As the case count in the E. coli outbreak rises, romaine has remained in the spotlight. ( File Photo )

It has been three weeks since the Centers for Disease Control and Prevention released its first alert about romaine from Arizona, linking the product to a multistate E. coli outbreak, and the Food and Drug Administration is still looking for the source.

With 121 people sickened, this E. coli outbreak is the largest since spinach sickened more than 200 people in 2006.

As the investigation continues, the CDC continues to advise consumers not to eat romaine unless they know it is not from Arizona.

What follows is a Q&A that covers what is known about the situation now and what to expect.


Is there any romaine from Yuma still in the supply chain, or is everything available now definitely safe?

It is quite unlikely there is any romaine from Arizona still in the supply chain. After the CDC issued its alert April 13, grocery stores and restaurants across the U.S. got rid of that product, and shipments of romaine from Arizona stopped shortly thereafter.

In the weeks since, many retailers and foodservice operators have gone out of their way to let consumers know they are carrying only California romaine, which is not implicated in the outbreak.

Even so, health officials are hesitant to state definitively that no Arizona product remains. Because the FDA has been unable to determine the source of the chopped romaine that caused most of the illnesses, it cannot be sure where all it ended up and whether it has been discarded.

Without having a clear picture of the supply chain — and it is more of a web than a chain — the CDC and FDA must consider illness start dates and shelf life, and they want to be cautious because consumer health is the priority.


Given the relatively short shelf life of the product, why has the outbreak not been declared over?

The CDC wants to account for the lag time between when a person becomes ill and when his or her illness gets reported to the CDC. In each outbreak update so far, there have been not only significant increases in the number of cases, but illnesses with more recent onset dates.

The most recent one began April 21, according to the latest CDC update May 2.

Jennifer McEntire, vice president of food safety and technology for the United Fresh Produce Association, said in an update for members April 25 that the CDC indicated it might want to wait as many as 21 days after the most recent illness onset date before declaring the outbreak over.


How is the outbreak affecting demand for romaine?

Salinas, Calif.-based Tanimura & Antle provided some insight on this question in its recent Straight Talk blog.

“Iceberg lettuce and other leafy greens are experiencing a significant uptick in demand, a result of the ongoing fallout from the recent outbreak associated with Yuma, Ariz.-grown romaine,” the company wrote May 2. “While grower-shippers and customers alike understand that any potentially affected romaine is long past expiration dates, and growing regions have shifted, the return of consumer confidence can be difficult to predict.”

Chelsea, Mass.-based wholesaler Coosemans Boston also reported rising demand for alternatives to romaine.

The company noticed a spike in orders for its hydroponically grown Boston lettuce near the end of the week of April 16.

“We were like, ‘Wow, the numbers are going crazy,’ and then this week, too, it’s just continued,” vice president Maurice Crafts said April 26. “We’re getting slammed with orders for hydro lettuce, much more than we normally do.

“That’s what it is — a lot of customers are going from romaine, they’re going to other options, so we’ve seen a huge increase in our hydroponic lettuce business since this outbreak occurred,” Crafts said.

Bil Goldfield, director of corporate communications for Westlake Village, Calif.-based Dole Food Co., also noted that the outbreak had negatively affected business around romaine. Confusion prompted by media reports played a role, he said April 26.

“We are 100% focused on safe product first, but there has been a great deal of incorrect and misinformation circulating throughout consumer media,” Goldfield said. “Numerous stories have erroneously reported a recall around romaine and more reports that any and all romaine is tainted. Although romaine from Yuma has not been shipped for weeks, some retailers have removed all product containing romaine from their shelves — thereby exacerbating the confusion among consumers in stores.”

F.o.b. prices reported by the U.S. Department of Agriculture May 2 were significantly lower than at the same time in 2017.


Why is there not more information on the source of the romaine by now?

The Food Safety Modernization Act standard is “one step up, one step back,” so companies have to have records that show from where their product came and to where it was then shipped.

Fresh produce might go from a grower to a processor to a distributor before it ends up at a restaurant or a grocery store, so when the FDA starts trying to find out where a product originated, it has to go through the records of multiple companies.

With a widespread outbreak like this one — cases reported in 25 states — the process gets complicated quickly.

About 60% of fresh produce cases have Produce Traceability Initiative Labels, which include a lot number and bar code and other information, but numerous companies have not adopted that system.

Because of the perishability of romaine, it is uncertain whether the FDA will be able to figure out the source of the outbreak.

In the December outbreak in the U.S. that was eventually attributed to leafy greens, no source was identified.