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Genetic testing showed that the E coli strain involved in the outbreak produces a specific type of Shiga toxin that causes more severe illness, according to Matthew Wise, M.P.H., Ph.D., the CDC deputy branch chief for outbreak response.
Although the Food and Drug Administration (FDA) says there is no single grower or distributor to be blamed for the outbreak, and is still investigating, Arizona's Yuma growing region is thought to be the source of the contaminated lettuce.
Advice to travellers is that if they have symptoms of an E. coli infection, they should take action and talk to their healthcare provider.
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"Most of the newly reported cases are people who became sick two to three weeks ago, still within the window when contaminated romaine was available for sale", the CDC said. Some said they did not eat romaine lettuce but were in close contact with someone who got sick after eating it. Symptoms of E. coli vary, but by and large include bloody excrement and severe stomach cramps. The bacteria can be spread by contaminated water, animal manure or in undercooked beef. At least 89 have been hospitalized.
Health officials have tied the E. coli outbreak to romaine lettuce grown in Yuma, Arizona. According to certain critics, government investigators may never be able to get to the bottom of the crisis now that the growing season for the lettuce is over, and the vast majority of it has been removed from consumer shelves. Yuma is the place where the contaminated lettuce is believed to have originated from. Food is often shipped to central plants from various farms, where it is processed, mixed together, packaged, and redistributed. At the time, 17 people had been infected with the E. coli strain from seven states but no source had been identified. However, a particular farm or distributor has not yet has been found that started the outbreak.
"It's a labor-intensive task", said the FDA in a recent statement.
So far, they said, "there isn't a simple or obvious explanation for how this outbreak occurred within the supply chain". According to the Centers for Disease Control and Prevention, 197 people in 35 states have been fallen ill in the outbreak.