2019 E. coli Outbreak Linked to Romaine Lettuce – Frequently Asked Questions

This page includes a list of frequently asked questions about the ongoing outbreak of E. coli infections linked to romaine lettuce grown in Salinas, California. This list will be updated as more information becomes available.

1. Why is my grocery store still selling romaine lettuce from Salinas?

• Retailers and restaurants have been advised not to sell or serve romaine lettuce grown in Salinas. They may be selling or serving romaine lettuce that was grown in other areas.
• Many romaine lettuce companies have headquarters or offices in Salinas. This is not necessarily the harvest region. Harvest region labels are different than the information showing the company name and address.

2. How do I identify the affected romaine lettuce?

• Look for a label, sticker or pre-printed information that says “grown in” or “Romaine:” followed by a region to know where the romaine lettuce was grown and harvested. This information is usually located near the use-by date when it is printed on the package, or it may be on a sticker.
• If the label says “grown in Salinas” or “Romaine: Salinas” (whether alone or with the name of another location), don’t eat it. If you can’t find the label showing where it was grown, don’t eat it. Throw it away.
• If you can’t find the growing region, don’t eat it. Throw it away.
• If you don’t know if the lettuce is romaine or whether a salad mix or wrap contains romaine, don’t eat it. Throw it away.

3. What products are affected by this outbreak?

• CDC’s current advice applies to all brands, use-by dates, and types of romaine lettuce grown in the Salinas growing region.
• The advice includes all types of romaine lettuce harvested or grown in Salinas, such as whole heads of romaine; organic romaine; hearts of romaine; packages of precut lettuce and salad mixes which contain romaine, including baby romaine, spring mix, and Caesar salad; and wraps or sandwiches that contain romaine.

4. Is hydroponically- and greenhouse-grown romaine lettuce from Salinas affected by this outbreak?

• Hydroponically and greenhouse-grown romaine from any region does not appear to be related to the current outbreak. This lettuce may be labeled as “indoor grown.”

5. Are other produce items from Salinas, California affected by this outbreak?

• CDC’s current advice only applies to romaine lettuce grown in Salinas.
• If we find that additional products are contaminated and could make people sick, we will update our advice.

6. What should I do with romaine lettuce from Salinas?

• If you have romaine lettuce grown in Salinas, don’t eat it. Throw it away.
• Wash and sanitize drawers or shelves in refrigerators where romaine lettuce was stored. Follow these five steps to clean your refrigerator.

7. If I wash or cook romaine lettuce from Salinas, is it safe to eat?

• Don’t wash or cook romaine lettuce from Salinas. Don’t eat it. Throw it away.

8. If I ate romaine lettuce from Salinas, should I go to the doctor?

• People with a Shiga toxin-producing E. coli infection (STEC) usually get sick 3-4 days after eating food contaminated with the germ. See a doctor if you develop these symptoms:
  • Diarrhea that lasts more than 3 days
  • Diarrhea and a fever higher than 102°F
  • Bloody diarrhea or blood in your stool (poop)
  • So much vomiting you can’t keep liquids down and pass little urine
• Most people recover within a week. Some illnesses last longer and can be more severe, resulting in a type of kidney failure called hemolytic uremic syndrome (HUS).
  • HUS can occur in people of any age, but is most common in children younger than 5 years.
  • Symptoms of HUS include urinating less often; feeling very tired or irritable; losing pink color in cheeks and inside the lower eyelids; bruising or a rash of tiny red spots on the skin; decreased awareness.
  • People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems.
  • Most people with HUS recover within a few weeks, but some suffer permanent damage or die.

9. Can I send my leftover romaine lettuce to CDC for testing?

• CDC doesn’t test leftover food.
• If you think you got sick from eating romaine lettuce, contact your local health department to report your illness. They will ask you about foods you ate before you got sick.

10. Can pets and other animals get sick if they eat contaminated romaine?

• Some animals can get sick from germs that also make people sick.
• Don’t feed your pets any romaine lettuce grown in Salinas.

11. Is romaine lettuce grown in other areas affected by this outbreak?

• CDC’s current advice only applies to romaine lettuce grown in Salinas.
• We continue to investigate to determine the source of the contamination and to determine if additional products are linked to illness.
• If we find that additional products are contaminated and could make people sick, we will update our advice.

12. Is the outbreak ongoing?

• We continue to receive new reports of illnesses.
• This investigation is evolving rapidly, and new information is coming in every day. The investigation to determine the source of the contamination is ongoing.

13. How does romaine lettuce get contaminated?

• Germs that make people sick are found in many environments, including in the soil, in the intestines of healthy animals, and on refrigerator and kitchen surfaces.
• These germs can contaminate leafy greens at many points along the food production chain before they reach your plate. For example, leafy greens can get germs on them from soil and unclean water when they’re being grown, in the facilities where they’re processed, in trucks when they’re transported to the store, and even in the kitchen.