Consumer Reports is advising people against eating any Wendy’s sandwich or salad with romaine lettuce until more is known about a strain of E. coli that has at sickened 97 people in six states, hospitalizing 43.

The non-profit advocacy group cited its food safety experts in urging a cautious approach until the fast-food chain can confirm the source of the pathogen and details how it plans to address the problem.

“E. coli can be especially harmful to young children, infants, older persons and those with a compromised immune system,” James Rogers, CR’s director of food safety and testing, said in a statement. “The goal is to minimize your risk of getting it, and until we know more about its source, it’s safest to avoid consuming Wendy’s sandwiches served with lettuce and any Wendy’s salad containing romaine lettuce.”

While the source of the outbreak is unclear, many of those who recently contracted E. coli reported eating burgers or sandwiches with romaine lettuce at a Wendy’s restaurant before getting sick, the Centers for Disease Control and Prevention said.

“Romaine lettuce served on burgers and sandwiches at Wendy’s was one of the most common ingredients eaten among the menu items, but investigators continue to analyze data at the ingredient level to determine if there are any other possible foods that could be the source of the outbreak,” the agency said.

Still, there is no reason for people to stop eating at Wendy’s or purchasing romaine lettuce, according to the CDC. “At this time, there is no evidence to indicate that romaine lettuce sold in grocery stores, served in other restaurants or in people’s homes is linked to this outbreak,” it stated on Thursday.

Larger outbreak?

The CDC on Thursday more than doubled its tally to those infected to 97, including 58 who live in Michigan, 24 from Ohio, two from Pennsylvania, 11 Indiana residents and one in New York. Of the 67 of those who were interviewed as part of an agency probe, 54 said they ate at a Wendy’s in the week before they got sick.

But the actual number of those sickened in the outbreak is likely higher than reported, the CDC noted.

Of those sickened, 10 had developed hemolytic uremic syndrome (HUS), a potentially deadly type of kidney disease that often requires dialysis, the agency said.

A Wendy’s representative said the company is cooperating with public health officials investigating the outbreak. The company also has discarded and replaced the sandwich lettuce at some eateries in the region where people were stricken.

“The lettuce that we use in our salads is different, and is not affected by this action,” Wendy’s said.

Dublin, Ohio-based Wendy’s and its franchisees operate about 7,000 restaurants worldwide.

Romaine lettuce and other greens like spinach and clover sprouts have been involved in at least 17 E. coli outbreaks around the U.S. between 2006 and 2019, according to the CDC.

E. coli outbreaks involving romaine lettuce sickened nearly 200 people across the country in late 2019, with regulators eventually pointing to cow feces as the likely culprit. The infected lettuce was grown downslope from public land where cattle grazed in the Salinas Valley in California.

Four years ago, McDonald’s switched its lettuce supplier after its salads sickened more than 500 people in 15 states, with the cyclospora parasite found to be behind the infections.

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