Grocery stores and restaurants across Minnesota were scrambling to pull romaine lettuce from their shelves and menus Tuesday after federal health officials warned that the popular greens have been linked to a new national food illness outbreak.

The federal Centers for Disease Control and Prevention said 32 people in 11 states have been sickened by a dangerous type of E. coli linked to romaine. The outbreak has hospitalized 13 people, including one who developed kidney failure. No cases have been reported in Minnesota.

Disease detectives haven’t determined where the infected lettuce was grown, prompting federal health officials to issue a general warning and advise consumers to discard any romaine that they might have at home.

A Minneapolis attorney active in food-safety law said he was stunned by the sweep of Tuesday’s warning.

“This is the most drastic thing that I have heard come out of CDC in a decade,” said Ryan Osterholm, an attorney with the Pritzker Hageman law firm in Minneapolis. “It is like saying: Don’t eat beef. This lettuce is one of the most-consumed products in America.”

This is the second E. coli outbreak linked to romaine lettuce this year. In March and June, 210 people in 36 states became ill and five died after eating lettuce grown in the Yuma, Ariz., region.

Osterholm said most government food warnings are more specific about the exact origin of the contaminated item. He said he suspects that officials at the CDC and the U.S. Food and Drug Administration are concerned about a widening outbreak with more people falling ill.

“I am sure that this is going to be much larger,” he said.

The lack of specificity in the CDC advisory, however, left Twin Cities businesses few options but to pull all romaine lettuce just days before Thanksgiving.

Hy-Vee and Kowalski’s grocery chains were among the Twin Cities stores that took all romaine products off the shelves after the news broke early Tuesday afternoon.

“A lot of people are looking to buy these products now because of the holiday,” said Mike Oase, chief operating officer at Kowalski’s, which operates 12 stores plus one under the Cub brand. “It is definitely not the best time, but what is most important is the public safety.”

John Schiltz, chef and owner of the Lake Elmo Inn, heard about the outbreak via text messages from employees who saw television coverage.

“My chef and I sat and talked. Immediately we took all the romaine off the line,” said Schiltz. “We are going to err on the side of safety and caution for our customers’ sake.”

The decision hurt, because the restaurant is expecting 800 people for Thanksgiving brunch on Thursday and advertised a Caesar salad, a dish traditionally made with romaine lettuce.

Instead, they’ll use baby kale, Schiltz said. And if they can’t get enough of that they will make a different salad.

The Minnesota Department of Health also issued an advisory late Tuesday to all licensed food establishments echoing the warning not to use any type of romaine.

Consumers are being warned that the E. coli bacteria cannot be washed away from lettuce. In previous outbreaks, researchers found that the bacteria becomes embedded in the cellular structure of the lettuce leaves, making it difficult to eliminate. In addition to disposing of any romaine at home, consumers were urged to wash and sanitize areas where it has been stored, including refrigerator shelves and drawers.

E. coli infection can cause nausea, vomiting, stomach cramps, diarrhea and fever. The strain involved in the outbreak is known as E. coli O157: H7, which can be deadly. It produces a Shiga toxin that can cause hemolytic uremic syndrome, a type of kidney failure.

“It is a very serious infection,” Osterholm said. “The seriousness of these infections is reflected in the CDC’s tone and wording.”

So far the government’s investigation has determined that people stricken by the current outbreak became ill between Oct. 8 and Oct. 31. California has reported the most cases, 10, followed by Michigan with seven. The rest are scattered on the East Coast, Ohio, Illinois and Wisconsin. There are also 18 cases reported in Canada.

Osterholm said he expects that officials are working to narrow the source of the outbreak to focus the investigation, but that might take time.

“Produce is notoriously difficult to trace back because it is hard to know where it comes from,” he said. “I’ve seen up to four to five different entities involved from the farm to the fork where there are middlemen.”


The Washington Post contributed to this report.

Correction: A previous version of this article misstated the name of the chef and owner of the Lake Elmo Inn. His name is John Schiltz.