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E. coli in Romaine Lettuce in the USA

21 Nov 2018

The US Centres for Disease Prevention and Control (CDC) advises that romaine lettuce should not be sold, served or eaten anywhere in the USA until further notice.

Thirty-two people have been infected with Shiga toxin-producing E. coli (STEC) O157:H7 associated with  romaine lettuce in 11 states since 18 October 2018.

E. coli infection may be accompanied by: nausea, vomiting, abdominal pain, diarrhoea, headache and fever. The illness is usually self limiting over 3–5 days (up to 10 days with STEC)

There may be persistent diarrhoea lasting more than 2 weeks. Haemolytic Uraemic Syndrome can be fatal and occurs in 4 – 10% of STEC infections.

Advice for Travellers

Romaine lettuce should be avoided, according to CDC advice. Otherwise, prevention of E. coli and other forms of travellers' diarrhoea depends mainly upon practising good hand hygiene and effective food and water precautions.

  • Hands should be washed thoroughly before eating or handling food, and always after using the toilet.

    • Sanitising alcohol hand gel is an alternative when washing facilities are not available.

Diarrhoea may occur even in travellers who stick strictly to food and water precautions; in many destinations the risk is determined by local food hygiene and sanitation practices.

For more information see Travellers' Diarrhoea.