Wednesday's CDC update on the chopped romaine lettuce E. coli outbreak adds five states and 18 sick people, bringing those numbers to 16 states and 53 people.
But the most indicative numbers about this outbreak might be the hospitalization count, unusually high for an E. coli outbreak.
Of the 53 sick people in 16 states, 31 have been hospitalized, according to the Centers for Disease Control. That's 58.4 percent, much higher than four of the 2016 or 2017 E. coli outbreaks. The exception is the 2016 beef E. coli outbreak that sickened only 11 and put seven in the hospital.
The hospitalization rate of the other E. coli outbreaks in 2016 and 2017: 36.0, 37.5, 26.9 and 18.2.
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"It's a stunningly high number of hospitalizations," said food safety attorney Bill Marler, who made his bones on E. coli cases. "It means that this particular strain of E. coli O157 is especially virulent or we are just seeing the tip of the outbreak iceberg and are only seeing the most ill at this point."
Though the most recent case was reported April 6, the CDC says cases after March 29 still might not be reported. E. coli symptoms can last five to seven days and be as mild as bloody diarrhea or as serious as hemolytic uremic syndrome (HUS). That form of kidney failure can be fatal.
Five of the sick people have developed HUS. A lawsuit filed Monday by Marler Clark and The Ferrara Law Firm says New Jersey resident Louise Fraser is one of those five. The suit says Fraser spent 15 days in the hospital after eating a salad at Panera Bread with romaine lettuce supplied by Freshway Foods.
As far as the source, there's been no narrowing beyond the CDC tracking it to romaine lettuce from the Yuma, Arizona region. Nor have the CDC directions for consumers changed: if you have chopped romaine lettuce at home, throw it away. Don't buy it in stores or in restaurants unless you can confirm it doesn't come from the Yuma region.
E. coli travels well, however. Yuma's near neither of the two largest clusters that comprise 35 of 53 cases nor are those clusters near each other. Idaho and Montana combine for 16 confirmed cases. Pennsylvania has the most cases, 12, and New Jersey has seven.
The distribution of the other 18: Arizona, three; New York, Ohio, Michigan, Connecticut, two each; California, Alaska, Illinois, Louisiana, Missouri, Virginia and Washington, one each.
The 53 sick, ranging in age from 10 to 84, breaks down to 37 females and 16 males. The FDA and CDC interviewed 43 of the 53 and found 41 recalled eating romaine lettuce in the week before getting sick.