(June 6, 12:25 p.m.) Washington state health officials are investigating the possibility that romaine lettuce was the cause of E. coli illnesses in the Puget Sound area in May, based on interviews with the 10 people who got sick. No lettuce had been tested.

“I will tell you what we know. We have 10 people sick, and nine of them tested for the exact same strain of E. coli,” said Tim Church, spokesman for the Washington State Department of Health, Olympia.

A conclusive test was not done on the 10th victim, but officials believe it also may be the same strain.

Five of 10 victims were hospitalized and four of those five were released from the hospital by June 5, he said. About half of the victims were teenagers.

“They all ate romaine lettuce, and, working with the Centers for Disease Control and the (Food and Drug Administration), we believe it was the romaine lettuce,” he said June 6.

However, he said officials don’t have a sample of any tainted lettuce, and there has been no lettuce tested.

“It is the best we can conclude with the information at this point,” he said.

BEFORE FOODSERVICE SETTING

The fact E. coli was linked to a couple of locations leads officials to believe the lettuce had a problem when it got there as opposed to being contaminated in the foodservice setting, but Church said more investigation is needed.

“At this point we are watching the situation with concern and care, but nothing has been definitively linked to any (food) as far as I know,” said Scott Horsfall, chief executive officer of the Sacramento, Calif.-based California Leafy Green Products Handler Marketing Agreement. “We will do anything we can to cooperate and help as the process moves on.”

Spinach and lettuce growers, shippers, processors and marketers formed the marketing agreement following an E. coli outbreak linked to fresh spinach in September 2006.

Church said some of the Washington E. coli victims were teenagers and may have eaten in a common school setting. All who were sickened apparently ate romaine lettuce outside their homes.

“Some of them were connected through school and may have eaten at school, but we don’t know for sure,” he said.

BEGAN IN MID-MAY

The onset of the E. coli illnesses began in mid-May and the last case that health officials are aware of was reported May 29.

The FDA is involved with the investigation, Church said.

On average, the state of Washington sees 150-300 cases of E. coli in a year.

“Last year we had 133 cases in our state,” he said. Most of the cases are random and isolated, so the group of 10 cases is a bit larger than the typical E. coli sickness pattern.

Church said state officials are working with FDA officials to determine the source of possibly tainted romaine lettuce.

“The fact that these weren’t in-home settings makes it more complicated, and the other challenge is that by the time people get sick and get tested, that produce is long gone,” Church said.