A nationwide outbreak of E. coli bacteria, tracked to romaine lettuce from Arizona, has sickened its first Alaska victims – all eight of them at the state prison in Nome.

Dr. Joe McLaughlin, with the Epidemiology Section at the state Department of Health and Social Services, said health officials had responded last week to an outbreak of E. coli O157:H7 bacteria at the Anvil Mountain Correctional Center in Nome.

None of the eight patients have died or been hospitalized, in cases which were noticed between April 5 and April 15. All ate “significantly higher” numbers of salads than other people at Anvil Mountain, however, and have shown the same symptoms.

“Bloody diarrhea is one of the symptoms that people most commonly presented with, along with abdominal cramping, nausea and vomiting,” McLaughlin said.

Although no other Alaska cases have been reported, the outbreak is believed to be part of a larger one affecting at least 53 persons across 16 states. McLaughlin said the cause is believed to be romaine lettuce grown in Yuma, Ariz., which produces much of the nation’s romaine crop during the winter before spring romaine growing moves to Salinas, Calif.

The U.S. Centers for Disease Control and Prevention as well as the Food and Drug Administration, are closely examining the epidemic, which may have widened in scope slightly due to the Alaska cases.

“Our outbreak is the first one I know of nationally that’s been associated with the consumption of whole heads of lettuce rather than chopped lettuce,” McLaughlin said. “What this outbreak suggests is that the source of the contamination may actually be at the farm rather than the lettuce processing center.”

On Friday, the Associated Press reported that the CDC had expanded a warning about chopped romaine to whole romaine heads as well, based on information from the Alaska outbreak. 

E. coli, a disease typically spread through fecal contact, most frequently causes cramps, diarrhea and vomiting but can also lead to kidney failure and death. The O157:H7 strain also poses the threat of hemolytic uremic syndrome, a condition with potentially life-altering consequences for vulnerable groups like children and the elderly.

“About 15 percent of children who get E. coli will develop hemolytic uremic syndrome,” McLaughlin said.

Jeremy Ayers, a program manager with the Department of Environmental Conservation’s Food Safety and Sanitation program, said no other DOC facilities have seen any signs of E. coli contamination.

“As far as we’re aware they only get it as whole heads of lettuce,” Ayers said. “A lot of the lettuce will come to Alaska as whole heads; it will last longer and have a longer shelf life.”

DOC uses a dedicated lettuce provider, Ayers said, and authorities were quickly able to track it back to a potential source being confirmed by the FDA. Romaine lettuce from Yuma has been removed from state prisons’ food chains.

In addition, McLaughlin said, staff and inmates at the prison are paying greater attention to hand hygiene.

"This bacteria is transferred via the fecal-oral route,” McLaughlin said. “When a person who is sick goes to the bathroom, they can get some of these bacteria on their fingers.”

Although DEC isn’t aware of any other recent E. coli cases in Alaska, McLaughlin said, it isn’t clear whether that was because none had occurred or none have yet been reported.

In the meantime, authorities are recommending that people discard any romaine lettuce if they’re not sure whether it came from Yuma, out of what McLaughlin called “an abundance of caution.” Any preparation or storage areas for supplies of romaine should also be cleaned.

According to Ayers, some retailers like Fred Meyer have proactively removed romaine supplies from their shelves until they can find sources that aren’t in Yuma. The CDC and the FDA are continuing to use the information from Alaska’s cases to help isolate and end the outbreak.

“They’ll use our traceback information and they’ll use other states’ traceback information to try and put the whole puzzle together,” Ayers said.

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