Publisher’s Platform: FDA, CDC where is the transparency?

89 people were sickened, 36 were hospitalized, 7 developed kidney failure and 1 person died in 15 States

States impacted: Arizona (2), Colorado (1), Illinois (7), Indiana (8), Kansas (1), Kentucky (1), Missouri (50), Montana (1), North Dakota (2), Nebraska (3), Ohio (8), Pennsylvania (1), South Dakota (1), Tennessee (1), Wisconsin (2). 

As a father of three beautiful and strong young women, I have become nearly immune to constructive criticism. It is in that vein I call out my friends at the FDA and CDC for closing a romaine lettuce E. coli O157:H7 case without supplying the pubic – who they are supposed to serve – with information about the outbreak.

Here are the highlights (or lowlights) of the investigation – https://www.marlerblog.com/files/2025/03/2411MOEXH-2-Romaine-E.-coli-FDA-Records.pdf

Epidemiology Overview & Genomic Analysis

On November 25, 2024, PulseNet coded an outbreak of E. coli O157:H7 2411MOEXH-2. At the time of closing, this investigation included 89 cases across 15 states: AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50), MT (1), ND (2), NE (3), OH (8), PA (1), SD (1), TN (1), WI (2), all related within 0-4 alleles by cgMLST. Isolation dates ranged from November 7, 2024, to December 1, 2024. Reported onset dates (n=83) ranged from November 4, 2024, to November 30, 2024. Ages ranged from 4 to 90 years with a median age of 24. Sixty of 88 cases (68%) were female. Outcome information was available for 74 cases, of which 36 (49%) were hospitalized. There were 7 reported cases of HUS, and 1 death attributed to this outbreak.

A case in this investigation was defined as infection with E. coli O157:H7 with an isolate related to the outbreak strain within 0-4 alleles by cgMLST and isolation date ranging from November 7 to December 1, 2024.

This outbreak was coded following notification from colleagues in MO after they identified and investigated multiple illness linked to events catered by the same MO-based caterer. These events occurred between November 6 and November 8. All events included the same menu items with a few modifications. MO colleagues conducted a retrospective cohort study at 2 of the events and found that salads were the only statistically significant menu item across both events. Salads contained an iceberg/romaine lettuce blend, carrots, purple cabbage, onions, canned pimento, canned artichokes, parmesan cheese, and a house made salad dressing. (b)(4)In total, 7 subclusters were identified across the multistate outbreak. These included MO catered events, an OH (b)(4) school, an IN restaurant, and IL restaurant, and an IL event catered by a different MO-based caterer. Salads were the common link across all 7 subclusters, and cases in all subclusters ate an iceberg/romaine lettuce blend. CDC deployed a focused questionnaire on November 26, 2024; 27 questionnaires were returned. Epi information was available for 65 cases, of which 60 (95%) reported consuming any type of leafy green prior to illness. Of 57 cases who could remember the exact type of leafy green consumed, 50 (88%) consumed romaine lettuce. This is statistically significantly higher than the background rate of 49% from the FoodNet Population survey.

Traceback Abbreviated Summary

A traceback investigation was initiated in response to a E. coli 0157 outbreak with leafy greens as the suspected vehicle. Each case included in the traceback investigation reported consumption of leafy greens prior to illness onset. Based on information available at the points of service (POS), the traceback focused on iceberg and romaine lettuce. The investigation consisted of three traceback legs representing twenty-eight cases and 4 ) POS. The three traceback legs identified (b)(4) distribution centers, (b)(4) broker, (4) processors, (b4) grower, and *x*) ranch. The traceback investigation determined that (b)(4), the sole processor, sourced romaine lettuce from (b)(4) grower, (b)(4) This romaine was available at all points of service during the specified timeframe of interest. Additionally, romaine lettuce supplied to b)(4) POS was traced back to a common ranch and lot. Through analysis of records, (b)(4) lots of romaine lettuce were implicated, resulting in confirmation of romaine lettuce as the vehicle.

Who made the salad? The public has a right to know. I know it and the retailers, shippers, processor and grower know it. It will be made public.

Based on epidemiologic and traceback data, romaine lettuce was confirmed as the source of this outbreak. The traceback investigation determined that a sole processer sourced romaine lettuce from (b)(4) grower that would have been available at all points of service during the timeframe of interest. Additionally, romaine lettuce supplied to (b)(4) P O S w a s traced back to a common ranch and lot. While iceberg lettuce was also traced, there were no common growers identified. A farm investigation was performed at the identified grower to determine the route of contamination; however, there were no notable observations. At the conclusion of this response, this cluster included 89 cases across 15 states [AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50), MT (1), ND (2), NE (3), OH (8), PA (1), SD (1), IN (1), WI (2)].

These are real people on this list, our friends and families. There are people, many children, who became sick – some severely so – and, a death. They need the FDA and CDC to do their jobs.

Also, where are the health departments in Arizona (2), Colorado (1), Illinois (7), Indiana (8), Kansas (1), Kentucky (1), Missouri (50), Montana (1), North Dakota (2), Nebraska (3), Ohio (8), Pennsylvania (1), South Dakota (1), Tennessee (1), Wisconsin (2)?

Source: https://www.foodsafetynews.com/2025/03/publishers-platform-fda-cdc-where-is-the-transparency/