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E. coli Outbreak from Romaine Lettuce Discloses Deficiencies in Traceability

04/29/2018

Epidemiologists are frustrated by the absence of traceability documentation in their investigation of the source(s) of an outbreak of E. coli O157:H7 with severe complications.  To date over 100 patients have been diagnosed in 22 states. More than half the cases have required hospital treatment with 10 developing kidney failure.

 

All that the CDC and health authorities can offer in the way of advice to prevent the condition is to refrain from eating Romaine lettuce derived from the Yuma Valley in Arizona. This based on retrospective surveys disclosing that all but eight patients ate chopped Romaine lettuce in restaurant or home-prepared salads prior to onset of symptoms. The eight cases in a prison in Alaska consumed Romaine lettuce from a specific farm near Yuma. Investigations to confirm the presence of the outbreak strain on this unit and from neighboring area farms are in progress. The outbreak was first identified during the first week of April.  New supplies of lettuce should now be sourced from California. Incident cases are expected over the next two weeks until lettuce from the Yuma area is removed from the supply chain

 

Following the 2006 outbreak of E.coli due to contaminated leaf spinach the produce industry established a traceability initiative. Growers and intermediates in the supply chain have not adopted the system as an industry. Apparently the cost of labels, non-standardization of recordkeeping and disinclination to innovate have served as barriers to application of traceback. Successive, and in some cases extensive, outbreaks of foodborne disease attributed to produce and uncooked foods cries out for application of blockchain technology.

 

Contrary to the situation in the U.S. egg production industry there is no identification of green produce and many other uncooked foods, complicating the identification of potential sources of infection.  A specific restaurant chain in New Jersey was identified as the immediate source of infection of some patients and traceback to a distribution center in Ohio was established. Tracing further back the chain becomes murky with multiple distribution channels consistent with the extent of the outbreak.  A spokesperson with the FDA stated, “We are tracing back from multiple groupings of people reported ill that are located in diverse geographic areas.  The reason for this is to avoid redundant distribution channels that converge on a single source of grower.

 

The CDC efforts to identify cases through reporting systems appears to have functioned well. The ability of the FDA to mount an intensive and rapid field investigation is questioned. This outbreak and similar episodes suggest that consumers could be best served by a single comprehensive food safety agency analogous to the EPA with scientific and field operatives trained in prevention, investigation and suppression of foodborne disease.