Federal officials are reporting that an outbreak of E. coli O121:H9 infections linked to romaine lettuce has ended.

Four illnesses were confirmed in the outbreak. Little other information was available from the Food and Drug Administration.

“The information collected over the course of this investigation indicated that romaine lettuce was the likely source of this outbreak; however, it appears that this outbreak is over, and there is no actionable advice for consumers,” according to FDA officials.

“FDA has been conducting a traceback investigation and other activities in an effort to learn more about possible sources or routes of contamination.”

The FDA first reported the outbreak two weeks ago but has not shared any information about patient demographics or what states are involved. The agency did not report when the first illness was reported or when the last one was logged by public health officials.

As of Jan. 26, the Centers for Disease Control and Prevention had not posted any information about the outbreak. That is generally standing procedure for the agency if a specific product is not identified.

Romaine and other leafy greens have been behind many foodborne illness outbreaks in recent years. Most involved bagged or otherwise packaged salads. Those outbreaks include:

2018 — E. coli — romaine lettuce
62 people infected with the outbreak strain of E. coli O157:H7 were reported from 16 states and the District of Columbia; 25 patients were hospitalized.
Canada also identified patients infected with the outbreak strain. 

2018 – Cyclospora — romaine lettuce-carrot mix in McDonalds salad
511 infections were confirmed in people from 15 states.

2018 — E. coli — romaine lettuce
210 people infected with the outbreak strain were reported from 36 states; 96 people were hospitalized, including 27 people who developed a type of kidney failure called hemolytic uremic syndrome; 5 deaths were reported.

2018-19 — E. coli — romaine lettuce
167 people infected with the outbreak strain of E. coli O157:H7 were reported from 27 states; 85 hospitalizations were reported, including 15 people who developed hemolytic uremic syndrome, a type of kidney failure.

2020 — E. coli — leafy greens
40 people were infected with the outbreak strain of E. coli O157:H7 from 19 states; 20 were hospitalized.

2020 — Cyclospora — bagged salad
701 people with laboratory-confirmed Cyclospora infections were reported from 14 states; 38 were hospitalized.

2021 — E. coli — packaged salad
10 people infected with the outbreak strain of E. coli O157:H7 were reported from four states; four were hospitalized and one person developed a type of kidney failure called hemolytic uremic syndrome (HUS).

2021 — Listeria — packaged salad
16 people infected with the outbreak strain of Listeria monocytogenes were reported from 13 states; 12 were hospitalized; 2 deaths were reported.

2021 — Listeria — packaged salad
10 people infected with the outbreak strain of Listeria monocytogenes were reported from eight states; all 10 people were hospitalized; 1 death was reported.

2021 — E. coli — baby spinach
15 people infected with the outbreak strain of E. coli O157:H7 were reported from 10 states; 4 were hospitalized and 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS).

2021 — Salmonella — packaged salad
31 people infected with the outbreak strain of Salmonella Typhimurium were reported from 4 states; 4 people were hospitalized.

Additional outbreaks associated with leafy greens included:

DateVehicleEtiologyConfirmed
Cases
States/Provinces
July 1995Lettuce (leafy green; red; romaine)E. coli O157:H7741:MT
Sept. 1995Lettuce (romaine)E. coli O157:H7201:ID
Sept. 1995Lettuce (iceberg)E. coli O157:H7301:ME
Oct. 1995Lettuce (iceberg; unconfirmed)E. coli O157:H7111:OH
May-June 1996Lettuce (mesclun; red leaf)E. coli O157:H7613:CT, IL, NY
May 1998SaladE. coli O157:H721:CA
Feb.-Mar. 1999Lettuce (iceberg)E. coli O157:H7721:NE
Oct. 1999SaladE. coli O157:H7923:OR, PA, OH
Oct. 2000LettuceE. coli O157:H761:IN
Nov. 2001LettuceE. coli O157:H7201:TX
July-Aug. 2002Lettuce (romaine)E. coli O157:H7292:WA, ID
Nov. 2002LettuceE. coli O157:H7131:Il
Dec. 2002LettuceE. coli O157:H731:MN
Oct. 2003-May 2004Lettuce (mixed salad)E. coli O157:H7571:CA
Apr. 2004SpinachE. coli O157:H7161:CA
Nov. 2004LettuceE. coli O157:H761:NJ
Sept. 2005Lettuce (romaine)E. coli O157:H7323:MN, WI, OR
Sept. 2006Spinach (baby)E. coli O157:H7 and other serotypes205Multistate and Canada
Nov./Dec. 2006LettuceE. coli O157:H7714:NY, NJ, PA, DE
Nov./Dec. 2006LettuceE. coli O157:H7813:IA, MN, WI
July 2007LettuceE. coli O157:H7261:AL
May 2008RomaineE. coli O157:H791:WA
Oct. 2008LettuceE. coli O157:H759Multistate and Canada
Nov. 2008LettuceE. coli O157:H7130Canada
Sept. 2009Lettuce: Romaine or IcebergE. coli O157:H729Multistate
Sept. 2009LettuceE. coli O157:H710Multistate
April 2010RomaineE. coli O145335:MI, NY, OH, PA, TN
Oct. 2011RomaineE. coli O157:H760Multistate
April 2012RomaineE. coli O157:H728

1:CA

Canada

June 2012RomaineE. coli O157:H752Multistate
Sept. 2012RomaineE. coli O157:H791:PA
Oct. 2012Spinach and Spring Mix BlendE. coli O157:H733Multistate
Apr. 2013Leafy GreensE. coli O157:H714Multistate
Aug. 2013Leafy GreensE. coli O157:H7151:PA
Oct. 2013Ready-To-Eat SaladsE. coli O157:H733Multistate
Apr. 2014RomaineE. coli O12641:MN
Apr. 2015Leafy GreensE. coli O14573:MD, SC, VA
June 2016Mesclun MixE. coli O157:H7113:IL, MI, WI
Nov. 2017Leafy GreensE. coli O157:H767Multistate and Canada

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