Updated: 8:30 a.m., Nov. 21

The Centers for Disease Control and Prevention is advising all U.S. restaurants and retailers not to serve or sell romaine lettuce until the agency completes an investigation of a multistate outbreak of Shiga toxin-producing Escherichia E. coli O157:H7 infections linked to romaine lettuce.

As of this afternoon, the CDC had reported 32 cases in 11 states, resulting in 13 hospitalizations, but no deaths. One illness did result in hemolytic uremic syndrome, a type of kidney failure. Onset of the known illnesses occurred between Oct. 8 and Oct. 31.



"Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick," the CDC stated on its website.

This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix and Caesar salad. The CDC also advised the sanitation of any drawers or shelves in refrigerators where romaine was stored.



"That's what Produce Alliance is instructing us to do," Core Life Eatery President Scott Davis wrote in an email to FastCasual. "I'm sending out notices to operators now."

The Public Health Agency of Canada also identified 18 ill people who were infected with the same DNA fingerprint of E. coli O157:H7 bacteria in the provinces of Ontario and Quebec.

Although the CDC has not mandated a recall, Michael Droke, a specialist in agriculture and cooperative law and a partner at the international firm Dorsey & Whitney, suggested retailers pull romaine and possibly all other lettuce and leafy greens from their shelves, a process called quarantining, until the source is found.

"Before the FDA can use its mandatory recall authority, the FDA must make a determination that there is a reasonable probability that the food is adulterated or misbranded," he wrote in an email to FastCasual. "The FDA must also make a determination that there is a reasonable probability that using or exposure to such food will cause serious adverse health consequences or death to humans or animals, in a tongue twister referred to a SAHCODHA hazard," Droke said.

The FSMA mandatory recall authority gives teeth to FDA enforcement, Droke said. "This agency's guidance helps employers understand when that authority will be used, and will encourage companies to voluntary recall products to avoid a mandatory sanction. Food and ingredient companies should prepare in advance for the need to recall their products to minimize the risk of a mandatory order."

New York-based Just Salad has removed all romaine lettuce from its nearly 40 locations around the country, a decision that CEO Nick Kenner said he made with "an abundance of caution."

"Food safety is always our number one concern, which is why our guests continue to choose Just Salad over others," he said in an email to FastCasual.

The removal, of course, isn't ideal, but Just Salad doesn't expect to take a hit as its director of supply chain is working with suppliers and farms to bring in additional greens to replace romaine, Kenner said in an email to FastCasual.

"During the last romaine issue in April, business was not affected, as our guests switched out romaine in favor of our six other lettuce options: organic mesclun, organic arugula, shredded kale, baby spinach, red cabbage and Iceberg," Kenner said. "Starting Monday, we're bringing back iceberg lettuce to all U.S. locations for guests who want that extra crunch in their salad."

Kenner and his team will continue to monitor CDC announcements but said customers can rest assured that any lettuce the chain serves is safe to consume.

"We have a dedicated supply chain team who is in constant contact with our suppliers and our farms to ensure the safety of all of our produce," Kenner said.