PHILIPSBURG, Sint Maarten — The Inspectorate VSA is alerting the public on romaine lettuce originating from the United States due to potential contamination with the E coli bacteria. Exactly a year ago an outbreak due to romaine lettuce contaminated with E. Coli from the upper California region occurred.
Romaine lettuce is widely available in supermarkets on the island. Consumers should not eat romaine lettuce harvested from Salinas, California.
This advice is based on the food safety alert issued by of both the FDA and CDC  not to consume any romaine lettuce from the Salinas region. The Salinas region as defined by the United Fresh Produce Association and the Produce Marketing Association includes: Santa Cruz, Santa Clara, San Benito, and Monterey counties in California.
According to the CDC, as of November 21, 2019, 40 people infected with the outbreak strain of E. coli O157:H7 have been reported from 16 states. The case patients report that illnesses started on dates ranging from September 24, 2019 to November 10, 2019.
Romaine lettuce may be voluntarily labeled with a harvest region. If romaine lettuce has “Salinas” on the label in any form (whether alone or with the name of another location) do not eat it. Throw it away or return it to the place of purchase. If romaine lettuce does not have information about harvest region or does not indicate that it has been grown indoors (i.e., hydroponically- and greenhouse-grown), throw it away or return it to the place of purchase.
At this time, romaine lettuce that was harvested outside of the Salinas region has not been implicated in this outbreak investigation. Hydroponically- and greenhouse-grown romaine, which is voluntarily labeled as “indoor grown,” from any region does not appear to be related to the current outbreak. There is no recommendation for consumers to avoid using romaine harvested from these other sources.
The symptoms of Shiga toxin-producing E. Coli (STEC) infections vary for each person but often include severe stomach cramps and bloody diarrhea. If there is fever, it is usually not very high (less than 101 degrees Fahrenheit/less than 38.5 degrees Celsius). Most people get better within 5–7 days.
Vigorous rehydration and other supportive care is the usual treatment; antibiotic treatment is generally not recommended. Most infections are very mild, but can be severe or even life threatening in some cases. It is advised to consult a GP in case of persisting or severe symptoms.
Most people recover within a week, but, rarely, some develop a more severe infection.
The Inspectorate is advising the public not to consume and discard of already purchased Romaine Lettuce from the Salinas region. Drawers or shelves in the refrigerator where the lettuce was stored should be washed and sanitized. Consumers ordering salad containing romaine at a restaurant or at a salad bar should ask the staff whether the romaine came from Salinas. If it did, or they do not know, do not eat it.
Restaurants are strongly advised not to serve romaine lettuce harvested from Salinas, California, including salads and salad mixes containing Romaine. If you do not know the source of your romaine lettuce, and if you cannot obtain that information from your supplier, you should not serve, nor sell it.
Suppliers, distributors and others in the supply chain should not ship or sell romaine harvested in Salinas, California. If the source of the romaine lettuce is unknown, you should not ship, nor sell the product.
In trying to prevent the outbreak from spreading, the Inspectorate has ordered retailers not to sell and discard all Romaine lettuce originating from the Salinas region in California.
Currently, the FDA does not have enough trace back information to identify the specific source of the contamination that would allow a targeted recall from specific growers. FDA is deploying investigators to the farms in question to try to determine the source and extent of the contamination. More information will be forthcoming as the investigation proceeds. Additionally, state partners are conducting laboratory analyses of romaine lettuce samples from case patients potentially linked to the outbreak.
At this stage in the investigation, the most efficient way to ensure that contaminated romaine is off the market would be for industry to voluntarily withdraw product grown in Salinas, and to withhold distribution of Salinas romaine for the remainder of the growing season in Salinas. FDA has made this request of industry.
The Inspectorate is in close contact with the USDA/FDA and is monitoring the developments. Importers and re-sellers are informed and the necessary spot checks are performed.
 U.S. Food and Drug Administration
 U.S. Centers for Disease Control and Prevention