The FDA and CDC should not be stopped from doing their jobs

Since the start of the Trump Administration, the CDC and FDA have withheld from the public details about a Romaine Lettuce E. coli O157:H7 outbreak that sickened 89 in 15 states with 36 hospitalized, 7 with kidney failure – hemolytic uremic syndrome –  and 1 death.

(Bainbridge Island, WA – April 21, 2025)  “It is disappointing, but with 20,000 employees at Health and Human Services (HHS) being fired, investigating, and reporting on outbreaks and alerting the public to the cause is clearly not a priority for this administration.  If the gutted CDC and FDA can no longer do the job, we will step up to inform and protect the public – so much for ‘Make America Healthy Again (MAHA),’” said William “Bill” Marler.  See,Marler Blog post: “CDC and FDA ‘Romaine’ Silent.”

In November 2024, the CDC and FDA began an investigation into an outbreak of E. coli O157:H7. By the time the CDC and FDA closed the investigation in January 2025, and reported it February 5, 20205, the outbreak included 89 people across 15 states: AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50)^[1], MT (1), ND (2), NE (3), OH (8), PA (1), SD (1), TN (1), WI (2). Onset dates ranged from November 4, 2024, to November 30, 2024. Ages ranged from 4 to 90 years, with a median age of 24. Outcome information was available for 74 cases, of which 36 (49%) were hospitalized. There were 7 reported cases of HUS, and 1 death attributed to the outbreak. All cases were linked by whole genome sequencing (WGS) to each other.^[2] See NCBI WGS Tree of Outbreak Cases.

According to documents reviewed, 7 subclusters of illnesses were identified across the multistate outbreak. These included 3 MO catered events, an OH secondary school, an IN restaurant, an IL restaurant, and an IL event catered by a different MO-based caterer. Salads were the common link across all 7 subclusters, and cases in all subclusters ate a romaine lettuce blend. At the time, based on information available at the points of service (POS), the traceback focused on romaine lettuce.

The CDC and FDA investigation consisted of three traceback legs representing twenty-eight cases and five POS. The three traceback legs identified four distribution centers, one broker, two processors, one grower, and one ranch – all names redacted in the documents. The traceback investigation determined that a sole processer sourced romaine lettuce from a single grower that would have been available at all points of service during the timeframe of interest. Additionally, romaine lettuce supplied to four of the five POS were traced back to the common ranch and lot. Through analysis of records, four lots of romaine lettuce were implicated, resulting in confirmation of romaine lettuce as the outbreak vehicle. Epidemiologic and traceback data supported the conclusion that romaine lettuce was the source of illnesses in the outbreak. The CDC and FDA closed the investigation on January 15, 2025, with the confirmed vehicle being romaine lettuce, without alerting the public who was the source of the outbreak. See, CDC Report and FDA Report.

“Because we represent people and families from several states that were WGS matches to each other, it was not long until our on-staff Epidemiologist determined that there was a common link to romaine lettuce in the outbreak period.  Had the CDC and FDA been allowed to do their jobs they would have publicized the conclusion,” said Marler.

William “Bill” Marler has been a food safety lawyer and advocate since the 1993 Jack-in-the-Box E. coli O157:H7 Outbreak which was chronicled in the book “Poisoned” and in the recent Emmy Award winning Netflix documentary by the same name. Bill’s work has been profiled in the New Yorker, “A Bug in the System;” the Seattle Times, “30 years after the deadly E. coli outbreak, A Seattle attorney still fights for food safety;” the Washington Post, “He helped make burgers safer, Now he is fighting food poisoning again;” and several others. 

Dozens of times a year Bill speaks to industry and government throughout the United States, Canada, Europe, Africa, China, and Australia on why it is important to prevent foodborne illnesses.  He is a frequent commentator on food litigation and food safety on Marler Blog. Bill is also the publisher of Food Safety News.

To contact Bill, reach out to Julie Dueck at jdueck@marlerclark.com or 1-206-930-4220.

^[1] According to the St. Louis Health Department, there were a total of 115 cases, including 13 hospitalizations with two with HUS.

^[2] “What is whole genome sequencing (WGS) and why is it pivotal in foodborne illness investigations?”