In late November, the Center for Disease Control and Prevention (CDC) issued a stern alert for people to throw away all types of romaine lettuce they have in their kitchen right now.

The food safety alert was due to an E. coli outbreak in 15 states and the District of Columbia linked to the lettuce that’s infected as of Dec. 6 at least 59 people and hospitalized 23, including two people who developed hemolytic uremic syndrome, a type of kidney failure.

Nearly a month later, the CDC is still warning people to avoid romaine lettuce "harvested from Monterey, San Benito, and Santa Barbara counties in the Central Coastal growing regions of northern and central California while FDA continues its investigation of farms identified in traceback." The agency is currently investigating farms and cooling facilities in central California and in that process identified Adam Bros. Farming, Inc. as having E. coli in the sediment from its water reservoir. After this finding, Adam Bros. issued a recall on Dec. 13 of its cauliflower, red leaf lettuce and green lettuce "out of an abundance of caution."

The CDC recommends people take the following steps:

  • This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.
  • If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.
  • Wash and sanitize drawers or shelves in refrigerators where romaine was stored. Follow these five steps to clean your refrigerator.

If the lettuce doesn't list its growing region, do not eat it.

If this alert sounds familiar, it’s because earlier this year there was a massive romaine lettuce recall.

At least 210 people in 36 states were infected with E. coli after eating romaine lettuce grown in Yuma, Arizona. Five people died, more than 90 have been hospitalized and 27 have been diagnosed with hemolytic uremic syndrome.

The CDC announced in August that samples of canal water in Yuma tested positive for E. coli, and the agency "continues to consider that contaminated water coming into contact with produce, either through direct irrigation or other means, is a viable explanation for the pattern of contamination." The canal is located near the contaminated lettuce farms and also close to a Concentrated Animal Feeding Operation (CAFO), a facility that can hold up to 100,000 heads of cattle.

Raw vegetables and fruits are often a source for E. coli because the bacteria can't be fully washed off. Thoroughly cooking produce will kill the bacteria, but that's the only way to be certain contaminated fruits and vegetables are safe. Raw vegetables are not the only food that can be contaminated, though.

Here are five other foods that you'll see recalled from time to time because of E. coli, along with tips on how to safely prepare them.


broccoli sprouts Growing conditions make sprouts particularly susceptible to E. coli. (Photo: margouillat photo/Shutterstock)

Sprouts are grown in warm, humid conditions ideal for the growth of bacteria like E. coli, as well as salmonella and listeria. They're at their most dangerous when eaten raw, but cooking them can reduce risks and kill harmful bacteria. Between 1996 and 2016, there were 46 U.S. outbreaks of food-borne illness from sprouts. In 2017, the U.S. Food and Drug Administration (FDA) began taking steps to curb the high number of bacterial illnesses linked to contaminated raw sprouts.


bottled water Even water isn't safe from contamination. (Photo: ericlefrancais/Shutterstock)

Bottled water is usually safe when it comes to bacterial contaminants, but in 2015, Niagara Brand bottled water issued a recall out of an abundance of caution because of possible E. coli contamination, even though no illnesses were reported. The danger from E. coli-infected water usually comes from sources like private wells or drinking straight from a body of water that has been contaminated. If you're getting your drinking or cooking water from a source that could possibly be contaminated, there are ultraviolet water-treatment systems that can kill the bacteria, or in a pinch, boiling the water for at least one minute will also kill contaminants.


well done beef Cooking beef so it's well done can kill any E. coli contamination (Photo: Allen.G/Shutterstock)

Earlier this year, 7 tons of ground beef were recalled because of E. coli contamination. These bacteria commonly live in the digestive tracts of cows, whose meat may become infected during slaughtering and processing. Since E. coli in beef is fairly common, beef should be fully cooked before being consumed. That means a medium-rare cheeseburger, while delicious, may also be dangerous. To stay clear of E. coli poisoning from beef, burgers, steaks, roasts and other cuts of meat, they should be cooked to well-done. The U.S. Department of Agriculture recommends cooking beef to an internal temperature of 160 degrees Fahrenheit (71 Celsius).

Unpasteurized juice

juice Unpasteurized juice can be contaminated with E. coli. (Photo: baibaz/Shutterstock)

Pasteurization kills bacteria in juice (and in dairy and eggs), but fresh juice can have E. coli passed on from the fresh produce it was made from. In 2013, 13 people became ill from E. coli after drinking unpasteurized apple juice from High Hill Ranch in California. The one sure way to avoid E. coli in any juice is to make sure it's been pasteurized before drinking it.

Deli meats

deli tray Deli meat, especially if it's past its prime, can be a source of E. coli bacteria. (Photo: Elena Elesseeva/Shutterstock)

Deli slicers aren't typically cleaned between each use, given the impracticality of sterilizing them after every order. But, because of this, if one package of deli meat contains E. coli, the bacteria can spread to other meats prepared on the same slicer. While the risk from deli meats isn't as high as fresh produce or raw meats, a CBS News report indicates about half of locations visited by FDA inspectors didn't clean and sanitize their meat slicers as often as the FDA recommends. When buying deli meat, you might want to inquire about how often their slicers are cleaned. And discard of any sliced deli products that have been in your refrigerator for more than a few days. The longer they sit, the more the bacteria can grow.

While people with a healthy immune system generally make a full recovery from E. coli poisoning, there are some cases — as with the recent romaine outbreak — when healthy individuals can still suffer serious health problems. Those with compromised immune systems, the elderly and infants face the highest risks from E. coli poisoning and should see a doctor immediately if symptoms occur. According to WebMD, symptoms appear two to five days after E. coli has been ingested; the most common symptoms are abdominal cramps, diarrhea, nausea and fatigue.

Editor's note: This file has been updated since it was published in April 2018.

Robin Shreeves ( @rshreeves ) focuses on food from a family perspective from her home base in New Jersey.

5 foods besides romaine that can have E. coli
Treat these foods with caution to avoid food poisoning.