Update: On Apr. 16, 2018, Consumer Reports advised against eating romaine lettuce again after an E. coli outbreak sickened 35 people across the U.S.

Update: On Jan. 25, 2018, U.S. food safety and health officials declared an end to the E. coli outbreak linked to leafy greens. In light of this development, Consumer Reports is no longer recommending that consumers avoid romaine lettuce. For more information, read our update.

An E. coli outbreak has sickened nearly 60 people and caused two deaths in the U.S. and Canada, and Consumer Reports advises that for the time being, you should steer clear of any romaine lettuce—the likely culprit.

What if you already have some romaine in the fridge? Can’t you just rinse the lettuce well to remove the bacteria?

In a word, no.

According to James Rogers, Ph.D., director of Food Safety and Research at Consumer Reports, if E. coli (or any other type of bacteria that can cause food poisoning) is present in your produce, washing it won’t remove all of those organisms. And it doesn’t take much bacteria to make you sick.

More on Foodborne Illness

“It is very difficult to remove bacteria from leafy greens,” he says. “Bacteria have the ability to adhere to the surface of the leaves, and to get stuck in microscopic crevices.” E. coli bacteria can even find their way into the interior of your produce.

Washing lettuce in water (or water combined with baking soda) may help remove pesticide residue, surface dirt and debris from produce, but Rogers cautions that washing has not been proven an effective way to remove E. coli and related bacteria. And if you’re thinking that buying organic romaine will keep you safe, think again: According to Charlotte Vallaeys, senior policy analyst at Consumer Reports, there is little evidence that organic produce is less vulnerable to E. coli outbreaks than conventional produce.

To build your salad, choose other types of lettuce, such as arugula or baby kale. Or you can opt for cooked greens, suggests Rogers. The heat kills E. coli and other types of bacteria that can make you sick. Even greens that are typically consumed raw, such as romaine lettuce, can be cooked. E. coli is destroyed at about 160°F, but, unlike with meat, it’s tough to take the temperature of leafy greens. “If you cook the greens until they are fully wilted, they’re likely to have been heated enough to be safe,” Rogers says. 


Read “
Avoid Romaine Lettuce for Now, Consumer Reports Says” for details on how this salad green is likely the cause of recent cases of E. coli food poisoning.
 

Spotting E. coli Symptoms

If you’re concerned because you’ve recently eaten raw romaine (the staple lettuce in a classic Caesar salad), be aware that E. coli symptoms generally pop up within 24 to 48 hours of eating contaminated food, according to Marvin Lipman, M.D., Consumer Reports’ chief medical adviser. “However, you should continue to watch for symptoms for up to 10 days,” he says, “as there can sometimes be a significant lag between consumption and illness.”

The strain of E. coli in this new outbreak is classified as 0157:H7, a type that produces a toxin that can cause serious illness. Symptoms include severe (often bloody) diarrhea, abdominal pain, and vomiting. Fever is not typically associated with this strain. About 5 to 10 percent of people infected with E. coli 0157:H7 may develop hemolytic uremic syndrome, a serious condition which affects the blood vessels and can lead to kidney failure and death.

If you’re exhibiting these symptoms, Lipman says it can be hard to determine whether it’s actually food poisoning or a stomach virus. If you are experiencing bloody diarrhea, severe vomiting, or if diarrhea lasts longer than 3 days, contact your doctor. In addition, if you’ve eaten romaine lettuce and you get sick, seeing a doctor may help track down the specific source of this E. coli outbreak. Doctors and hospitals often report suspected cases of food poisoning to local health officials. But it can still be a good idea to contact health authorities yourself if you suspect romaine lettuce or any other food has made you sick.

And if you suspect you’ve contracted some form of food poisoning, Lipman’s advice is to drink plenty of water, or perhaps some fruit juice or chicken broth to replenish your electrolytes. “Staying hydrated is one of the most important ways to avoid complications from food poisoning,” he says.


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