What You Need to Know

Over the past several weeks Americans have been warned against eating romaine lettuce due to associated foodborne illness outbreaks. Romaine lettuce grown in the Yuma, Arizona area was found to be contaminated with Escherichia coli (E. coli). A report from May 15, 2018 showed that 172 people were infected with E. coli 0157:H7, a Shiga-toxin producing E. coli (STEC) strain, from 32 states, with one related death in California.  

The most common germs that cause foodborne illness in the United States are norovirus, Salmonella, Clostridium perfingens, Campylobacter, and Staphylococcus aureus. E. coli is a bacterium that causes fewer, but more serious foodborne diseases which often requires hospitalization. Older adults, pregnant women, young children, and immunocompromised persons are at greatest risk. Common presenting symptoms include nausea, vomiting, watery or bloody diarrhea, moderate to severe abdominal cramps, and occasionally low-grade fever.

Diagnosis is made based on patient history, physical exam, and stool culture. Clinicians should avoid prescribing antibiotics until E. coli 0157:H7 is ruled out, as these medications significantly increase the risk of hemolytic uremic syndrome (HUS) in infected persons.  

Read more about food poisoning here:

Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e >  Chapter 159: Food and Waterborne Illnesses

Harrison’s Principles of Internal Medicine, 19e> Chapter 160: Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning

Centers for Disease Control and Prevention: Multistate Outbreak of E. coli 0157:H7 Infections Linked to Romaine Lettuce