Questions & Answers
Taco Bell E. Coli O157:H7 Lettuce Outbreak

Shredded Iceberg lettuce has been implicated in the current E. coli O157:H7 outbreak. The U.S. Centers for Disease Control and Prevention (CDC), in conjunction with state and local health authorities, initially identified three food items served at the Taco Bell restaurants considered to be the most likely sources of the bacterial infection: shredded iceberg lettuce, cooked ground beef, and cheddar cheese. For a variety of reasons, it now appears very likely that the shredded lettuce was the vehicle of transmission, and very unlikely that the infections were transmitted by the meat or cheese.

The cheese is not suspected for the following reasons: the cheddar cheese served by Taco Bell is pasteurized, the cheese served in the restaurants where illnesses were confirmed was also distributed to other places where illnesses have not been reported and the cheese is routinely tested for E. coli.

The ground beef is not suspected because it is thoroughly cooked at a central location and is then reheated after distribution to individual Taco Bell restaurants. Also, the same meat served in the Taco Bell restaurants where illnesses have been confirmed was also distributed to other areas of the country where illnesses have not been reported. Additional details are available at the following website: http://www.cdc.gov/ecoli/current.htm

This outbreak is considered to be over. According to the CDC, the latest onset of illness connected with this outbreak is December 6, 2006. The rate of newly reported illnesses has declined substantially. Cases still remain under investigation, but the data indicates that these individuals consumed iceberg lettuce no later than the first week of December.

All information indicates that the implicated lettuce is no longer being served.

A total of 71 cases in five states have been reported to the CDC: Delaware (2 cases), New Jersey (33 cases), New York (22 cases), Pennsylvania (13 cases) and South Carolina (1 case — this person ate at a Taco Bell in Pennsylvania). 53 hospitalizations and 8 cases of Hemolytic Uremic Syndrome (HUS) have been reported. Taco Bell restaurants in other states have not been connected with this outbreak.

There is no reason to suspect that lettuce in grocery stores is unsafe. Lettuce available in grocery stores has not been connected with the lettuce implicated in the outbreak linked to some Taco Bell restaurants in the Northeast.

Early reports that green onions were implicated in this outbreak were inaccurate. There is no indication that any type of onions, including green onions, are unsafe or are connected in any way with this outbreak.

The precise source of the shredded lettuce is under investigation. FDA has expedited its traceback efforts in an attempt to quickly find the source of the lettuce. The agency has set up a special team of food safety experts to review all available information as quickly as possible to pinpoint where the lettuce originated.

It is too soon to tell. FDA is working with state health agencies and the CDC to determine how and where the lettuce may have become contaminated.

FDA believes that this is unlikely and that the suspect lettuce was distributed only to some Taco Bell restaurants.

Detailed DNA analysis (fingerprinting) has proved that the E. coli O157:H7 causing illnesses in Iowa and Minnesota is a different strain than that linked to illnesses from Taco Bell restaurants in the Northeast.

E. coli 0157:H7 is a pathogenic bacterium that can be transmitted through eating contaminated food. Infection with E. coli O157:H7 can cause diarrhea which is often bloody. Most healthy adults recover completely within a week. Infections in the very young, elderly, or health-compromised individuals can be much more serious. Some may develop a type of kidney failure called Hemolytic Uremic Syndrome (HUS), a condition that can lead to permanent kidney damage and even death.

Consumers who are concerned that they may have contracted E. coli O157:H7 infection from eating this lettuce should contact their health care provider to seek appropriate medical evaluation and treatment.

The FDA developed the Lettuce Safety Initiative in response to recurring outbreaks of E. coli O157:H7 in lettuce. The primary goals of the initiative are to reduce public health risks by focusing on the product, agents and areas of greatest concern and to alert consumers early and respond rapidly in the event of an outbreak. On August 24, 2006, the State of California Department of Health Services and Department of Food and Agriculture and the FDA met with industry and academia to further clarify the goals, objectives and the next steps for the Lettuce Safety Initiative. This meeting was facilitated by the Western Institute for Food Safety and Security. This initiative is based on the 2004 Produce Safety Action Plan, intended to minimize the incidence of food borne illness associated with the consumption of fresh produce.

FDA is considering a variety of options to increase the safety of all fresh produce marketed in the United States. The agency will hold a public hearing on the issue in early 2007.