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Taco Bell E. coli O157:H7 Outbreak: Q&A with the FDA

The Food and Drug Administration’s Center for Food Safety and Applied Nutrition has published a fact sheet, titled, "Questions and Answers: Taco Bell E. coli O157:H7 Outbreak."

Q. Does FDA know what caused the E. coli O157:H7 infections linked to some Taco Bell Restaurants in several Northeastern states?
Shredded Iceberg lettuce has been implicated in the current E. coli O157:H7 outbreak. The U.S. Centers for Disease Control and Prevention (CDC), in conjunction with state and local health authorities, initially identified three food items served at the Taco Bell restaurants considered to be the most likely sources of the bacterial infection: shredded iceberg lettuce, cooked ground beef, and cheddar cheese. For a variety of reasons, it now appears very likely that the shredded lettuce was the vehicle of transmission, and very unlikely that the infections were transmitted by the meat or cheese.

Q: Are people still getting sick as a result of this outbreak?
This outbreak is considered to be over. According to the CDC, the latest onset of illness connected with this outbreak is December 6, 2006. The rate of newly reported illnesses has declined substantially. Cases still remain under investigation, but the data indicates that these individuals consumed iceberg lettuce no later than the first week of December.

Q: Where exactly are the restaurants and the reported illnesses located that have been associated with this outbreak?
A total of 71 cases in five states have been reported to the CDC: Delaware (2 cases), New Jersey (33 cases), New York (22 cases), Pennsylvania (13 cases) and South Carolina (1 case — this person ate at a Taco Bell in Pennsylvania). 53 hospitalizations and 8 cases of Hemolytic Uremic Syndrome (HUS) have been reported. Taco Bell restaurants in other states have not been connected with this outbreak.

Q: Is lettuce in grocery stores and other restaurants safe?
There is no reason to suspect that lettuce in grocery stores is unsafe. Lettuce available in grocery stores has not been connected with the lettuce implicated in the outbreak linked to some Taco Bell restaurants in the Northeast.

Q: Are onions and green onions safe?
Early reports that green onions were implicated in this outbreak were inaccurate. There is no indication that any type of onions, including green onions, are unsafe or are connected in any way with this outbreak.

Q: Where did the shredded lettuce at Taco Bell restaurants come from?
The precise source of the shredded lettuce is under investigation. FDA has expedited its traceback efforts in an attempt to quickly find the source of the lettuce. The agency has set up a special team of food safety experts to review all available information as quickly as possible to pinpoint where the lettuce originated.

Q: How could the lettuce have become contaminated?
It is too soon to tell. FDA is working with state health agencies and the CDC to determine how and where the lettuce may have become contaminated.

Q: Could any of the shredded lettuce connected with the outbreak still be in distribution?
FDA believes that this is unlikely and that the suspect lettuce was distributed only to some Taco Bell restaurants.

Q: Is the lettuce in this outbreak related in any way to the current outbreak linked to Taco John’s restaurants in Iowa and Minnesota?
Detailed DNA analysis (fingerprinting) has proved that the E. coli O157:H7 causing illnesses in Iowa and Minnesota is a different strain than that linked to illnesses from Taco Bell restaurants in the Northeast.

Q: What should I do if I believe I may be infected?
Consumers who are concerned that they may have contracted E. coli O157:H7 infection from eating this lettuce should contact their health care provider to seek appropriate medical evaluation and treatment.

Q: What is FDA doing to increase the safety of lettuce and other fresh produce?
The FDA developed the Lettuce Safety Initiative in response to recurring outbreaks of E. coli O157:H7 in lettuce. The primary goals of the initiative are to reduce public health risks by focusing on the product, agents and areas of greatest concern and to alert consumers early and respond rapidly in the event of an outbreak. On August 24, 2006, the State of California Department of Health Services and Department of Food and Agriculture and the FDA met with industry and academia to further clarify the goals, objectives and the next steps for the Lettuce Safety Initiative. This meeting was facilitated by the Western Institute for Food Safety and Security. This initiative is based on the 2004 Produce Safety Action Plan, intended to minimize the incidence of food borne illness associated with the consumption of fresh produce.
FDA is considering a variety of options to increase the safety of all fresh produce marketed in the United States. The agency will hold a public hearing on the issue in early 2007.

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