Health advisory: Caution out vs lettuce


The U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration are alerting consumers, restaurants and retailers to an ongoing widespread, multistate outbreak of gastroenteritis caused by romaine lettuce contaminated by E.coli.


E.coli is bacteria that can cause severe gastroenteritis.


The CDC state that information collected to date indicates that romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 bacteria and could make people sick.


Advice to consumers


  • Do not buy or eat romaine lettuce at a grocery store or restaurant unless you can confirm it is not romaine lettuce from the Yuma, Arizona, growing region.


  • Unless the source of the product is known, consumers with store-bought romaine lettuce that have been shipped from the United States or are U.S brands should not be eaten and should throw it away, even if some of it was eaten and no one has gotten sick. This includes whole heads and hearts of romaine, chopped romaine, and salads and salad mixes containing romaine lettuce. If you do not know if the lettuce is romaine, do not eat it and throw it away.


  • Product labels often do not identify growing regions, so throw out any romaine lettuce if you’re uncertain about where it was grown.


  • Wash and sanitize drawers or shelves in refrigerators where romaine lettuce was stored.


Symptoms of E.coli gastroenteritis include


  • People usually get sick from colitoxin gastroenteritis 2–8 days (average of 3–4 days) after swallowing the germ.


  • Most people infected with  colidevelop diarrhea that can be bloody, severe stomach cramps, and vomiting.


  • Most people recover within 1 week.



  • Some infections are very mild, but others are severe or even life-threatening.


If you have symptoms of an E. coli infection:


  • Talk to your healthcare provider.


  • Write down what you ate in the week before you started to get sick.


  • Assist public health investigators by answering questions about your illness.


Follow these general ways to prevent E. coli infection:


  • Wash your hands. Wash hands after using the restroom or changing diapers, before and after preparing or eating food, and after contact with animals.


  • Don’t prepare food or drink for others when you are sick.


  • Don’t cross-contaminate food preparation areas. Thoroughly wash hands, counters, cutting boards, and utensils after they touch raw meat.


  • Wash fruits and vegetables before eating, unless the package says the contents have been washed.


Advice to restaurants and retailers


  • Restaurants and retailers should not serve or sell any romaine lettuce from the Yuma, Arizona growing region. This includes whole heads and hearts of romaine, chopped romaine, and salads and salad mixes containing romaine lettuce.


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


To report a notifiable disease or possible E.coli infection, notify the Territorial Epidemiologist Dr Paul White in the Public Health and Hospital Emergency Preparedness and Epidemiology and Laboratory Capacity Program by email at or call the CHCC at (670) 234-8950.


To report a possible source of contaminated romaine lettuce (produce sold in stores or served in restaurants), call the Bureau of Environmental Health at (670) 664-4870/72/73 or by sending an email to BEH director John Tagabuel at (PR)

Saipan Tribune

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