A recall of romaine lettuce that has sickened students with E. coli poisoning is expanding as the government tries to find out where the contamination occurred.
The Food and Drug Administration said late Monday that a food distributor in Moore, Okla., is recalling romaine lettuce that came from the same farm in Yuma, Ariz., that grew lettuce that sickened students in Michigan, Ohio and New York. Ohio-based Freshway Foods announced a 23-state recall of romaine lettuce last week related to those outbreaks.
At least 19 people have been sickened in connection with the E. coli outbreaks, which come from a rare strain of the disease that is difficult to diagnose. Officials at the federal Centers for Disease Control and Prevention say they are looking at an additional 10 probable cases of E. coli poisoning from tainted lettuce.
The FDA said it is investigating the Yuma farm where the romaine lettuce was harvested and is attempting to determine the point in the supply chain where the contamination occurred. The agency declined to identify the farm.
Many of those who became ill were college students in the three states. Middle and high school students in New York were also sickened, including a 15-year-old and a 17-year-old who developed hemolytic uremic syndrome, which can cause bleeding in the brain or kidneys. Local health authorities in Dutchess County, where the students fell ill, said they are all expected to make a full recovery.
Most of the lettuce recalled was sold to food service establishments. The recall does not affect bagged lettuce in the grocery store.
California-based Andrew Smith Co. said Monday it is recalling lettuce sold to Vaughn Foods in Moore, Okla., and to a distributor in Massachusetts. Amy Philpott, speaking for the company, would not identify that distributor because the lettuce is already past its expiration date.
Philpott would not say if Andrew Smith Co. sold the lettuce recalled last week to Freshway Foods, though she did confirm that Freshway Foods is one of the company's clients.
The "use by" date of the lettuce sold to Vaughn Foods is May 9 or 10, according to the FDA. The FDA said lettuce distributed by the company was sold to restaurants and food service facilities and were not available for purchase at retail establishments by consumers.
Andrew Smith Co. buys bulk romaine lettuce from farms and sells it to distributors. Those distributors, such as Freshway Foods and Vaughn Foods, then sell it to food service outlets or retail customers.
Freshway Foods said last week it was recalling the romaine lettuce sold in 23 states and the District of Columbia under the Freshway and Imperial Sysco brands. No contamination was found at the company's processing plant, according to the FDA. New York officials discovered the contamination in a bag of Freshway Foods shredded romaine lettuce last week after local authorities had been investigating the outbreak for several weeks.
Students at the University of Michigan in Ann Arbor, Ohio State in Columbus and Daemen College in Amherst, N.Y., are among those who were affected by the outbreak. Middle and high school students sickened by the lettuce attended four schools in Wappingers Falls, N.Y. and nearby Hopewell Junction, N.Y.
Health officials said most of the college-age victims fell ill in April and have already recovered. No new cases have been reported in the middle and high schools since April 25.
The most common strain of E. coli found in U.S. patients is E. coli O157. The CDC said the strain linked to the lettuce, E. coli 0145, is more difficult to identify and may go unreported. E. coli infection can cause mild diarrhea or more severe complications, including kidney damage.
Dr. Patricia Griffin at the CDC said only about 5 percent of labs do a special test that identifies E. coli 0145. This is the first time that strain has been identified as part of a food-borne outbreak in the United States, she said.
"Because of problems identifying these infections we've probably missed outbreaks," she added.