigation canal water. The first illnesses in this outbreak occurred in March 2018, and therefore the outbreak strain may have been present in the irrigation canal months before the EA team collected the positive samples, or the outbreak strain may have been repeatedly introduced into the irrigation canal. A large concentrated animal feeding operation (CAFO) is located adjacent to this stretch of the irrigation canal. The EA team did not identify an obvious route for contamination of the irrigation canal from this facility; in addition, the limited number of samples collected at the CAFO also did not yield the outbreak strain. Other possible explanations for how the irrigation canal became contaminated are possible, but the EA team found no evidence in support of alternative explanations.

Growers suggested weather events in the Yuma growing region may have contributed to crop contamination. The EA team considered the possibility that leaf freeze damage and dew on romaine leaves created conditions favorable for windborne contamination of the crop with dust carrying the outbreak strain of E. coli O157:H7. While this type of STEC contamination has been demonstrated (Berry et. al, 2015), it does not explain the presence of the outbreak strain in a free-flowing irrigation canal months later when there was little wind in the region."

https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbrea...

Long to short, the "pollution" from large scale factory animal farming is poisoning the downstream vegetable farming. Is that it?

Given the disconnect between the FDA and the EPA can't the CDC step in? Is there no authority at the state level?

I don't know. Evidence is inconclusive, but suggestive.

I'm throwing out my lettuce like CDC told me to, but I woundn't go pointing fingers on twitter just yet. :)

Well, we do know that in this case shit __doesn't__ just happen. The sources has to be from somewhere. And we do know factory animal farms have plenty of unsavoury byproducts.

I agree. Can't jump to conclusions. Even so, if feels like a preventable accident that's eventually going to happen (if it hasn't done so already). The ag industry is a strong lobby. Given that those animals need feed there's a clear incentive for all involved to keep the truth from coming out.

Is anyone on our side here in a world where ag-gag laws exist?

Same strain in spinach back in 2006 as well.

https://en.wikipedia.org/wiki/2006_North_American_E._coli_O1...

http://www.washingtonpost.com/wp-dyn/content/article/2006/09...

We really need a way to quickly test if a sample of anything is contaminated with these common pathogens prior to raw consumption at home.

Wash (obviously) discard any damaged leaves, use plenty of vinegar in dressing, vinegar is quite effective at killing bacteria, balsamic is best, salt, sugar, lemon juice also kill em.

Romaine lettuce is less nutritious, more expensive and make you fart more than spinach. The last part is what made me stop buying Romaine for good.

Its always the lettuce!

Again?

just soak your fresh vegies in 10% bleach and you will be fine

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