Image copyright AFP/Getty Image caption No clear source for the outbreak has yet been identified

Five people have now died in a major E. coli outbreak in the US involving romaine lettuce, with 197 cases reported across 35 states.

The Centers for Disease Control and Prevention (CDC) said 25 more people had been affected since its last report on 16 May.

Two of the victims were from Minnesota, with the other three from Arkansas, California and New York.

It is the largest US outbreak of E. coli since 200 people fell ill in 2006.

According to the latest statement from the CDC, many of the people affected fell ill two to three weeks ago, when the contaminated lettuce was still on shop shelves.

Romaine lettuce from the Yuma growing region in Arizona is thought to be the source of the latest outbreak, although the Food and Drug Administration says no single grower, distributor or region can account for the spread.

An investigation is ongoing.

The CDC said that some of the affected people had not eaten lettuce, but had contact with others who had fallen ill.

When eaten, it can cause diarrhoea, vomiting and even kidney failure in severe cases.

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Of the infected people, 89 have been hospitalised, and 26 have developed a kidney failure type known as hemolytic uremic syndrome.

Canada's Public Health Agency has also recorded six cases of E. coli "with a similar genetic fingerprint" to the US infections.

The E. coli outbreak began in April and has spread across the US.

California and Pennsylvania are recording the most cases.</s>The mysterious E. coli outbreak linked to romaine lettuce is not over just yet, with four additional deaths and dozens of new cases, the CDC announced Friday.

So far, a total of 197 people have gotten sick and five people have died after becoming infected with E. coli O157:H7, according to the most recent update from the US Centers for Disease Control and Prevention (CDC), which was published on Friday. Since the last case count on May 16, four more deaths were reported — these were in Arkansas, California, Minnesota, and New York. There were also 25 additional cases reported and the outbreak now spans across 35 states.

However, most of the new cases are people who got sick two or three weeks ago, when the contaminated romaine lettuce was still available for sale and in people's homes, the CDC reported. There can be a lag in reporting these cases and deaths to the CDC from local health departments. A portion of the people who became sick did not report eating any romaine lettuce, but instead came into direct contact or cared for someone who was sick with E. coli.

Escherichia coli (E. coli) are bacteria commonly found in the digestive tracts of humans and animals. Most types of E. coli are harmless, but some strains are pathogenic, meaning they can cause diarrhea or other illnesses. The strain in this outbreak is called E. coli O157:H7 and it's particularly bad because the bacteria produce a potentially life-threatening toxin. These toxin-carrying bacteria are called Shiga toxin-producing E. coli, or STEC.

Most strains cause severe diarrhea and cramping, but some can cause urinary tract infections, respiratory illness and pneumonia, and kidney problems, according to the CDC. You can get exposed to E. coli from contaminated water or food, or through contact with sick people or their fecal material.</s>Four more people died from an E. coli outbreak linked to romaine lettuce, the U.S. Centers for Disease Control and Prevention said on Friday, bringing the total death toll to five.

Twenty-five more people have taken ill since the last update from the agency on May 16, with 197 patients from 35 states now affected, the CDC said on Friday.

The additional patients who died were from Arkansas, California, Minnesota and New York and some did not report eating lettuce themselves, but came into contact with those who did, the CDC said.

Most new cases involve people who became sick two or three weeks ago, when the tainted lettuce was still available for sale.

The US Food And Drug Administration said on May 16 that the harvest season for romaine lettuce is over, so the E. coli outbreak, too, should be coming to an end.

The reported strain of E. coli, which produces poisonous substances known as Shiga toxins, can cause severe stomach cramps, bloody diarrhea and vomiting.

The Food and Drug Administration (FDA) said that romaine has only a 21-day shelf life, and, since the last of it was harvested on April 16, we should be safe from bad salad.

The Shiga-toxins that have made this outbreak so dangerous bind to white blood cells, riding to them to the kidneys where it breaks into the heart of cells.

Cell death triggers the body to send red blood cells to the kidneys, causing clots and kidney failure.

The Centers for Disease Control and Prevention announced the outbreak-related death of one person in California on May 2.

Nearly half of those that contracted E. coli infections since the outbreak began in March had to be hospitalized.

Women have accounted for 65 percent of the infections reported so far.

Although E. coli is typically to primarily pose a danger to elderly people and very young children, the median age of those affected in this outbreak is 29.

The FDA and Centers for Disease Control and Prevention traced the contamination to the Yuma region of Arizona, where about 90 percent of winter leafy greens are grown.

So far, the FDA has identified one grower, Harrison Farms, involved in the outbreak.

But that lettuce from farm was a bit of anomaly, accounting for only the handful of illnesses reported in an Alaska prison.

Aside from Harrison, the FDA says that many farms could be involved, though they do not yet have a number and are still investigating.</s>Four more people have died of E. coli infections spread by romaine lettuce and 25 more illnesses have been reported, the Centers for Disease Control and Prevention said Friday.

The outbreak is over and romaine lettuce is no longer on the warning list, but reports of cases in three more states have come in, the CDC said.

A total of five people have died and 197 got sick in the outbreak, the largest E. coli outbreak in the U.S. in more than a decade, the CDC said.

It can take a while for case reports to make their way to the federal level from state and local officials, and people often do not die right away from complicated E. coli infections.

“Most of the newly reported cases are people who became sick two to three weeks ago, still within the window when contaminated romaine was available for sale,” the CDC said.

Most E. coli bacteria are harmless, but one strain, called E. coli O157:H7, can cause severe disease. It may cause severe stomach cramps, bloody diarrhea and vomiting. The bacteria can be spread by contaminated water, animal manure or in undercooked beef.

Romaine is no longer being grown in the Yuma area and the CDC and the Food and Drug Administration both said lettuce grown elsewhere is not involved in this outbreak.The FDA said it may take a while to find out how the bacteria got into so much of the romaine lettuce supply.

“Any contaminated product from the Yuma growing region has already worked its way through the food supply and is no longer available for consumption. So any immediate risk is gone,” FDA Commissioner Dr. Scott Gottlieb and Dr. Stephen Ostroff, FDA’s Deputy Commissioner for Foods and Veterinary Medicine, said in a joint blog post.

It can take weeks to track down the source of a food poisoning outbreak. Food is often shipped to central plants from various farms, where it is processed, mixed together, packaged, and redistributed.

Gottlieb and Ostroff said the FDA is working to track the source of this outbreak, but is so far coming up with very little.

Researchers have to visit people who are reported sick, test them to make sure they were infected by the specific strain being investigated, and then question them intensively about what they ate or drank days and weeks before.

“It often includes investigating the multiple steps along the way. These steps can include suppliers, distributors and processors where the lettuce was chopped and bagged, and then back to the farm or farms that could have grown the lettuce that ended up in those bags. It’s a labor-intensive task.”

So far, they said, “there isn’t a simple or obvious explanation for how this outbreak occurred within the supply chain. If the explanation was as simple as a single farm, or a single processor or distributor, we would have already figured that out.”

Last winter, Consumer Reports criticized the CDC and the FDA for not warning people away from romaine lettuce when there was a similar outbreak, but the CDC said at the time that it couldn’t pinpoint what type of salad green might be responsible.</s>U.S. health officials say five people have now died from an E. coli outbreak involving romaine lettuce.

The U.S. Centers for Disease Control and Prevention announced Friday that another four people had died from the outbreak. The patients who died were from Arkansas, California, Minnesota and New York.

The agency said 197 patients from 35 states have become ill from eating contaminated romaine lettuce or from coming into contact with those who did. At least 89 people have been hospitalized.

The CDC said many of the new cases involved people who became ill two to three weeks ago, when contaminated romaine lettuce, which is popular in salads, was still being sold.

Health officials have linked the E. coli outbreak to romaine lettuce grown in Yuma, Arizona. Officials urged people to throw away all romaine lettuce after the first outbreak was reported in March and now officials say the growing season in Arizona has ended.

While the danger has mostly passed, reports of the illness are still coming in because of the time it takes officials to collect hospital information.

Most E. coli bacteria are not harmful, but some produce poisonous substances known as Shiga toxins, which can cause severe stomach cramps, bloody diarrhea and vomiting.</s>Although the E. coli contaminated Romaine lettuce is off the shelves in supermarkets, the effects of the illnesses caused by it are still being felt throughout the United States as four more people have died.

According to a Time report, the Centers for Disease Control and Prevention (CDC) reported the four additional deaths include two people from Minnesota, a person from Arkansas, and a person from New York. As the Inquisitr reported, a person from California was the first death that resulted from the outbreak. The contaminated lettuce originated in the Yuma, Arizona area.

So far, across 35 states, a total of 197 people contracted an infection from the tainted Romaine lettuce. Roughly half of the people who fell ill ended up hospitalized because of the severity of the illness. Among those who’ve been sickened by either eating the lettuce or close contact with another infected person, 26 developed hemolytic uremic syndrome, which is a type of kidney failure. The rate at which this kidney failure occurred in this outbreak is unusually high for E. coli infections.

The CDC explained that it takes two to three weeks from the time a person becomes ill with E. coli until the time the illness is reported to the CDC. Because of that lag time, people who become sick after May 6, 2018, may not be included in reports at this time.

The harvest season in Yuma, Arizona is over, and because of the 21-day shelf life of Romaine lettuce, officials do not believe that any of the tainted vegetables is on store shelves or in people’s homes at this point. If you suspect you may have E. coli infection, seek medical assistance as soon as possible.

Although this particular lettuce shouldn’t be a risk anymore, E. coli is almost always a danger, and steps can be taken to avoid getting ill. To prevent contamination, thoroughly wash your hands before handling or cutting fruits and vegetables, and also wash or scrub all fruits and vegetables under running water before consuming or cooking. Plus, use separate cutting boards for fruits and veggies and raw meat, seafood, and poultry to avoid cross contamination. Additionally, wash hands after using the bathroom, changing diapers, and having contact with animals.

E. coli can affect persons of any age, but children under five, the elderly, as well as people with compromised immune systems can be especially prone to complications from the infection, so it is essential to take careful precautions for these age groups.</s>Four more people have died of E. coli infections spread by romaine lettuce and 25 more illnesses have been reported, the Centers for Disease Control and Prevention said Friday.

The outbreak is over and romaine lettuce is no longer on the warning list, but reports of cases in three more states have come in, the CDC said.

A total of five people have died and 197 got sick in the outbreak, the largest E. coli outbreak in the U.S. in more than a decade, the CDC said.

It can take a while for case reports to make their way to the federal level from state and local officials, and people often do not die right away from complicated E. coli infections.

“Most of the newly reported cases are people who became sick two to three weeks ago, still within the window when contaminated romaine was available for sale,” the CDC said.

“Some people who became sick did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce.”

Most E. coli bacteria are harmless, but one strain, called E. coli O157:H7, can cause severe disease. It may cause severe stomach cramps, bloody diarrhea and vomiting. The bacteria can be spread by contaminated water, animal manure or in undercooked beef.

This strain is involved in the Yuma romaine outbreak.

“Eighty-nine people out of 187 with available information (48 percent) have been hospitalized, including 26 who developed a type of kidney failure called hemolytic uremic syndrome,” the CDC said.

Romaine is no longer being grown in the Yuma area and the CDC and the Food and Drug Administration both said lettuce grown elsewhere is not involved in this outbreak.

The FDA said it may take a while to find out how the bacteria got into so much of the romaine lettuce supply.

“Any contaminated product from the Yuma growing region has already worked its way through the food supply and is no longer available for consumption. So any immediate risk is gone,” FDA Commissioner Dr. Scott Gottlieb and Dr. Stephen Ostroff, FDA’s Deputy Commissioner for Foods and Veterinary Medicine, said in a joint blog post.

But in early spring, Yuma is the main source for lettuce sold across much of the U.S.

It can take weeks to track down the source of a food poisoning outbreak. Food is often shipped to central plants from various farms, where it is processed, mixed together, packaged, and redistributed.

Gottlieb and Ostroff said the FDA is working to track the source of this outbreak, but is so far coming up with very little.

Researchers have to visit people who are reported sick, test them to make sure they were infected by the specific strain being investigated, and then question them intensively about what they ate or drank days and weeks before.

“Traceback involves working backwards from the point of consumption or purchase of the product through the supply chain,” Ostroff and Gottlieb wrote.

“It often includes investigating the multiple steps along the way. These steps can include suppliers, distributors and processors where the lettuce was chopped and bagged, and then back to the farm or farms that could have grown the lettuce that ended up in those bags. It’s a labor-intensive task.”

So far, they said, “there isn’t a simple or obvious explanation for how this outbreak occurred within the supply chain. If the explanation was as simple as a single farm, or a single processor or distributor, we would have already figured that out.”

Last winter, Consumer Reports criticized the CDC and the FDA for not warning people away from romaine lettuce when there was a similar outbreak, but the CDC said at the time that it couldn’t pinpoint what type of salad green might be responsible.

The CDC estimates that foodborne illnesses affect 47.8 million people in the U.S. every year, putting 127,000 into the hospital and killing more than 3,000.</s>NEW YORK (AP) — Four more deaths have been linked to a national food poisoning outbreak blamed on tainted lettuce, bringing the total to five.

Health officials have tied the E. coli outbreak to romaine lettuce grown in Yuma, Arizona. The growing season there ended six weeks ago, and it’s unlikely any tainted lettuce is still in stores or people’s homes, given its short shelf life. But there can be a lag in reporting, and reports of illnesses have continued to come in.

In an update Friday on the nation’s largest E. coli outbreak in a decade, health officials said 25 more cases have been added, raising the total number of illnesses to 197 in 35 states. At least 89 people were hospitalized.

Previously one death had been reported, in California. On Friday, health officials said they had learned of four more — one in Arkansas, one in New York, and two in Minnesota.

The first illnesses occurred in March, and the most recent began on May 12, according to the Centers for Disease Control and Prevention.

Many of the new cases were people who became ill two to three weeks ago, when contaminated lettuce was still being sold. Some said they did not eat romaine lettuce but were in close contact with someone who got sick after eating it.

Most E. coli bacteria are not harmful, but some produce toxins that can cause severe illness. People who get sick from toxin-producing E. coli come down with symptoms about three to four days after swallowing the germ, with many suffering bloody diarrhea, severe stomach cramps and vomiting.

Most people recover within a week, but some illnesses can last longer and be more severe.</s>FRIDAY, June 1, 2018 (HealthDay News) -- This spring's outbreak of E. coli illness tied to tainted Arizona romaine lettuce is likely over, U.S. health officials say, but not before claiming five lives.

"Romaine lettuce from the Yuma growing region [of Arizona] is past its shelf life and is likely no longer being sold in stores or served in restaurants," officials at the U.S. Centers for Disease Control and Prevention said in a statement released Friday. The last shipments of suspect lettuce from the Yuma area were harvested April 16, and the harvest season is over.

So, although 25 more people got sick after the last CDC update on the outbreak, issued May 16, no new illnesses are expected. "The latest reported illness started on May 12," the CDC said.

In total, 197 cases of illness tied to the E. coli O157:H7 strain of bacteria were linked to tainted romaine lettuce, with cases spread across 35 states. Eighty-nine of the cases required hospitalization, 26 of those cases involved a potentially lethal kidney failure, and five cases resulted in death.

"This is a higher hospitalization rate than usual for E. coli O157:H7 infections, which is usually around 30 percent," the agency noted.

Deaths were reported in Arkansas (1), California (1), Minnesota (2) and New York (1).

In April, the CDC warned Americans to toss out any romaine lettuce they might have bought in stores. The agency expanded its warning from just chopped romaine to any and all forms of the lettuce.

The sweeping advisory came after information tied to some new illnesses prompted health officials to caution against eating all kinds of romaine lettuce that came from Yuma.

The agency also warned restaurants not to serve romaine lettuce to customers.

Genetic testing showed that the E. coli strain involved in the outbreak produces a specific type of "Shiga toxin" that causes more severe illness, according to Matthew Wise, the CDC deputy branch chief for outbreak response.

This is the biggest Shiga-toxin producing E. coli outbreak since a 2006 outbreak linked to spinach grown in the Salinas Valley in California, Wise said recently.

The CDC stressed that E. coli illness can be very serious, even deadly.

Usually, illness sets in "an average of three to four days after swallowing the germ. Most people get diarrhea [often bloody], severe stomach cramps and vomiting," according to the CDC.

For most, recovery will occur within a week, but more severe cases last longer.

"Talk to your doctor if you have symptoms of an E. coli infection and report your illness to your local health department," the agency said.</s>Four more people have died because of the E. coli infection spread by romaine lettuce and 25 more illnesses have been reported from a now confined outbreak.
The CDC reports that five people have died and 197 have been hospitalized in the United States, in the largest incidence of E. coli since the 2006 North American E. coli outbreak.