Case Count: ongoing DOH/CDC E. coli outbreak investigation April 2018

County of Residence Cases
Hunterdon 4
Monmouth 1
Sussex 1
Somerset 1
Total 7*

 * Additional testing is ongoing to see if additional cases match the multistate outbreak

E. coli (Shiga toxin-producing E. coli) STEC

Report within 24 hours of Diagnosis to the Local Health Department.

E. coli are bacteria that normally live in the intestines of healthy people and animals. Most strains are harmless. E. coli 0157:H7 is a specific strain of E. coli that causes illness. A person becomes infected with E. coli 0157:H7 by swallowing the bacteria. This can occur when a person eats food which has been contaminated with E. coli 0157:H7, most often undercooked ground beef and raw milk. It can also spread within families, child care centers, and other institutional settings. Symptoms may be mild to severe including diarrhea (which may be bloody).

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E.Coli sickens at least 84 people in 19 states; chopped romaine lettuce identified as source

Romaine lettuce grown in the Yuma, Arizona region is likely the source of an E. coli O157:H7 outbreak that has sickened at least seven New Jersey residents and a total of 84 people in 19 states, according to the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA).

Based on new information, CDC is expanding its warning to consumers to cover all types of romaine lettuce from the Yuma, Arizona growing region. This warning now includes whole heads and hearts of romaine lettuce, in addition to chopped romaine and salads and salad mixes containing romaine.

At this time, the CDC said, no common grower, supplier, distributor, or brand has been identified. 

Consumers who have bought romaine lettuce - including salads and salad mixes containing romaine lettuce - should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick. If you don’t know if the lettuce is romaine, throw it away.  Before purchasing romaine lettuce at a grocery store or eating it at a restaurant, consumers should confirm with the store or restaurant that the romaine lettuce did not come from the Yuma, Arizona growing region.

“Individuals with this infection usually get better within about 5 to 7 days, however some illnesses can be serious or even life-threatening," said Dr. Shereef Elnahal, Commissioner of the New Jersey Department of Health. “Anyone experiencing symptoms of this illness should see a healthcare provider.”

The symptoms of E. coli infection vary. Some individuals may have mild to severe diarrhea, which may contain blood. Abdominal cramps, nausea and vomiting may occur. Usually there is little or no fever present. We encourage people to contact their health care provider if they have diarrhea that lasts for more than 3 days or is accompanied by high fever, blood in the stool, or so much vomiting that they cannot keep liquids down and they pass very little urine.

In addition, about 5 to 10% of people who are diagnosed with Shiga toxin-producing E. coli infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). HUS develops about 7 days after symptoms first appear, when diarrhea is improving. Clues that someone is developing HUS include decreased frequency of urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. Any who develop these symptoms should seek out medical care immediately.

Currently in New Jersey, DOH has confirmed a total of seven cases of E. Coli; 4 in Hunterdon County, and one each in Monmouth, Sussex and Somerset counties. As additional testing is completed, more cases may be added. DOH is continuing to work with our local health partners to identify, interview and obtain lab specimens from New Jersey residents who may have become ill from this contaminated food.

The CDC also advises that all restaurants and retailers ask their suppliers about the source of their romaine lettuce and refrain from selling or servicing any that was grown in Yuma, Arizona.

The CDC and DOH will continue to provide updates as more information becomes available.

For more information on this outbreak, visit the CDC website at

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Last Reviewed: 4/26/2018