Which is why, although Canadian officials urged consumers to avoid romaine lettuce, USA health authorities have not yet identified which type of "leafy greens" had led to the spread of the illness. Cases were later confirmed in Ontario as well. Leafy greens, including romaine lettuce, were the cause of outbreaks from E. coli 0157:H7 in 2006, 2011, 2012, and 2013.
Some stores, including the, pulled romaine lettuce products from its shelves.
Two people have died, one of which was in Canada. CDC continues to work with regulatory partners in several states, at the U.S. Food and Drug Administration, and the Canadian Food Inspection Agency to identify the source. Officials determined that the E. coli bacteria found in both countries were genetically "related".
The cases occurring in both the USA and Canada are of the same strain and appear to share a , but the CDC said this was not sufficient data to prove a link. The group also refused to issue a warning against a particular food, saying, "Because we have not identified a source of the infections, CDC is unable to recommend whether USA residents should avoid a particular food".
US officials are continuing their investigation. Early symptoms of an infection include bloody diarrhea, fever, nausea and vomiting, with later symptoms including excessive bleeding, nosebleeds, seizures and shortness of breath.
Healthy adults usually recover within a week, but young children and older adults have an increased risk of developing a life-threatening type of kidney failure called hemolytic uremic syndrome. While the CDC refuses to make a similar warning, it does offer this advice for limiting the spread of E. coli: "You can protect yourself by washing your hands thoroughly before and after preparing or eating food". Ill people also reported eating different types and brands of romaine lettuce.
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