990817 Washed Lettuce Linked to E. Coli OutbreakAugust 11, 1999New York - Experts believe water used to wash lettuce during processing was the source of a 1996 outbreak of E. coli gastrointestinal illness that affected dozens of individuals in Connecticut and Illinois. “The outbreak points out that E. coli and other (intestinal) illnesses can be associated with lettuce and other produce... not just meat,” lead author of the report, Dr. Elizabeth Hilborn said. Her team published their findings in the August 9th/23rd issue of the Archives of Internal Medicine. Hilborn, now with the Environmental Protection Agency in North Carolina, and colleagues at the Centers for Disease Control and Prevention, and elsewhere investigated the outbreak, which included 21 reported cases in Connecticut and 28 reported cases in Illinois between May 28th and June 27th, 1996. The investigators identified mesclun lettuce from a single grower-processor as the source of E. coli infection. Moreover, patients in one other state to which the lettuce was shipped were also found to have been infected with the implicated E. coli strain, according to the report. Although contaminated wash water appeared to be the main source of E. coli in the lettuce, inadequate worker hygiene was also implicated in the outbreak, Hilborn said. She added that a number of steps have been taken to help prevent future produce-related E. coli outbreaks. For instance, the Food and Drug Administration has developed a set of guidelines called Good Agricultural Practices that cover everything from the use of manure as a fertilizer to wash water quality and worker hygiene. “Ideally, all lettuce should be washed before consumption, but, because washing reduces but does not eliminate bacterial contamination, production and processing methods need to be designed to minimize the number of (bacteria) present in finished lettuce,” the researchers write. In addition, physicians can take the “first essential step” in identifying and controlling an outbreak of foodborne illness, Hilborn said, by ensuring that all patients who present with serious gastrointestinal illness are properly diagnosed by testing at a state laboratory.
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