The Food and Drug Administration (FDA) today narrowed its investigation of an outbreak of E. coli O157:H7 infections linked to Taco Bell restaurants in Northeastern states by focusing its efforts on finding the sources of shredded lettuce served at the stores. This new focus is based on the fact that three items — shredded lettuce, cheddar cheese and cooked ground beef — were implicated in a study conducted by the U.S. Centers of Disease Control and Prevention (CDC) as the items most likely to have been the vehicles of pathogen (disease-causing agent) transmission in this outbreak. Based on a number of other factors, as well as food processing techniques used for cheese (pasteurization) and ground beef (cooking), lettuce is considered overall to be the single most likely source of the outbreak at this time.
The peak of the outbreak occurred in the last week of November. A total of 71 cases in five states — Delaware, 2 cases; New Jersey, 33 cases; New York, 22 cases; Pennsylvania, 13 cases; and South Carolina, 1 case — have been reported to the CDC. The single case in South Carolina occurred in a person who ate at a Taco Bell in Pennsylvania. The number of new cases has declined substantially. For the latest details about these cases, see the CDC website at http://www.cdc.gov/ecoli/2006/december/120806.htm.
The information about items likely to have transmitted the pathogen in this outbreak comes from a CDC “case control” study, which involves interviewing ill and well Taco Bell restaurant patrons about what food items they consumed. By comparing foods consumed by ill and well persons, investigators can show statistical links to particular food ingredients. This does not establish that these foods are the causes of the outbreak, but it does give clues as to where further investigation should focus to try to find hard evidence of the cause.
Because of this, FDA investigators are further expediting review of Taco Bell records obtained from the firm in order to trace the distribution channels of the lettuce and identify the farm or farms where the lettuce was grown, as well as all firms and facilities that handled the product between harvest and delivery.
FDA has no indication that lettuce or cheese served at any other restaurant, or lettuce or cheese sold in any other venue, is connected with this outbreak. The agency is aware of the outbreaks of E. coli O157:H7 at Taco John’s restaurants in Iowa and Minnesota, and is monitoring these closely in cooperation with state health authorities. Based on available information these outbreaks do not appear at this time to be related to the Taco Bell outbreak.
FDA continues to collaborate with CDC, and with state and local health officials, to determine how the outbreak occurred and find the source of suspect food items.
Infection with E. coli O157:H7 can cause diarrhea, often bloody. Although most healthy adults can recover completely within a week, some people can develop hemolytic uremic syndrome, which can lead to a form of kidney failure. This condition is most likely to occur in young children and the elderly. The condition can lead to serious kidney damage and even death. Consumers who are concerned that they may have contracted E. coli O157:H7 infection should notify their local health department, and contact their physician or health care provider to seek medical attention as needed.
More information about E. coli O157:H7 and the outbreak linked to Taco Bell restaurants on the East Coast is available at: http://www.fda.gov/oc/opacom/hottopics/EcoliOutbreaks/restaurants.html.
FDA will provide additional media updates on this investigation as more information becomes available.