E. Coli outbreak could be linked to romaine lettuce at Wendy’s; Michigan has 43 confirmed illnesses

Michigan health officials have confirmed 43 cases of E. coli that match the strain (E. coli O157) in a multi-state outbreak.

More than 55% of the outbreak cases reported eating food at a Wendy’s restaurant. A specific food has not yet been identified as the source, but officials are focusing on sandwiches topped with romaine lettuce.

There is no recommendation to avoid eating at Wendy’s and the restaurant is working with local public health departments to remove certain products.

The illness onset dates range from late July through early August. Outbreak cases have been reported in the following counties: Allegan, Branch, Clinton, Genesee, Gratiot, Jackson, Kent, Macomb, Midland, Monroe, Muskegon, Oakland, Ogemaw, Ottawa, Saginaw, Washtenaw, and Wayne and the City of Detroit.

The people who have experienced illness have ranged in age from 6 to 94 years old. Among the Michigan outbreak cases, 56% have been hospitalized. Four cases of hemolytic uremic syndrome (HUS), a severe complication that occurs in some people diagnosed with STEC infection, have been identified.

Michigan is working with local health departments, the CDC, and the FDA to determine an exact source of the illnesses. The investigation may be broader than a single restaurant chain. Michigan health officials expect the investigation to include Ohio, Indiana and Pennsylvania.

“We are reminding residents in Michigan to seek medical attention if they experience symptoms of E. coli illness such as severe stomach cramps, diarrhea, vomiting or other gastrointestinal distress,” said Dr. Alexis Travis, senior deputy director of public health administration at MDHHS. “Additionally, we urge residents to take proper precautions when handling food and practice safe food preparation.”

What the CDC is saying

CDC is not advising that people avoid eating at Wendy’s restaurants or that people stop eating romaine lettuce.

• Wendy’s is taking the precautionary measure of removing the romaine lettuce being used in sandwiches from restaurants in this region.
• At this time, there is no evidence to indicate that romaine lettuce sold in grocery stores, served in other restaurants, or in people’s homes is linked to this outbreak.
• CDC will update this advice if the investigation identifies foods to avoid.

Previous: Nearly 100 cases of E. coli reported within 3 Michigan counties

What is Escherichia coli (E. coli)?

Escherichia coli (E. coli) are bacteria that are found in the environment, foods and intestines of people and animals. They are a large and diverse group of bacteria, according to the CDC.

Most strains are harmless, but some can make people sick. Some strains can cause diarrhea, urinary tract infections, respiratory illness and pneumonia -- among other illnesses.

What are the symptoms of E. coli-related illness?

Symptosm vary from person to person, but often include severe stomach cramps, diarrhea (often bloody) and vomiting.

Some people have a fever, which is usually not very high. Most people feel better within five to seven days. Some infections are mild, but others are severe or even life-threatening.

Symptoms usually appear three to four days after the exposure, but may appear in just one day or as long as 10 days. Young children and older adults may be more likely to experience severe illness.

Around 5% to 10% of people diagnosed with an infection develop hemolytic uremic syndrome, which appears seven days after symptoms begin, often when diarrhea is improving. Symptoms include decreased frequency of urination, feeling very tired and losing color in cheeks and inside the lower eyelids.

If you have symptoms, you should contact your doctor immediately. Your doctor should contact their local health department to report suspected or confirmed cases to the state.

What can you do to protect yourself from E. coli?

People with higher chances for foodborne illness are pregnant women, newborns, children, older adults, and those with weak immune systems, such as people with cancer, diabetes, or HIV/AIDS.

Health officials say you can prevent an E. coli-related illness by following proper hand hygiene and food handling practices.

The CDC said proper hand hygiene practices are as follows:

• Wash your hands thoroughly after using the bathroom and changing diapers.
• Wash your hands thoroughly before and after preparing or eating food.
• Wash your hands thoroughly after contact with animals or their environments (at farms, petting zoos, fairs, even your own backyard).
• Wash your hands thoroughly before preparing and feeding bottles or foods to an infant or toddler, before touching an infant or toddler’s mouth, and before touching pacifiers or other things that go into an infant or toddler’s mouth.
• Keep all objects that enter infants’ and toddlers’ mouths (such as pacifiers and teethers) clean.
• If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 60% alcohol (check the product label to be sure). These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and running water.

Food safety tips

You should also follow the four steps to food safety when preparing food: Clean, separate, cook and chill.

• Clean: Wash your hands for 20 seconds with soap and water before, during and after preparing food and before eating. Wash your utensils, cutting boards and countertops with hot, soapy water, after preparing each food item. Rinse fruits and vegetables under running water.
• Separate: Raw meat, poultry, seafood and eggs can spread germs to read-to-eat foods unless you keep them separate. Use separate cutting boards and plates for raw meat, poultry, seafood and keep their juices away from other foods. Keep raw meat, poultry, seafood and eggs separate from all other foods in the refrigerator.
• Cook: Cook to the right temperature. Food is safely cooked when the internal temperature is high enough to kill germs that can make you safe. The only way to tell is by using a food thermometer (except for seafood). Click here to learn more about safe internal temperatures.
• Chill: Bacteria can multiply rapidly if left at room temperature or at temps between 40 degrees and 140 degrees. Divide warm foods into several clean, shallow containers so they will chill faster. Refrigerate perishable food within two hours.

Read: More health coverage