Central District Health Department (CDHD) has identified six Shiga-Toxin Producing E. coli (STEC O157:H7) cases who are associated with a nation-wide cluster. Onset dates for CDHD patients range from March 25 to March 30. Please continue to watch for new cases.

On April 13, 2018, the Centers for Disease Control and Prevention issued an advisory that chopped romaine lettuce from the Yuma, Arizona, growing region could be contaminated with E. coli O157:H7. Consumers and retailers should discard chopped salads and salad mixes containing romaine lettuce.

If you suspect that a patient has diarrheal illness associated with romaine lettuce, consider a bacterial enteric screen. If E. coli is suspected, antibiotic therapy is not recommended due to increased risk for hemolytic uremic syndrome (HUS).

For more information on this outbreak and the romaine lettuce advisory, see https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html or contact the Office of Communicable Disease Control at 208-327-8625.

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_{ROMAINE ENTERIC MEDICAL PROVIDERS APRIL 2018}