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A recent outbreak in E. coli

Food-borne illnesses are the result of infections or irritations in the gastrointestinal (GI) tract. Food-borne illnesses are caused by foods or beverages that are contaminated with harmful bacteria, parasites, viruses, or chemicals. Bacteria and viruses are the main causes of illness.

Bacteria are tiny organisms, while viruses are tiny capsules (smaller than bacteria) that contain genetic material. Parasites are tiny organisms that live inside another organism and chemicals are toxins that can occur naturally in foods or are added to foods. Examples of each follows:


  • Salmonella: undercooked meat, poultry, dairy products, seafood and eggs

  • Campylobacter jejuni (C. jejuni): undercooked chicken and unpasteurized milk

  • Shigella: spread from person to person and is present in the stools of people who are infected. Lack of hand washing is the main reason for the spread of this bacterium.

  • Escherichia coli (E. coli): E. coli O157:H7 is the strain that causes the most severe illness. Common sources include raw or undercooked hamburger, unpasteurized fruit juices and milk, and fresh produce

  • Listeria monocytogenes (L. monocytogenes): raw and undercooked meats, unpasteurized milk, soft cheeses, and ready-to-eat deli meats and hot dogs

  • Vibrio: fish or shellfish.

  • Clostridium botulinum (C. botulinum): improperly canned foods and smoked and salted fish


Common sources of foodborne viruses include:

  • Food prepared by a person infected with a virus

  • Shellfish that comes from contaminated water

  • Produce that has been irrigated with contaminated water

Common foodborne viruses include

  • Norovirus: causes inflammation of the stomach and intestines

  • Hepatitis A: causes inflammation of the liver


  • Cryptosporidium parvum and Giardia intestinalis: are spread through water contaminated with the stools of people or animals who are infected

  • Trichinella spiralis: people may be infected with this roundworm parasite by consuming raw or undercooked pork or wild game


Food contaminated with chemicals may include:

  • Fish or shellfish: Some types may “feed on algae that produce toxins, leading to high concentrations of toxins in their bodies. Some types of fish, including tuna and mahi mahi, may be contaminated with bacteria that produce toxins if the fish are not properly refrigerated before they are cooked or served.”

  • certain types of wild mushrooms

  • unwashed fruits and vegetables that contain high concentrations of pesticides

How Big is the Problem?

The CDC estimates that each year approximately 48 million Americans get sick, 128,000 are hospitalized and 3,000 die from a food-borne illness.

The Centers for Disease Control and Preventions states that there are two major groups that cause food-borne illnesses, they are known food-borne pathogens and unspecified agents. There are currently 31 known pathogens that cause food-borne illnesses, many of which are tracked by public health systems around the United States. Unspecified agents are "agents with insufficient data to estimate agent-specific burden; known agents not yet identified as causing food-borne illness; microbes, chemicals, or other substances known to be in food whose ability to cause illness is unproven; and agents not yet identified.”

Current Outbreak: Romaine Lettuce: Update April 13, 2018

There is a multi state outbreak of E. coli O157:H7 infections that has been linked to chopped romaine lettuce. Information that has been collected to date has indicated that chopped romaine lettuce from the Yuma, Arizona area has been infected with E. coli O157:H7. As of April 14, 2018, no common grower, supplier, distributor, or brand has been identified as the source of the contaminated lettuce.

So far 11 states have had illnesses reported that are related to the E. coli O157:H7 infection. From the 11 states, 35 people have been known to be infected. Idaho (8) and Pennsylvania (9) have the most people infected followed by New Jersey (7), Ohio (2), Connecticut (2), New York (2) and Illinois, Michigan, Missouri, Virginia, and Washington each have one person infected.

The Centers for Disease Control and Prevention offers the following advice:

"Advice to Consumers:

  • Consumers who have store-bought chopped romaine lettuce at home should not eat it and should immediately throw it away.

  • Before buying romaine lettuce at the grocery store or eating it at a restaurant, confirm where the lettuce came from. If you cannot confirm the source of the romaine lettuce, do not buy it or eat it.

Advice to Restaurants and Retailers:

  • Restaurants and retailers should not serve or sell any chopped romaine lettuce, including salads and salad mixes containing chopped romaine lettuce, from the Yuma, Arizona growing region.

  • Restaurants and retailers should ask their suppliers about the source of their chopped romaine lettuce."

For more information on Foodborne Illness and to track outbreaks and food recalls, refer to the following links:

About the Author: Leanne DiMaio earned her Master’s degree in Applied Clinical Nutrition from New York Chiropractic College in December 2017. She is currently working on her Doctorate degree in Clinical Nutrition degree at Maryland University of Integrative Health.Leanne is passionate about helping others achieve their optimal state of health and wellness. She is currently earning clinical hours toward the Certified Nutrition Specialist (CNS) credential under Kim Ross's supervision.