An E. coli outbreak linked to romaine lettuce has been found in 12 states.

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The FDA announced a major E. coli outbreak linked to romaine lettuce earlier this month. Getty Images

Leery about eating lettuce? Many people are, considering the multistate outbreak of E. coli that was linked to romaine earlier this month.

The outbreak caused 43 people in 12 states to become ill as of Sunday, November 26, and that’s just in the United States.

Another 22 people were affected in Canada. Because the origins of contamination could not be firmly determined until recently, the FDA recalled all romaine lettuce.

Now the tainted lettuce has been linked to northern and central California.

As a result of the outbreak, the FDA has announced steps to give consumers more information about the origins and harvest dates of lettuce. They’re suggesting a voluntary labeling program, which would require growers and distributors to label where romaine was grown and when it was harvested. This will include if the lettuce was grown in a hydroponic or greenhouse environment. They have initiated discussions with major producers, distributors, and trade associations to talk about a voluntary labeling program.

The FDA has said romaine lettuce grown outside of a target area is not linked to the recent outbreak, and is working toward a program that would better help identify tarnished produce.

As it stands, lettuce must be labeled with the name of the manufacturing facility or distributor, and include contact information, an FDA spokesperson told Healthline. As of now, it doesn’t have to state where it was grown or when it was harvested. Only produce from other countries must carry a label with the country of origin.

Creating a regulation to mandate the label system would require FDA to go through a formal rulemaking process, the United Fresh Produce Association and the Produce Marketing Association said in a statement. They also noted that the label would cover all forms of romaine lettuce, which includes baby romaine and red romaine.

“It appears that FDA expects that this labeling will be the ‘new normal’ so that if there are outbreaks moving forward, FDA can limit advisories to affected regions, and consumers would be able to readily discern if they had product from a potentially affected area,” the statement said.

“Knowing the growing origin of produce will continue to play an important role in allowing consumers to avoid contaminated products and facilitating market withdrawals and tracebacks,” FDA commissioner Dr. Scott Gottlieb, said in a statement published Sunday.

Bacteria breakout

Elliot T. Ryser, PhD, a professor at Michigan State University in the Department of Food Science and Human Nutrition, said that E. coli bacteria comes from the field where lettuce is grown from a variety of environmental sources. That can include contaminated irrigation water, animals, runoff from cattle feed lots, and other sources.

“It’s very difficult to control,” he said. Lettuce and spinach are prone to E. coli contamination.

Most E. coli cases on lettuce come from precut, bagged varieties. He operates a cutting facility that has researched ways to reduce contamination.

“I’m not convinced that fresh-cut produce will ever be 100 percent safe,” Ryser said, noting that the sanitizers are still a problem in spreading contaminants.

Protecting your produce — And your health

Purchasing a whole head of lettuce is generally safer to avoid contamination, Ryser said.

If you purchase bagged lettuce, don’t try to wash it at home. You won’t be able to remove contamination and you may be more likely to re-contaminate the lettuce at home.

Shelley Feist, executive director of The Partnership for Food Safety Education, said there is not much else consumers can do to identify produce that may be affected by pathogens. They should inspect it for any bruising, follow safe handling tips such as washing hands when touching produce, and keep produce chilled after purchasing.