H2 “temporary worker” visas—granted to central and South Americans to work as farmhands in Arizona have doubled in the past year—exactly the same time that there has been a record outbreak of E.coli infections resulting from “contaminated water” in the state’s agricultural irrigation canals.

According to a statement issued by Food and Drug Administration (FDA Commissioner Scott Gottlieb, “contaminated water” is the cause of a widespread romaine lettuce E. coli outbreak this year.

The water was “contaminated” in the irrigation canals in Yuma Valley, Arizona—used as toilets by the farmworkers.

According to the statement, the E.coli outbreak sickened 210 people across 36 states, causing 95 hospitalizations and five deaths as of June 27.

“Investigators from the FDA and CDC linked the E. coli outbreak to tainted canal water that flooded into growing fields.”

“To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic fingerprint as the outbreak strain,” the FDA said in a June 28 update.

The FDA, the CDC, and Arizona state officials continue to analyze samples from the Yuma region collected in early June and initial results are starting to become available. Several environmental samples of canal water in the area have been found to contain E. coli O157:H7 that genetically match the strain of bacteria that caused the outbreak. We have also identified additional strains of shiga-toxin producing E. coli in collected samples, but initial testing of these isolates indicates they are different than the outbreak strain.

While most strains of E. coli are harmless to humans, the 0157:H7 strain is linked to kidney failure, stomach cramps, bloody diarrhea and vomiting.

“Despite our best efforts to ensure the safest food supply possible, foodborne illness continues to occur in the US,” the FDA statement continued. “In the U.S., CDC—the agency that primarily detects multi-state outbreaks of illness—estimates that foodborne illness affects nearly 50 million people annually, which is about one in six Americans. Of these, an estimated 128,000 people are hospitalized and 3,000 die each year.”

A January 2018 report in the Arizona Central news service reported that the number of H-2A visas issued to agricultural workers in Arizona has more than doubled in the past five years, mirroring a national increase in the temporary “guest worker program” for non-citizens.

The U.S. Department of Labor certified 5,391 H-2A workers in the state in fiscal 2016, compared to just 2,110 that were certified in fiscal 2011, according to department data. Nationally, the number jumped from 77,246 workers to 165,741 in the same period.

The H-2A program is for seasonal workers, generally for a period of 10 months or less, to provide farms with “short-term agricultural labor when the number of available domestic workers is insufficient.”

Most come from Central and Southern America, regions where the E.coli strains are common.

According to a report in the March 2017 edition of the medical journal Pathogens and Disease, E.coli diseases are so widespread in “Latin America” that governments there have been force to establish a “Latin American Coalition for Escherichia coli Research (LACER)” to try and “reduce the impact of human disease.”

Prevalence of diarrheagenic E. coli in Latin America. The different colors depicted E. coli pathovars per geographical region. The font size represents the most prevalent pathovars per country with the largest font showing the pathogenic E. coli causing the largest number of diarrheal diseases. ETEC, enterotoxigenic E. coli; EAEC, enteroaggregative E. coli; EPEC, enteropathogenic E. coli; aEPEC, atypical EPEC; tEPEC, typical EPEC; EHEC, enterohemorrhagic E. coli; EIEC, enteroinvasive E. coli; DAEC, diffusely adherent E. coli.