More people are sick, more people have died, and more states are reporting E. coli infections in an ongoing outbreak linked to romaine lettuce. As the CDC was releasing the new numbers Friday, growers were promising to figure out what happened and take action.
Outbreak investigators have been trying to trace the romaine for two months, but they still can’t determine who grew, processed and shipped the implicated produce. 

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Five people in the United States have died in the outbreak, which has sickened at least 197 as of May 30. That’s 25 more confirmed cases since the previous update on May 16.
Almost half of the infected people have been so ill that they had to be admitted to hospitals; 26 people developed hemolytic uremic syndrome (HUS), a type of kidney failure. At least six people in Canada are also confirmed with the outbreak strain of E. coli.
All of the victims who reported eating romaine before becoming sick — except for eight inmates in an Alaskan prison — said they ate chopped romaine. The sick prisoners ate romaine from whole heads, according to prison officials. Those whole heads were traced to Harrison Farms in Yuma, but the farm finished harvesting and plowed the field before investigators could visit it. 
Leaders at the Food and Drug Administration reiterated on Thursday that incomplete and incompatible shipping and receiving records continue to slow their traceback efforts on the chopped romaine, which restaurants and grocery stores sold to consumers. They continue to review dozens of growers, processors and distributors, many of whom do not use labeling to provide complete supply chain traceability.
The assumption has been that the implicated romaine was harvested in the Yuma, AZ, area because of the illness onset dates. The first person infected with the outbreak strain of E. coli O157:H7 became ill on March 13. The most recent victim developed symptoms on May 12, according to the Friday update from the Centers for Disease Control and Prevention.
The outbreak victim who became sick on May 12 is likely among the last new cases that will develop, according to a CDC spokesperson. It usually takes one to eight days for infection symptoms to develop after a person consumes contaminated foods or beverages. 
However, additional cases are likely to be added to the overall count because of the two-to four-week lag time there is between a person becoming ill and confirmed reports reaching federal authorities. The numbers of newly reported cases has declined in the past few weeks and CDC officials are hopeful the outbreak is nearing the end.
“Most of the people who recently became sick ate romaine lettuce when lettuce from the Yuma growing region was likely still available in stores, restaurants, and in peoples’ homes,” the CDC spokesperson told Food Safety News on Friday afternoon. 
“Some of these people may have eaten romaine near the end of its shelf life and had longer than average incubation periods. … Other people likely got sick from someone else who was sick from the romaine. This can happen when someone is caring for a sick family member.”
Stumbling blocks and promisesSince the first FDA report on the outbreak investigation, which was posted April 10, the agency has repeatedly stated the implicated romaine was likely grown or originated from the winter growing areas in or around the Yuma region. The region generally supplies romaine lettuce to the U.S. during November-March each year.
Produce industry representatives have contended all along that the Yuma area romaine harvest was virtually finished by the end of March, with low volumes continuing to be harvested through April 16. The FDA and produce groups say romaine has a shelf life of about 21 days after being harvested.
Leaders the California and Arizona Leafy Greens Marketing Agreement (LGMA) organizations have said numerous times in the past two months that their industry is doing everything possible to help the FDA pinpoint who grew, chopped and distributed the implicated romaine. They have also said they are working with state and federal investigators who are looking for the source of the E. coli that apparently contaminated the romaine.
“This incident is a stark reminder of the size and scope of our reach, and we, more than anyone want to understand how it happened,” Arizona Leafy Greens Food Safety Committee Administrator Teressa Lopez said in a news release issued Friday by the California LGMA leaders.
California and Arizona grow 98 percent of U.S. produced romaine lettuce. The two states “grow, harvest and ship 130 million servings of leafy greens every day,” according to the news release. To protect their customers — and their livelihood — the two leafy greens groups are establishing a task force “to sharpen food safety systems through the entire supply chain from production, to packaging, processing and distribution.” 
The steering committee for the task force has 18 members, including co-chairmen who are from Church Brothers Farms and Dole. The other 16 members include representatives from six other produce companies, as well as government officials, researchers, produce trade association leaders, and a representative of the consumer advocacy group STOP Foodborne Illness. 
The California and Arizona Leafy Greens Marketing Agreements are taking the lead in creating this task force, said Scott Horsfall, CEO of the California LGMA. We want to ensure comprehensive representation from the entire supply chain.
While the leafy greens representatives say they are committed to making changes, they, like the FDA investigators, need information that might not be available no how long they look for it.
“It is very difficult to identify an issue weeks or months after the fact, primarily because of the expediency with which our product is harvested and in the marketplace,” Arizona Leafy Greens Marketing Agreement Chair Jerry Muldoon said in the news release.
Muldoon said the leafy greens groups believe they can “help get to the bottom of this and make changes to processes after our product leaves the farm, as well as closely examine other factors at play.”
The LGMA organizations were founded in the wake of the deadly 2006 E. coli outbreak traced to fresh spinach from California. That outbreak sickened at least 205 people, killing four. The current outbreak has already claimed five lives and is on track to eclipse the number of overall cases confirmed in the 2006 outbreak.
The chairman of the California LGMA, Steve Church of Church Brothers Farms said the leafy greens organizations are ready to act.
“The strength of the LGMA is that if we learn how and where problems may be occurring, we can quickly change our program,” said Church said in the news release.
Leafy Greens Food Safety Task ForceCo-Chairmen:
  • Jerry Muldoon of Dole Fresh Vegetables, Arizona; and
  • Steve Church of Church Brothers, California
Members:
  • John Boelts of Desert Premium Farms
  • Mary Campbell of Yuma Safe Produce Council
  • Bonnie Fernandez-Fenaroli of Center for Produce Safety
  • Ed Foster of Arizona Department of Agriculture
  • Hank Giclas/Sonia Salas of Western Growers
  • Scott Horsfall of California Leafy Greens Marketing Agreement
  • Natalie Krout-Greenberg of California Department of Food and Agriculture
  • Teressa Lopez of Arizona Leafy Greens Marketing Agreement
  • Drew McDonald of Taylor Farms
  • Jennifer McEntire of United Fresh Produce Association
  • Vicki-Lynne Scott of Amigo Farms
  • Victor Smith of JV Smith Companies
  • Abby Taylor of Grower-Shipper Association of Central California
  • Michael Taylor of STOP Foodborne Illness and former FDA deputy commissioner of foods
  • Shelly Tunis of Yuma Fresh Vegetable Association
  • Jack Vessey of Vessey Farms
  • Kami Weddle of Rousseau Farms
  • Bob Whitaker of Produce Marketing Association
Federal agencies will be involved with the task force on a collaborative basis, serving as technical and informational advisers to the task force, according to the LGMA news release.