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                Outbreaks of Foodborne Illness

Outbreaks of Foodborne Illness

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                        Foodborne Pathogens Home
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          Outbreaks of Foodborne Illness
          Outbreak Investigation of E. coli - Leafy Greens (December 2020)Outbreaks of Foodborne Illness Outbreak Investigation of E. coli - Leafy Greens (December 2020)
  
  					FDA Releases Outbreak Investigation Report
	
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    PrintThe FDA, along with CDC and state and local partners, investigated a multistate outbreak of *E. coli* O157:H7 infections in the fall of 2020. The epidemiology and traceback investigation have determined that the outbreak was linked to leafy greens. The epidemiological and traceback investigations were not able to determine a specific type of leafy green linked to illnesses. On 12/22/2020, the CDC announced that this outbreak appears to be over. This outbreak, announced by FDA and CDC on October 28, 2020, was caused by a strain of *E. coli* that is genetically related to a strain linked to the fall 2019 romaine outbreak.

The FDA completed a traceback investigation of multiple types of leafy greens identified in patient interviews. Although no single ranch was identified as a common source of the leafy greens, FDA and state partners also conducted on-site investigations on farms of interest.

Teams were deployed to dozens of ranches in the region to conduct large scale environmental sampling. Additionally, no Shiga toxin-producing *E. coli* were found on leafy greens. As part of the field investigation, teams conducted environmental sampling on and around ranches of interest to identify any factors that could have led to contamination. Samples of soil, scat or animal droppings, compost, water, and other environmental sources were collected and analyzed.

Laboratory analysis confirmed a positive match to the outbreak strain in a sample of cattle feces, which was collected during follow-up investigations on a roadside, uphill from where leafy greens or other food identified in the traceback investigation were grown. While the finding does not provide definitive information on how *E. coli* may have contaminated product during the growing and harvesting season, it does confirm the presence of a strain of *E. coli* O157:H7 that causes recurring outbreaks in a more narrowly defined growing region and a potential, continued source of contamination.

At this time, FDA’s investigational activities have concluded. The FDA continues to review the findings from this outbreak and a detailed report will be released in the near future. This report will include recommendations shaped by the investigation findings.

In the meantime, as recommended in our Leafy Greens Action Plan, the FDA continues to recommend growers assess and mitigate risk associated with adjacent and nearby land use practices, particularly as it relates to the presence of livestock, which are a persistent reservoir of *E. coli* O157:H7 and other STEC.

FDA released the report: Factors Potentially Contributing to the Contamination of Leafy Greens Implicated in the Fall 2020 Outbreak of E. coli O157:H7.

Recommendation

CDC has declared this outbreak to be over. There is no recommendation for consumers, retailers, or suppliers.


Case Count Map Provided by CDC

Outbreak Investigation of of E. coli in Leafy Greens (December 2020) - Case Count Map from CDC 12/22/2020


Case Counts

Total Illnesses: 40
Hospitalizations: 20 (4 Cases HUS)
Deaths: 0
Last Illness Onset Date: October 31, 2020
States with Cases: AZ (2), CA (6), IL (2), IN (1), KS (4), MI (3), MN (2), MO (3), ND (4), OH (1), OR (1), PA (2), TN (2), TX (1), UT (1), VA (1), WA (1), WI (2), WY (1)
*States with confirmed distribution; product could have been distributed further


Useful Links

Food Safety Tips for Retailers and Consumers During an Outbreak
	Food Safety Resources for Produce Shippers and Carriers During a Foodborne Illness Outbreak
	What is *E. Coli*?
	CDC's Outbreak Page
	FDA In-Brief
	Factors Potentially Contributing to the Contamination of Leafy Greens Implicated in the Fall 2020 Outbreak of E. coli O157:H7


Previous Updates

**Jamuary 27, 2021**

The FDA, along with CDC and state and local partners, investigated a multistate outbreak of *E. coli* O157:H7 infections in the fall of 2020. The epidemiology and traceback investigation have determined that the outbreak was linked to leafy greens. The epidemiological and traceback investigations were not able to determine a specific type of leafy green linked to illnesses. On 12/22/2020, the CDC announced that this outbreak appears to be over. This outbreak, announced by FDA and CDC on October 28, 2020, was caused by a strain of *E. coli* that is genetically related to a strain linked to the fall 2019 romaine outbreak.

The FDA completed a traceback investigation of multiple types of leafy greens identified in patient interviews. Although no single ranch was identified as a common source of the leafy greens, FDA and state partners also conducted on-site investigations on farms of interest.

Teams were deployed to dozens of ranches in the region to conduct large scale environmental sampling. Additionally, no Shiga toxin-producing *E. coli* were found on leafy greens. As part of the field investigation, teams conducted environmental sampling on and around ranches of interest to identify any factors that could have led to contamination. Samples of soil, scat or animal droppings, compost, water, and other environmental sources were collected and analyzed.

Laboratory analysis of samples is now complete. The analysis has confirmed a positive match to the outbreak strain in a sample of cattle feces, which was collected during follow-up investigations on a roadside, uphill from where leafy greens or other food identified in the traceback investigation were grown. While the finding does not provide definitive information on how *E. coli* may have contaminated product during the growing and harvesting season, it does confirm the presence of a strain of *E. coli* O157:H7 that causes recurring outbreaks in a more narrowly defined growing region and a potential, continued source of contamination.

At this time, FDA’s investigational activities have concluded. The FDA continues to review the findings from this outbreak and a detailed report will be released in the near future. This report will include recommendations shaped by the investigation findings.

In the meantime, as recommended in our Leafy Greens Action Plan, the FDA continues to recommend growers assess and mitigate risk associated with adjacent and nearby land use practices, particularly as it relates to the presence of livestock, which are a persistent reservoir of *E. coli* O157:H7 and other STEC.

**December 22, 2020**

The FDA, along with CDC and state and local partners, investigated a multistate outbreak of *E. coli* O157:H7 infections in the fall of 2020. The epidemiology and traceback investigation have determined that the outbreak was linked to leafy greens. The epidemiological and traceback investigations were not able to determine a specific type of leafy green linked to illnesses. On 12/22/2020, the CDC announced that this outbreak appears to be over. This outbreak, announced by FDA and CDC on October 28, 2020, was caused by a strain of *E. coli* that is genetically related to a strain linked to the fall 2019 romaine outbreak.

The FDA completed a traceback investigation of multiple types of leafy greens identified in patient interviews. Although no single ranch was identified as a common source of the leafy greens, FDA and state partners also conducted on-site investigations on farms of interest.

Teams were deployed to dozens of ranches in the region to conduct large scale environmental sampling. Additionally, no Shiga toxin-producing *E. coli* were found on leafy greens.

At this time, FDA’s investigational activities, including sample analysis are ongoing. A detailed report of FDA’s findings in the investigation will be released in early 2021, following the conclusion of investigational activities.

Who to Contact

**Consumers who have symptoms**should contact their health care provider to report their symptoms and receive care.

To report a **complaint**or **adverse event**(illness or serious allergic reaction), you can

Call an FDA Consumer Complaint Coordinator if you wish to speak directly to a person about your problem.
	Complete an electronic Voluntary MedWatch form online.
	Complete a paper Voluntary MedWatch form that can be mailed to FDA.Submit Questions/Get Assistance

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                                                                                  Content current as of:
      12/13/2022
              
              
Regulated Product(s)
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			  OutbreakOutbreaks of Foodborne Illness

          
                        Investigations of Foodborne Illness Outbreaks
          Public Health Advisories from Investigations of Foodborne Illness Outbreaks
          Food Safety Tips for Consumers & Retailers During an Outbreak of Foodborne Illness
          Food Safety Resources for Produce Shippers and Carriers During a Foodborne Illness Outbreak
          Outbreak Investigation Reports
          How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses
          About the CORE Network
          CORE Annual Reports
          CORE Publications


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