Health officials say to avoid all forms of romaine lettuce after an E. coli outbreak sickened people in 16 US states

The CDC recommended on Friday that Americans avoid all forms of romaine lettuce.
E. coli is a species of bacteria that live in the intestines of people and animals.
Some E. coli are harmless and live inside our healthy guts, but other strains can make you really sick and cause kidney failure or death.
The recent outbreak that the

If you have any romaine lettuce in the fridge — be it pre-chopped, whole heads, or hearts — the Centers for Disease Control and Prevention recommend throwing it out.

The CDC believes romaine lettuce from the Yuma, Arizona, region is responsible for infecting at least 53 people in 16 US states with a dangerous, diarrhea-inducing E. coli bug. The outbreak is still growing: officials initially said only pre-chopped romaine was a problem, but have since expanded that warning to all types of the lettuce.

The CDC has not linked the outbreak to any one brand of greens or retailer, so it is warning everyone who has bought romaine recently. The CDC is also asking people who are eating out or shopping for greens to be extra cautious about where their salad came from.

"Do not buy or eat romaine lettuce at a grocery store or restaurant unless you can confirm it is not from the Yuma, Arizona, growing region," the CDC says on its website. "."

The nasty strain of O157:H7 E. coli has landed 31 patients in the hospital so far. Five people have developed kidney failure, and others have the more common signs of E. coli contamination like bloody diarrhea, stomach cramps, and vomiting.

Here's how an E. coli bug like this spreads and what can you do to reduce your risk of catching the potentially deadly bacteria.

What is E. coli?

E. coli gets a bad reputation as an illness-causing, bad-guy bacteria, but you probably have a bit of good-guy E. coli inside your body right now.

Escherichia coli is a broad term for a species of diverse bacteria. Certain strains of E. coli colonize our guts almost immediately after birth and stick to the mucus of our intestines, keeping our intestinal tract humming along smoothly.

The strain that has been linked to this recent outbreak, however, O157:H7, tends to be a pretty naughty version of the bug.

The O157:H7 strain sickened 25 people who ate leafy greens including romaine lettuce last November and December. One Californian died. In May of last year, O157:H7 turned up in soy-nut butter. Thirty-two people got sick from that outbreak, and nine developed kidney failure.

O157:H7 usually originates in the guts of cattle, but it can also be found in goats, sheep, deer, and elk. It can travel from cattle farms to nearby fields where lettuce is grown and contaminate the greens in the soil. It can also get on the lettuce when food-handlers don't wash their hands properly after coming into contact with E. coli-harboring feces.

What makes the O157:H7 strain so dangerous for people is that it produces a nasty Shiga toxin, which can make us really sick. This kind of Shiga-toxin-producing E. coli, or STEC, as it's sometimes called, spreads to humans when little bits of feces get inside our mouth. That's why a bit of undercooked meat or raw milk can make you ill.

But that's not the only way to catch the bug.

"People have gotten infected by swallowing lake water while swimming, touching the environment in petting zoos and other animal exhibits, and by eating food prepared by people who did not wash their hands well after using the toilet," according to the CDC.

Some signs that you've got a Shiga toxin-producing strain of E. coli inside include:

What you can do to reduce your risk

The No. 1 piece of advice for reducing your risk of getting a nasty E. coli bug is something you've probably heard before: Wash your hands. And make sure people who are preparing your food are washing their hands, too.

Because E. coli contamination spreads from ingesting little bits of poo, any person or animal along the food chain from field to table can easily contaminate your produce or meat with feces, so it's important to:

Leafy greens (like spinach and romaine) are especially prone to picking up bacteria from nearby cattle farms. Rinsing away extra dirt can help reduce your risk of illness, but if a bit of lettuce is contaminated with E. coli, washing it won't save you.

Pregnant women, young children, older adults, and those with compromised immune systems need to be extra careful about steering clear of E. coli-contaminated food. But most of us can survive E. coli food poisoning — the miserable symptoms listed above usually last five to seven days. More severe complications can include kidney failure, which happens in about 5% to 10% of cases and usually affects people under the age of 5 and over 60, according to the Merck Manual. There's not much you can do to treat the illness, and typically the best thing to do is try to stay hydrated until it's over.

It can be tough for public-health officials to track the source of an E. coli outbreak to one specific ingredient, but investigators tend to notice certain common foods when they interview sick people about what and where they ate.

The most recent outbreak has hit people on both coasts of the US, and the 53 ill patients range from ages 10 to 85 years old, with female victims accounting for 70% of cases.

Health officials say to avoid all forms of romaine lettuce after an E. coli outbreak sickened people in 16 US states

What is E. coli?

What you can do to reduce your risk

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