89 people became ill, 36 were hospitalized, 7 developed kidney failure, and 15 died in 15 states
Affected conditions: Arizona (2), Colorado (1), Illinois (7), Indiana (8), Kansas (1), Kentucky (1), Missouri (50), Montana (1), North Dakota (2), Nebraska (3), Ohio (8), Pennsylvania (1), Wasa (2).
As the father of three beautiful, strong young women, I was almost immune to constructive criticism. It’s in that vein I call my friend at FDA and CDC Close Romaine Lettuce E. coli O157: H7 case Provide information about the outbreak without supplying the pubic bone they are supposed to serve.
Here are the highlights (or low lights) of the survey.
Epidemiology overview and genomic analysis
On November 25, 2024, Pulsenet encoded the occurrence of E. coli O157:H7 2411MoExh-2. At the time of closure, the study included 89 cases in 15 states: AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50), MT (1), NE (3), OH (8), PA (1), SD (1), TN (1), WI (2), All 0-4 Alles Quarantine dates ranged from November 7, 2024 to December 1, 2024. The reported date of onset (n = 83) ranged from November 4, 2024 to November 30, 2024. Result information was available in 74 cases, of which 36 (49%) were hospitalized. Seven cases of HUS have been reported, with one death attributing this outbreak.
The cases in this study were defined as infection of E. coli O157:H7 with isolates associated with an occurrence strain within the 0-4 allele by CGMLST and isolates associated with isolates on the day of isolate through November 7, 2024.
This outbreak was coded following notifications from MO colleagues after identifying and investigating multiple illnesses related to events catered by the same MO-based caterer. These events took place between November 6th and November 8th. All events contained the same menu items with some changes. A colleague at MO conducted a retrospective cohort study at two events and found that salad was the only statistically important menu item at both events. The salad included an iceberg/romaine lettuce blend, carrots, purple cabbage, onions, canned pimento, canned artichokes, parmesan cheese and salad dressing. (b) (4) In total, seven subclusters were identified across the multistate occurrence. These include Mo Catered Events, OH(B)(4) schools, restaurants, IL restaurants and IL events offered by another MO-based caterer. The salad was a common link across all seven subclusters, and all subcluster cases ate the iceberg/romaine lettuce blend. CDC conducted an intensive survey on November 26th, 2024. 27 surveys have been returned. EPI information is available in 65 cases, of which 60 (95%) reported consuming all sorts of lush greenery before illness. Of the 57 cases that remember the exact type of lush greenery, 50 (88%) consumed romaine lettuce. This is statistically significantly higher than the 49% background rate from the FoodNet census.
Summary overview of Traceback
In response to the occurrence of E. coli 0157 with lush green as a suspicious vehicle, trace investigations have begun. Each case included in the Traceback study reported consumption of lush greenery prior to the onset of the disease. Traceback focused on icebergs and romaine lettuce based on information available at Service Points (POS). The study consisted of 28 cases and 3 traceback legs representing 4) POS. The three traceback legs identified (b) (4) distribution centers, (b) (4) brokers, (4) processors, (b4) growers, and *x*) ranches. Traceback investigation determined that (b)(4) and Romaine lettuce was sourced from the grower, the only processor (b)(4); Furthermore, Romaine Lettuce, supplied to B) (4) POS, dated back to general ranches and lots. Through analysis of records, (b) (4) many romaine lettuces were involved, and as a result, romaine lettuce was confirmed as a medium.
Who made the salad? The citizens have a right to know. I know that, and retailers, shippers, processors, growers know that. It will be published.

Based on epidemiological and trace data, romaine lettuce was identified as the cause of this outbreak. Traceback’s research determined that only processors sourced Romaine Lettuce from (4) growers that are available at any point of service during the time frame of interest. Furthermore, the romaine lettuce supplied to (b)(4)pos dates back to general ranches and lots. Iceberg lettuce was also tracked, but no typical growers were identified. Farm surveys were conducted on identified growers to determine the route of contamination. However, there were no significant observations. At the end of this response, this cluster contained 89 cases in 15 states [AR (2), CO (1), IL (7), IN (8), KS (1), KY (1), MO (50), MT (1), ND (2), NE (3), OH (8), PA (1), SD (1), IN (1), WI (2)].
These are the real people of this list, our friends and family. There are many children who have become ill. They need the FDA and CDC to do their job.

Also, where is the health department? Arizona (2), Colorado (1), Illinois (7), Indiana (8), Kansas (1), Kentucky (1), Missouri (50), Montana (1), North Dakota (2), Nebraska (3), Ohio (8), Pennsylvania (1), South Dakota (1),?