By E.J. Mundell
TUESDAY, Dec. 18, 2018 (HealthDay News) -- The California farm where romaine lettuce was implicated in the recent nationwide E. coli outbreak said it is expanding its recall to include other forms of produce.
According to a company statement, Adam Bros. Farming Inc., in Santa Barbara County, said it is also recalling red and green leaf lettuce as well as cauliflower.
The company said it did so, "after it was discovered that sediment from a reservoir near where the produce was grown tested positive for E. coli O157:H7," the strain implicated in the outbreak.
As well, "the Adam Bros. recall has prompted a sub-recall by Spokane Produce Inc., of Spokane, Wash.," the U.S. Food and Drug Administration said in its own news release issued late Monday.
Spokane Produce "recalled sandwiches and other products under the Northwest Cuisine Creations and Fresh&Local labels," the FDA said.
Federal health investigators announced on Dec. 13 that they had pinpointed Adam Bros. as at least one California farm implicated in the recent outbreak of E. coli illness tied to romaine lettuce. They said that more farms in the same area are probably connected to the outbreak.
So far, 59 people across 15 states have come down with the often severe gastrointestinal illness. Health concerns were so high that just before Thanksgiving, the FDA and the U.S. Centers for Disease Control and Prevention asked Americans to temporarily stop consuming all romaine lettuce while they investigated the source of the outbreak.
That investigation has now pinpointed Adam Bros. as a source, experts at the FDA and CDC have said.
"One of the samples tested by the CDC was positive for the outbreak strain by genetic fingerprinting, and was found in the sediment of an agricultural water reservoir at one ranch that is owned and operated by Adam Brothers Farming in Santa Barbara County, Calif.," said Dr. Stephen Ostroff, senior advisor to the FDA Commissioner.
He said the farm was cooperating with the investigation. The farm hasn't shipped romaine lettuce since Nov. 20, and Ostroff said the farm is "committed to recalling products that may have come into contact with water from the agricultural water reservoir."
That said, other farms in the area might still be implicated, so "people should still pay close attention to where their lettuce is from," he added.
Because of this and other recent outbreaks, romaine lettuce now sold in the United States has labeling indicating the place and date of harvest. If heads of romaine are sold loose, without affixed labels, retailers are being asked to post a notice showing place and date of harvest near the store register.
Most romaine sold in the United States is safe to eat. Right now, precautions are limited to romaine lettuce from just a few California counties, the FDA said.
"We continue to advise avoiding romaine lettuce from Monterey, San Benito and Santa Barbara counties in California," Ostroff said.
Hydroponically- and greenhouse-grown romaine also does not appear to be related to the current outbreak.
Illnesses from the E. coli O157:H7 strain implicated in this outbreak have sometimes been severe. Although no deaths have been reported, there have 23 hospitalizations and 2 cases of kidney failure, health officials said.
"The E. coli strain isolated from ill people in the current romaine lettuce outbreak is also closely related to the E. coli strain isolated from people in a 2017 outbreak linked to leafy green in the United States and romaine lettuce in Canada," noted FDA Deputy Commissioner Frank Yiannas.
So who's most at risk from E. coli?
Dr. Robert Glatter is an emergency physician at Lenox Hill Hospital in New York City who's seen the effects of infection with the gastrointestinal bug firsthand. It's not a minor ailment, he said.
"In general, symptoms of E. coli infection generally begin about three to four days after consuming the bacteria, and may include abdominal cramping, nausea, vomiting, and watery or bloody diarrhea, along with fever," Glatter said.
And while healthy people who battle a bout of E. coli typically recover within five to seven days, the illness can be more protracted -- and even deadly -- for people already made vulnerable by chronic disease or advanced age.
"People with diabetes, kidney disease or those with cancer or autoimmune disease run the risk of a more severe illness," Glatter explained.
The particular strain of E. coli detected in the current lettuce outbreak -- E. coli O157:H7 -- is particularly nasty, he noted.
"Most strains of E. coli do not actually cause diarrhea, but E. coli O157 produces a powerful toxin that injures the inner lining of the small intestine, leading to bloody diarrhea," Glatter said. Even a tiny amount of ingested bacteria could spur this type of illness.
"It can make people much more ill, and may lead to hemolytic uremic syndrome, a type of kidney failure, in some cases," he said.
In many cases, antibiotics are used to help beat back an E. coli infection, but these drugs can affect the kidneys, Glatter noted.
"Antibiotics may be necessary in certain cases, so it's important to see your doctor if you have continued and severe symptoms such as fever, bloody diarrhea, and you are not able to eat or drink," he said.
However, in the case of E. coli O157:H7, "taking antibiotics may actually increase your risk of developing kidney failure, so it's important to speak with your health care provider if you should develop severe symptoms," Glatter advised.
And if you do think you might be sick with E. coli, or any other foodborne illness, make sure you don't spread it to those near you.
The bacterium "can be transmitted person-to-person, so it's vital that anyone who is potentially infected wash their hands thoroughly and not share utensils, cups or glasses," Glatter said. "This also goes for bath towels. Linens also need to be washed in hot water and treated with bleach."
He noted that "ground beef, unpasteurized milk, fresh produce and contaminated water are common sources of E. coli bacteria."