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The Centers for Disease Control and Prevention says it's using whole genome testing and on-the-ground investigation to try to determine why the current E. coli outbreak from romaine lettuce is more virulent than normal — about half of all people affected have been hospitalized .

Expand chart
Data: Centers for Disease Control; Cartogram: Lazaro Gamio/Axios

What's new: The E. coli outbreak stemming from romaine lettuce grown in Yuma, Ariz., has spread to 19 states and infected at least 84 people, of whom 42 have been hospitalized with 9 suffering from the dangerous hemolytic uremic syndrome, according to a CDC update today.

Threat level: Matthew Wise, deputy branch chief of CDC's Outbreak Response, tells Axios the CDC has confirmed the pathogen is E. coli 157:H7, which is part of the Shiga toxin-producing strain, but they don't know why so many patients need to be hospitalized.

"157:H7 can be a very severe illness, but [50%] is a much higher hospitalization [rate] than we expect," Wise says. "We're doing whole genome sequencing to see if there's anything unique or unusual in this particular strain."

Benjamin Chapman, food safety specialist and associate professor of North Carolina State University, tells Axios that normally the 157:H7 has about a 25%–30% hospitalization rate. He says the higher rate now could be because the strain "picked up genes from other bacteria which cause toxins [in] us," during its normal evolutionary process.

The big question: This episode of E. coli 157:H7 is one of 7 main multistate foodborne outbreaks of E. coli and salmonella that CDC has investigated in 2018. While this appears high compared with 2017 (which had a total of 8 including listeria and cyclospora), it's too early to tell if this is a new trend for the year, Wise and Chapman both say.

  • Chapman says one reason it appears higher is that "we are getting better at connecting the dots, nationally." He says with new safety standards and systems to identify outbreaks, "food is probably safer now than it was for the last 50 years."

Looking ahead: Wise says the CDC is focused on improving via 2 programs:

  1. An increase of funds to the state health departments so they can better track, report and halt outbreaks.
  2. A transition to whole genome sequencing during outbreaks, which should enable officials to see which illness is spreading where. They've completed a similar program for listeria, and the program for salmonella and E. coli should be finished by late 2018–early 2019.

Some challenges facing the CDC:

  • New lack of cultures: Chapman says the state public health system encourages new testing called culture independent diagnostic tests (CIDTs), which can quickly identify pathogen DNA shards but uses up the stool sample that the federal investigators need to be cultured. "It's a challenge," Wise says, because clinicians want the faster CIDT results but "the whole system relies upon the health care facilities to culture the bacteria."
  • IG report: While not directly part of the CDC, the Food and Drug Administration was checked out by the Inspector General's office and its food recall program was found inefficient and ineffective.

Go deeper

Updated 15 mins ago - Science

This powerful new accelerator looks for keys to the center of atoms

Illustration: Eniola Odetunde/Axios

Nuclear physicists trying to piece together how atoms are built are about to get a powerful new tool.

Why it matters: When the Facility for Rare Isotope Beams begins experiments later this spring, physicists from around the world will use the particle accelerator to better understand the inner workings of atoms that make up all the matter that can be seen in the universe.

Updated 18 mins ago - Politics & Policy

Omicron dashboard

Illustration: Aïda Amer/Axios

  1. Health: FDA OKs antiviral drug remdesivir for non-hospitalized COVID patients — Walensky: CDC language "pivoting" on "fully vaccinated" — Pfizer and Moderna boosters overwhelmingly prevent Omicron hospitalizations, CDC finds.
  2. Vaccines: The case for Operation Warp Speed 2.0 — Teens and adults missed 37 million vaccinations during COVID — Team USA 100% vaccinated against COVID ahead of Beijing Olympics — Kids' COVID vaccination rates are particularly low in rural America — Annual COVID vaccine preferable to boosters, says Pfizer CEO.
  3. Politics: Arizona governor sues Biden administration over COVID funds tied to mandates — Biden concedes U.S. should have done more testing — Arizona says it "will not be intimidated" by Biden on anti-mask school policies.
  4. World: American Airlines flight to London forced to turn around over mask dispute — WHO: COVID health emergency could end this year — Greece imposes vaccine mandate for people 60 and older — Austria approves COVID vaccine mandate for adults — Beijing officials urge COVID-19 "emergency mode" before Winter Olympics.
  5. Variant tracker
45 mins ago - World

UK government: Kremlin has plan "to install pro-Russian leadership" in Ukraine

British Foreign Secretary Elizabeth Truss. Photo: Gints Ivuskans / AFP via Getty Images

The United Kingdom's Foreign Secretary on Saturday night said the government has "information that indicates the Russian Government is looking to install a pro-Russian leader in Kyiv as it considers whether to invade and occupy Ukraine."

Driving the news: U.S. National Security Council spokeswoman Emily Horne called the intelligence "deeply concerning" in a statement to Axios. The Biden administration has said Russia is actively manufacturing a pretext for invasion and warned that Putin could use joint military exercises in Belarus as cover to invade from the north.