An E. coli outbreak linked to romaine lettuce ripped across 15 states in November, sickening dozens of people, including a 9-year-old boy in Indiana who nearly died of kidney failure and a 57-year-old Missouri woman who fell ill after attending a funeral lunch. One person died.
But chances are you haven’t heard about it.
The Food and Drug Administration indicated in February that it had closed the investigation without publicly detailing what had happened — or which companies were responsible for growing and processing the contaminated lettuce.
According to an internal report obtained by NBC News, the FDA did not name the companies because no contaminated lettuce was left by the time investigators uncovered where the pathogen was coming from.
“There were no public communications related to this outbreak,” the FDA said in its report, which noted that there had been a death but provided no details about it.
Federal officials are not required by law to reveal detailed information about all known outbreaks of foodborne illnesses, and there are reasons the FDA may choose not to publicize an outbreak, including when the cause is unknown or when officials are still working behind the scenes with the companies responsible.
But the FDA had shifted in recent years toward greater transparency in the wake of large-scale outbreaks and heightened public concern about contaminated food, said Frank Yiannas, the former deputy commissioner of food policy and response at the agency.
“It is disturbing that FDA hasn’t said anything more public or identified the name of a grower or processor,” said Yiannas, who was at the FDA from 2018 to 2023.
By declining to name the culprit, he said, the FDA was withholding critical information that consumers could use to make decisions about what they buy. It’s also possible that someone could have been sickened during the outbreak and not have realized the cause, and serious bacterial illness can cause long-term damage.
The FDA, which is a part of the Department of Health and Human Services, denied that its response to the recent E. coli outbreak marked any shift in policy.
“The FDA names firms when there is enough evidence linking an outbreak to a firm and there is actionable advice for consumers, as long as naming the firm is not legally prohibited,” a spokesperson said in a statement to NBC News. “By the time investigators had confirmed the likely source, the outbreak had already ended and there was no actionable advice for consumers.”
Food safety advocates argue that disclosing such information is still critical to ensure that people will dispose of contaminated food they may have frozen and stored and to allow consumers to make informed choices.
“People have a right to know who’s selling contaminated products,” said Sandra Eskin, a former official at the U.S. Agriculture Department who now works as a food safety advocate.
But much of the staff responsible for developing and distributing information to the public about foodborne illnesses was terminated this month as part of the Trump administration’s sweeping effort to shrink the federal government.
“We no longer have all the mechanisms in place to learn from those situations and prevent the next outbreak from happening,” said Taryn Webb, who led the FDA’s public engagement division for human foods until she was laid off during the mass firing this month.
And the administration has separately moved to delay a new federal rule requiring food companies and grocery stores to rapidly track down contaminated food and pull it off the shelves, though the FDA said the delay was meant to give time to ensure better compliance.
The FDA said its staff members “continue to provide critical communications to consumers associated with foodborne outbreaks,” including information about recalls and investigations.
The morning the first cases of E. coli started coming in, Dr. Amanda Brzozowski sensed something was very wrong.
It was early November, and all three were E. coli 0157:H7 — an especially dangerous strain that can result in severe illness, organ damage and, in rare cases, death — and the people sickened were all high school students who lived in the same area of St. Louis County.
Brzozowski, a senior epidemiologist for the county, immediately reached out to the school they attended, and, within hours, more families were reporting symptoms of E. coli infection: bloody diarrhea, stomach cramps, vomiting and dehydration.
Ultimately, the county Public Health Department found 115 confirmed or probable E. coli cases linked to food served by a local catering company — and that the salads they ate were a likely culprit. The catering company has declined to comment.
“It was really scary,” Brzozowski told NBC News. “This type of situation we’ve never seen before.”
The victims included 15-year-old Austin Carnaghi, who opted for more salad instead of a brownie at his marching band’s annual banquet before he developed severe stomach pain and needed to be hospitalized, according to his mother, Kristiana Carnaghi. “It was an unbelievable amount of cramping,” she said.
Miles away in Indiana, the same strain of E. coli had stricken another boy.
The morning after he played basketball, Colton George, 9, woke up and was doubled over in pain. His parents rushed him to the hospital, where testing confirmed the presence of E. coli 0157:H7.
He had developed hemolytic uremic syndrome, a life-threatening complication from the E. coli infection, and needed to be put on around-the-clock dialysis, without food or drink for days.
His parents, Christopher and Amber George, tried to prepare Colton for what was happening. “Unfortunately, if we don’t do this,” his mother said she told him, “there is a chance you won’t make it.”
Colton was on dialysis in a hospital bed for two weeks — including over his 10th birthday — before he was released. Months later, he is back to playing basketball but still experiences chronic stomach pain and fatigue because of the complications.
And his parents have been wrestling with the same question ever since the doctors told them that the E. coli must have come from something Colton had eaten.
“Where did he get this from?” his father said. “Something must have gone wrong somewhere.”
Colton's parents say it wasn't just a coincidence their son had symptoms similar to those of the Missouri high-school students, around the same time and with the same diagnosis of E. coli 0157:H7.
The bacteria that infected them had the same genetic sequencing, according to a lawsuit by the Georges that alleges the tainted produce came from Taylor Farms, one of the country’s largest producers of salads and fresh cut vegetables.
Public health officials use genetic fingerprints of bacteria to help pinpoint the source of foodborne illnesses. In late November, FDA officials were alerted to a cluster of E. coli O157:H7 cases after Missouri officials investigated the cases linked to the catering company, according to the FDA’s report on the outbreak.
The genomic fingerprint of the pathogen was also posted to a national laboratory network for tracking foodborne illnesses.
That data was used to help connect 89 cases across 15 states: The youngest victim was 4, and the oldest was 90. They all first had symptoms in November; more than a third were hospitalized, and seven had developed hemolytic uremic syndrome, a disease that affects kidney function. But the number of probable cases local health officials tallied was significantly higher, since not all victims went to the hospital and had samples that were genetically sequenced, Brzozowski said.
Using the genetic analysis, local health surveys and other evidence, federal investigators came to a conclusion. “Based on epidemiologic and traceback data, romaine lettuce was confirmed as the source of this outbreak,” according to the report, which noted the contaminated produce came from “a sole processor” that had obtained the lettuce from a grower.
But the FDA redacted the name of the companies that processed and grew the lettuce before it released the report in response to a public records request filed by the Georges’ attorney, Bill Marler.
As part of the lawsuit, Marler obtained receipts, also reviewed by NBC News, that he says show the salad linked to the outbreak originally came from Salinas, California-based Taylor Farms, which supplies major supermarkets and chain restaurants across the country.
The Georges, the Carnaghis and other victims have all accused Taylor Farms in nine different lawsuits, arguing in court papers that it sold “defective and unreasonably dangerous” food products.
Taylor Farms denied that any of its products were responsible for the outbreak.
“We don’t believe Taylor Farms was the source of the referenced recent E. coli outbreaks, based on information collected during thorough third-party investigations and robust food safety controls,” it said in a statement.
After this article was published, Taylor Farms released an updated statement saying, in part, “Taylor Farms product WAS NOT the source of the referenced 2024 E. Coli outbreak. We perform extensive raw and finished product testing on all our product and there was no evidence of contamination.”
Asked whether Taylor Farms had produced the contaminated lettuce involved in the outbreak, the FDA said in a statement that it was restricted by federal law from disclosing “confidential commercial information.”
The accusations against the company come on the heels of another deadly outbreak: In October, just weeks before the St. Louis cases surfaced, Taylor Farms had voluntarily recalled yellow onions linked to a separate E. coli outbreak — one that also infected more than 100 people and killed one.
In that case, though, the FDA issued an advisory notifying the public about the contaminated onions, which were served on McDonald’s hamburgers, making headlines across the country.
Taylor Farms said it would always act out of an abundance of caution to protect consumers. It added that it had robust food safety and pathogen testing procedures and that onion samples that health officials had taken at McDonald’s restaurants had tested negative for E. coli O157:H7.
On the romaine lettuce outbreak, the FDA said only that it was investigating an E. coli O157:H7 outbreak involving 89 cases.
In mid-January, the Centers for Disease Control and Prevention declared the outbreak was over, according to a letter sent to state health departments obtained by NBC News. And in February, the FDA moved its outbreak investigation from “active” to “closed,” without providing further details, according to archived versions of its website.
The full scope of the outbreak came to light only in response to the public records requests filed by the victims' attorneys.
Even in outbreaks without recalled products, Yiannas said, he pushed the FDA to publish more advisories describing the cases and where they occurred, the symptoms to watch for and the brands of contaminated food that were sold, as well as investigative reports detailing the FDA’s findings.
In 2022, for instance, the FDA issued public health advisories in cases of hepatitis A in fresh strawberries and E. coli in packaged salad greens, even though they were not subject to recalls and were no longer sold.
The FDA told NBC News that it had issued such statements because “consumers could have frozen product for later use” and the outbreaks were still ongoing when it pinpointed the source, unlike with the 2024 E. coli case linked to romaine lettuce.
Federal officials may also hold off on making public statements while they are privately pushing food growers and processors to change their safety practices and procedures or because elements are still under investigation, former FDA staff members said. Other times, the federal government may not have enough definite evidence to pinpoint the source of an outbreak.
It’s especially challenging for FDA investigators to hunt down and identify foodborne illness linked to fresh produce, because the products have a short shelf life compared to canned goods, which can be stored for years. Highly perishable, fresh produce is often considered out of circulation once it is no longer available for sale.
But publicly identifying the source can help pressure companies to adopt and improve practices to prevent food from being contaminated in the first place, said Barbara Kowalcyk, a professor and food safety expert at George Washington University.
E. coli cases can stem in some cases from contamination between animal waste and produce while fruits and vegetables are still being grown in fields, because of runoff from livestock farms, the design of irrigation systems or even extreme weather that results in an unexpected flooding of contaminated water.
“The whole purpose of investigating these outbreaks is to stop the illnesses and to learn how to prevent future outbreaks,” Kowalcyk said. “If you don’t come out and talk about what happened, we’ve lost that opportunity.”
And the FDA’s reticence about the romaine lettuce outbreak has angered families like the Georges, who say they are still struggling to pay off about $20,000 in medical bills while their son continues to recover. Even if that contaminated lettuce is no longer sold, they believe the public has a right to know.
“It’s not fair for them to get off the hook,” Amber George said. “People are still going out and buying their product every day and have no idea what happened.”
