Today's Medicine

Health Alert: Local E. coli Case Linked to Romaine Lettuce Warnings

For weeks, health officials have been warning the public across the U.S. about eating romaine lettuce after concerns about E. coli contamination. Now, a Douglas County resident has tested positive for the bacteria – and the case is linked to romaine lettuce grown near Yuma, Arizona.

The person became ill about three weeks ago and has since recovered, but it’s an eye-opening reminder that E. coli outbreaks can and will strike close to home. According to the CDC, there have been 172 E. coli cases, including one death, in 32 states linked to the romaine lettuce from the Yuma region. Those numbers include the case right here in Nebraska.

What is E. coli?

The name E. coli is an abbreviation for Escherichia coli. These bacteria are found in the environment, foods and intestines of people and animals. 

There are many different strains of E. coli – most of which are harmless and are an important part of the digestive tract. However, some Shiga toxin-producing strains can make you very, very sick.

Symptoms of E. coli

Most people start to feel sick three to four days after eating or drinking something that contains the bacteria, but it can also begin to take effect up to 10 days after. Symptoms of e-coli infection vary for each person, but often include these symptoms:

  • Severe stomach cramps
  • Diarrhea (often bloody)
  • Vomiting
  • Low-grade fever (less than 101?)
  • Urinary tract infections
  • Respiratory illness
  • Pneumonia

Most people begin to feel better within five to seven days. Some infections are very mild, but others are severe or even life-threatening. If you have diarrhea that last more than three days or includes high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine, see the doctor right away. That’s a sign you may be suffering serious dehydration.

Preventing E. coli

Preventing illness from E. coli begins with practicing proper hygiene – including handwashing.

  • Wash your hands thoroughly before and after preparing or eating food, using the bathroom and changing diapers, and following contact with animals or their environments.
  • Follow the four steps to food safety when preparing food: clean, separate, cook and chill.
  • Wash fruits and vegetables well under running water, unless the package says the contents have already been washed.
  • Cook meats thoroughly:
  • Cook beef steaks and roasts to an internal temperature of at least 145°F and allow to rest for three minutes after you remove meat from the grill or stove.
  • Cook ground beef and pork to a minimum internal temperature of 160°F.
  • Always use a food thermometer to check that the meat has reached a safe internal temperature.
  • Don’t cause cross-contamination in food preparation areas. 
  • Thoroughly wash hands, counters, cutting boards and utensils after they touch raw meat.
  • Avoid raw milk, unpasteurized dairy products and unpasteurized juices (such as fresh apple cider).
  • Don’t swallow water when swimming and when playing in lakes, ponds, streams, swimming pools and backyard “kiddie” pools.


If you have questions about whether you may have signs of E. coli, talk with your Methodist Physicians Clinic primary care provider. Or you can visit us anytime at the Methodist Physicians Clinic Infectious Disease Clinic for more information about infection and prevention.

Article posted May 18, 2018

About the Author

Dr. Rudolf Kotula is a board-certified infectious disease physician. He specializes in areas such as antibiotic resistance, travel medicine and infection prevention.

You can visit Dr. Kotula at Methodist Physicians Clinic.

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