Two King County siblings, both under age 5, have been diagnosed with E. coli 0157:H7 infections that genetically match the ongoing national outbreak linked to romaine lettuce.  One child was hospitalized and has since been discharged. Both children have recovered and neither child developed hemolytic uremic syndrome (HUS), a type of kidney failure that can result from an E. coli infection.

Public Health’s disease investigators are currently working to identify the exact source of the E. coli exposure and suspect romaine lettuce as a potential source but it is not yet confirmed. Other members of the family ate romaine lettuce and were also ill but were not tested for E. coli.  It is possible that the children contracted the illness from other ill family members rather than from eating romaine lettuce. The family reported that they have not traveled out of state recently, suggesting that the family’s exposure to E. coli was local.

An additional case of E. coli linked to the national outbreak was found in a King County resident in her 50s who had eaten romaine lettuce while traveling out of state.

 Connection to national outbreak

The national outbreak related to romaine lettuce has been ongoing since mid-March. The infections in these two siblings appear to be the first locally acquired cases. As of April 26, 98 people ill from a matching E. coli 0157:H7 infection have been reported from 22 states. The Centers for Disease Control and Prevention (CDC) and the Food Drug Administration (FDA) have been looking into these cases and so far, the information indicates that romaine lettuce from the Yuma, Arizona growing region could be contaminated and make people sick.

Consumer advice about romaine lettuce

The CDC has issued advice to protect consumers:

•  Avoid all romaine lettuce from the Yuma, Arizona growing region, including whole heads and hearts of romaine lettuce, chopped romaine, and salads and salad mixes containing romaine lettuce.
• Do not eat or buy romaine lettuce unless you can confirm it is not from the Yuma, Arizona, growing region.
• Product labels often do not identify growing regions, so don’t eat or buy it if you don’t know where it was grown. If you do not know if the lettuce is romaine, do not eat it.

Symptoms of E. coli

Talk to your healthcare provider if you have symptoms of an E. coli infection: diarrhea that can be bloody, severe stomach cramps, and vomiting. Anyone who is ill with suspected E. coli should not work in food handling, patient care, or child care settings. Ill children with suspected E. coli should not attend daycare until they have seen a healthcare provider and been tested for E. coli infection even if their illness is mild.

What do restaurants and retailers need to do?

Retailers, restaurants, and other food service operators should not sell or serve any romaine lettuce from the winter growing areas in Yuma, Arizona. This includes whole heads and hearts of romaine, chopped romaine, baby romaine, organic romaine, and salads and salad mixes containing romaine lettuce. If you cannot verify the source of your romaine lettuce, do not sell or serve it.

Food workers should always take steps to avoid the cross contamination of cutting surfaces and utensils through contact with potentially contaminated products. As a reminder, follow these precautions:

• Regularly wash, rinse and sanitize display cases, cutting boards, refrigerators, and other food contact surfaces where potentially contaminated products were stored in order to avoid cross contamination of surfaces.
• Wash hands with hot water and soap following the cleaning and sanitation process.
• Always wash all leafy greens (e.g., romaine lettuce) with water thoroughly with water before use.
• Always store cut leafy greens in refrigerator under temperature control 41ºF or below.

If you have questions please call the Public Health – Seattle & King County at 206-263-9566. Learn more about recommendations for restaurants and retailers.

More information

For more about the national outbreak, visit the CDC’s webpage.

For more on E.coli, visit Public Health’s webpage on shiga-toxin producing E. coli.