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FDA’s Warning Shot For Leafy Greens

I hope it will serve as a call to urgent action that gets to the root of the problem of the persistent presence of dangerous E. coli in the growing environment for leafy greens and other fresh produce

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By Michael Taylor

April 8, 2021

OPINION

On April 6, the Food and Drug Administration fired an unmistakable warning shot at the leafy greens industry. I hope it will serve as a call to urgent action that gets to the root of the problem of the persistent presence of dangerous E. coli in the growing environment for leafy greens and other fresh produce.   

Carefully using the regulatory language in its produce safety rule (21 CFR 112.11) and citing the recurring nature of the E. coli hazard in the Salinas and Santa Maria growing area, FDA declared the recurring strain implicated in the 2020 outbreak to be a “reasonably foreseeable hazard,” which FDA attributed to the presence of cattle on land adjacent to growing fields

This finding seems obvious and shouldn’t be surprising. The surprise, however, is that FDA used regulatory language to express its finding and spelled out the implications: farms covered by the FSMA produce safety rules “are required to implement science and risk-based preventive measures” to minimize the risk of serious illness or death from the E. coli hazard.  

Make no mistake, however, FDA’s message is aimed not only at farms but at every entity involved in the commercial production, processing, and sale of leafy greens coming from the California Central Coast Growing Region.  The message is that, without effective preventive measures, such leafy greens are in violation of federal food safety regulatory standards. 

I do not anticipate FDA taking judicial action to enforce its April 6 finding, absent egregious practices or clear negligence in a particular leafy green growing situation. I do see, however, a heightened sense of urgency at FDA and frustration that efforts to date have not solved the leafy greens safety problem. I share that frustration.  

Fifteen years ago, the disastrous spinach outbreak caused by E. coli O157:H7 was linked by the Centers for Disease Control and Prevention (CDC) to run-off from nearby grazing land. Since then, we’ve had outbreak after outbreak associated with E. coli in leafy greens and other fresh produce. And the outbreaks are just the tip of the public health iceberg.  The federal government estimates that 60 percent of all food-related E. coli O157:H7 illnesses are associated with fresh produce. The vast majority of these illnesses are not part of an identified outbreak.

The E. coli outbreaks and illnesses persist despite a lot of hard work by a lot of people in the leafy greens industry, researchers, the California Department of Food and Agriculture (CDFA), the FDA and its federal partners.  Stop Foodborne Illness, the organization of illness victims and their families whose board I co-chair, works with the California LGMA on the common cause of strengthening food safety culture in the leafy green industry. We also advise the Leafy Greens Safety Coalition, a group of leading retailers working to strengthen safety practices.  I have participated in the California Agricultural Neighbors Workgroup convened by CDFA Secretary Karen Ross. So, I know serious people are at work on the problem.

What then is the urgent call to action?  What do consumers expect of the leafy greens industry, especially those individuals and families who know first-hand the devastating human impact E. coli infections can have?  What does the public health demand?  

At one level, the answer to all three questions is the same. The leafy greens industry and all those across the leafy greens supply chain and in government should be doing urgently everything they reasonably can to minimize the now well-known risk posed by E. coli O157:H7.  According to FDA, the law requires no less. Certainly, this includes prevention measures within the leafy greens production system, such as strict implementation of rigorous water quality and irrigation standards, improved compost management, sanitation of harvesting equipment, and pre-harvest test-and-hold programs.  

But the prevention strategy must go deeper. Modern food safety best practices dictate that prevention should begin at the root of the problem.  As long as leafy greens are grown outdoors in the vicinity of cattle operations, I believe the food safety problem will persist until the shedding by cattle and the release of dangerous E. coli into the environment is minimized at its source. Effective vaccines are available. Changed feeding practices have promise. Perhaps containment measures can reduce risk.  

The experts need to determine what combination of measures works best, but it is clear that no responsible food manufacturer would today deem it acceptable to produce food in an environment in which dangerous bacteria are being released or are present on a sustained basis. The same principle should apply to leafy greens and other fresh produce grown outdoors.  

The important difference, of course, is that the leafy greens producer has no direct control over the source of the hazard.  And the cattle producer isn’t responsible for where leafy greens are grown. That is why FDA Deputy Commissioner Frank Yiannas calls for “industry leadership and collaboration among growers, processors, retailers, state partners and the broader agricultural community,” including cattle producers.  

I am glad FDA is sounding the alarm, but I know from experience that the kind of leadership and collaboration that is urgently needed is easier said than done in an industry and government structure that is notoriously fragmented and often works in silos. And the obstacles to solving the problem are not just technical. They include the need for creative solutions on such matters as who pays for interventions needed in cattle production to make leafy greens safe.   

But too much is at stake for all concerned to let such obstacles stand in the way.  Now is the time for leaders from all across the commercial value chain and government to act together, with greater urgency, to get to the root of the problem and prevent it. 

Mike Taylor

About the author: Mike Taylor is co-chair of the board of the non-profit consumer advocacy group Stop Foodborne Illness, which is a 25-year-old group supporting and representing foodborne illness victims and their families in efforts to keep other people from getting sick. Before that Taylor served as FDA’s Deputy Commissioner for Foods and Veterinary Medicine from 2010 to mid-2016. His first tour in government began as a staff attorney at FDA, where he worked on seafood safety and nutrition labels. Later Taylor worked for USDA’s Food Safety and Inspection Service, where he became acting under secretary for food safety. Taylor was the government official who, after the deadly 1992-93 Jack in the Box hamburger outbreak, ruled that the pathogen E. coli O157:H7 is an adulterant in meat. Taylor also practiced law in the private sector.

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FDA: E. coli Outbreak Investigation Closes; No Specific Source Found

Epidemiological and traceback investigations did not determine a specific leafy green, brand, or supplier, but the E. coli strain is genetically related to a strain linked to a fall 2019 outbreak from romaine lettuce

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By CHRIS KOGER January 28, 2021

(Courtesy FDA)

An investigation into a fall 2020 outbreak of E. coli linked to leafy greens found cattle manure with the same strain about a mile from a field in California’s Salinas Valley, but the pathogen was not detected on any leafy greens or farms they were grown on.

The Food and Drug Administration released an update on its investigation on the outbreak on Jan. 27, and a full report will be released later. Forty people became sick in the outbreak, and half of them were hospitalized.

“Although the investigation has been unable to identify a specific type of leafy green at the heart of this outbreak, it is clear that this is yet another outbreak tied to leafy greens,” Frank Yiannas, the FDA’s deputy commissioner for food policy and response said in a news release on the agency’s findings.

Epidemiological and traceback investigations did not determine a specific leafy green, brand, or supplier, but the E. coli strain is genetically related to a strain linked to a fall 2019 outbreak from romaine lettuce.

Investigators from the FDA and other agencies visited dozens of farms in the Salinas Valley to collect samples. They also collected samples in adjacent areas, testing animal feces, compost, and water, according to the FDA. The cattle manure that yielded the positive test result was found on a roadside, uphill from where “leafy greens or other food identified on the traceback investigation were grown,” according to the FDA release.

“This finding draws our attention once again to the role that cattle grazing on agricultural lands near leafy greens fields could have on increasing the risk of produce contamination, where contamination could be spread by water, wind or other means,” Yiannas said in the release.

The FDA continues to recommend that growers assess and mitigate risks from areas adjacent to their fields, particularly in the vicinity of cattle operations, he said. That is a specific goal of the FDA’s Leafy Greens Action Plan, released in March, he said.

Yiannas said the FDA’s final report on the outbreak will include recommendations “shaped by these findings.”

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FDA Closes Investigations Into 2 E. coli Outbreaks; No Source Found

The Food and Drug Administration on Dec. 18 reported the investigations were completed, and the Centers for Disease Control and Prevention announced two of the three outbreaks were over

By CHRIS KOGER | December 18, 2020

Investigations into two of three E. coli outbreaks from this fall have been completed, and although the traceback process led authorities to farms, samples did not confirm link any particular food or source in either outbreak.

The Food and Drug Administration on Dec. 18 reported the investigations were completed, and the Centers for Disease Control and Prevention announced two of the three outbreaks were over. The FDA refers to the “Outbreak Unknown Source” 1, 2 and 3. Investigations into outbreaks 1 and 3 are over.

Outbreak 1

The CDC reported 32 people in 12 states became sick in Outbreak Unknown Source 1. The strain of E. coli identified in the investigation is genetically similar to a strain linked to a spring 2018 outbreak from romaine lettuce, according to the FDA. No food source was identified in the recent outbreak, however.

“FDA and state partners also conducted on-site inspections on farms of interest, though information collected in these inspections did not link these farms to the outbreak,” according to the FDA’s update.

Outbreak 3

The CDC reported 18 people in 9 states became sick in Outbreak Unknown Source 3. The FDA identified several potential food sources during interviews with people who became sick, but no farm was identified as a common source.

The FDA and state agencies conducted investigations at “farms of interest,” but information and samples collected did not lead to a source of the E. coli.

“The investigation of a farm does not mean that the farm is linked to an outbreak,” according to the FDA notice. “The results of an investigation into a farm may well lead to that firm being ruled out of the investigation.”

Outbreak 2

The investigation into Outbreak Unknown Source 2 is ongoing, according to the FDA. The CDC reports 39 cases, according to the CDC’s last update, which was Nov. 23. At that time, 22 of the people who became sick had been interviewed, with 16 reporting they ate spinach and 15 saying they ate romaine.

Lead photo: (Courtesy Food and Drug Administration)


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FDA Warns Jimmy John's And Sprouts Unlimited After Outbreak

The warning letter lays out evidence from five outbreaks, including the most recent outbreak in the state of Iowa during November and December 2019, of human infections with Escherichia coli O103, a Shiga toxin-producing Escherichia coli (STEC)

The U.S. Food and Drug Administration posted a warning letter issued to Jimmy John’s Franchise LLC for engaging in a pattern of receiving and offering for sale adulterated fresh produce, specifically clover sprouts and cucumbers. The FDA also posted a warning letter to Sprouts Unlimited Wholesale Foods for supplying sprouts to Jimmy John’s which sickened 22 people in November and December 2019.   

The FDA, along with the Centers for Disease Control and Prevention and state and local partners, have collaboratively investigated several outbreaks linked to Jimmy John’s restaurants. The warning letter lays out evidence from five outbreaks, including the most recent outbreak in the state of Iowa during November and December 2019, of human infections with Escherichia coli O103, a Shiga toxin-producing Escherichia coli (STEC).

The pathogens associated with these outbreaks are STECs and Salmonella enterica. STECs can cause serious illness in humans, including diarrhea, often with bloody stools. Although most healthy adults can recover completely within a week, some people can develop a form of kidney failure called hemolytic uremic syndrome (HUS). HUS is most likely to occur in young children and the elderly. This condition can lead to serious kidney damage and death. Salmonella is a pathogenic bacterium that can cause serious, sometimes fatal, infections. These infections can be especially serious in young children.

The FDA is currently developing a Strategic Blueprint that will outline how the agency plans to leverage technology and other tools, to create a more digital, traceable and safer food system. This work will build on the advances that have been and are being made in the FDA’s implementation of the Food Safety Modernization Act to further strengthen prevention of foodborne illnesses.

To read the warning letter, click here.

For more information: 
FDA
Tel: +1 (888) 463-6332
www.fda.gov 

Publication date: Wed 26 Feb 2020

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FDA: Do Not Eat Salinas Romaine, E. coli Traceback Continues

As the number of E. coli cases linked to romaine has risen to 40, federal health and regulatory officials are warning consumers not to eat romaine lettuce originating from Salinas, Calif., and the Food and Drug Administration has asked the industry to stop shipments from there

Chris Koger November 24, 2019

As the number of E. coli cases linked to romaine has risen to 40, federal health and regulatory officials are warning consumers not to eat romaine lettuce originating from Salinas, Calif., and the Food and Drug Administration has asked the industry to stop shipments from there.

The FDA issued a similar advisory days before Thanksgiving 2018 covering all romaine, but the current warning involves only product is grown and Salinas, as well as products included in a Nov. 21 recall by Missa Bay.

“At this stage in the investigation, the most efficient way to ensure that contaminated romaine is off the market would be for the industry to voluntarily withdraw product grown in Salinas, and to withhold distribution of Salinas romaine for the remainder of the growing season in Salinas,” according to a Nov. 22 notice from the FDA. 

FDA investigators are in Salinas following the outbreak, which as of Nov. 22 included 40 cases in 16 states; 28 people have been hospitalized, according to the Centers for Disease Control and Prevention. Cases were reported from Sept. 24. to Nov. 10.

Investigators have yet to pinpoint a source. The FDA said it doesn’t have enough traceback information to identify a specific source that would allow it “to request a targeted recall from specific growers.”

But epidemiologic, laboratory and traceback evidence has led the FDA, CDC and state health agencies to suspect romaine lettuce from the Salinas area as a likely source.

Genetic analysis of the E. coli O157:H7 strains from patients in the current outbreak are similar to those from the fall 2017 and fall 2018 in the U.S. and Canada. In the 2017 outbreak, Canadian officials named romaine as the source, while the U.S. named leafy greens, not specifically romaine.  

An outcome of the November 2018 E. coli outbreak was the industry’s voluntary acceptance of labeling romaine products with the growing region and harvested-by dates. The Nov. 22 notice from FDA advises consumers to throw away or return romaine products if “Salinas” is on the label, or if there is no harvest area listed.

However, if the label indicates it is hydroponic or greenhouse-grown, the FDA advises it is safe to eat. The 2018 FDA advisory covered all romaine, regardless of where it was grown or if it was field or indoor grown, bringing a backlash from greenhouse/indoor growers. 

“At this time, romaine lettuce that was harvested outside of the Salinas region has not been implicated in this outbreak investigation,” according to the FDA. “Hydroponically- and greenhouse-grown romaine, which is voluntarily labeled as ‘indoor grown,’ from any region does not appear to be related to the current outbreak.”

If a restaurant or retailer is unable to determine where romaine from a menu item or salad bar is from, consumers should not eat it, according to the FDA advisory.

According to the Romaine Task Force, convened in the wake of the 2018 outbreak, the Salinas growing region includes Santa Cruz, Santa Clara, San Benito, and Monterey counties.

The investigation focused on romaine after the Maryland Department of Health tested an unopened Ready Pac Foods Bistro Chicken Raised Without Antibiotics Caesar Salad that had been purchased by one of the patients with E. coli, and found the pathogen on romaine in the salad.

The states, and how many patients from each one in the outbreak, are: Arizona, 2; California, 4; Colorado, 1; Idaho, 3; Illinois, 1; Maryland, 3; Michigan, 1; Minnesota, 1; Montana, 1; New Jersey, 1; New Mexico, 2; Ohio, 5; Pennsylvania, 3; Virginia, 1; Washington, 1; and Wisconsin, 10.

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E. coli Prompts Wegmans To Recall Cauliflower Products From Six States

December 19, 2018

Wegmans Food Markets Inc. has issued a voluntary recall of fresh Cauliflower Rice, Veggie Cauliflower Rice Blend and Stir-Fry Mix with Cauliflower, sold in the produce department Dec. 7-18 because it may be contaminated with Escherichia coli O157:H7bacteria. The recalled products were distributed to 98 Wegmans stores in New York, New Jersey, Pennsylvania, Maryland, Virginia and Massachusetts.

E. coli O157:H7 causes a diarrheal illness often with bloody stools. Although most healthy adults can recover completely within a week, some people can develop a form of kidney failure called Hemolytic Uremic Syndrome, which is most likely to occur in young children and the elderly. The condition can lead to serious kidney damage and even death.

The recalled products are as follows:

  • Wegmans Cauliflower Rice, one-pound  UPC #25313500000

  • Wegmans Cauliflower Rice, eight-ounce UPC #25307200000

  • Wegmans Stir Fry Blend (with cauliflower), one-pound UPC #25335800000

  • Wegmans Veggie (cauliflower) Rice Blend (sold by the pound), UPC #253162000000

No illnesses have been reported to date.

The recall was initiated by Produce Packaging Inc. based in Cleveland, which supplies these products to Wegmans and notified Wegmans that the product may have been contaminated.

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"Situations Like This Remind Us Why Traceability And Transparency Are So Important In Our Food System"

Multiple statements were issued in regards to the E. coli outbreak

"Avoid eating romaine lettuce - it may be contaminated with E.coli." This very serious message has been given by the US Centers for Disease Control and Prevention and the U.S. Food and Drug Administration. They are advising consumers to avoid eating romaine lettuce until more is learned about the outbreak. It should be noted this outbreak and the consumer advisories are limited to romaine lettuce only. 

According to the CDC, currently romaine lettuce may be contaminated with E. coli O157:H7 and could make people sick. No grower, supplier, distributor or brand has been identified in the current outbreak, in which 32 people across 11 states fell ill.

The advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad. 

The FDA is conducting a traceback investigation. 

Traceability
For the greenhouse industry, this offers the opportunity to show the traceability of their products. Gotham Greens for example responds quickly. Only recently they've expanded into romaine lettuce. In doing so they wanted to offer a more reliable, transparent and traceable supply chain. 

"Situations like this remind us why traceability and transparency are so important in our food system", they respond. "We’ve seen today’s CDC report and while they have issued a blanket warning on all romaine lettuce, our internal environmental testing program shows NO E. coli in any of our greenhouse facilities. All of our lettuces, salad mixes and herbs, including Romaine, are grown, harvested and packed daily in controlled greenhouses in New York and Chicago. We only sell greens that we grow ourselves so we can assure 100% traceability. And through our water monitoring program we can guarantee that the water used to nourish our plants is free of harmful pathogens. Our hydroponic growing methods use municipal water and sterile agricultural inputs, reducing sources of contamination."

"Not from Florida" 
There's more groups responding and explaining why their product should be safe. The Florida Fruit & Vegetable Association for example strongly urges the agency to determine the source of the contamination as quickly as possible. "South Florida’s romaine harvest season starts in early November, so Florida product was not being harvested when people started becoming ill. However, it is unfortunate that anyone has become sick, and we remain concerned for those consumers." 

"Safe production and handling of crops is the top priority for growers of Florida produce. They adhere to the highest mandatory food safety standards, testing and safeguards to ensure Florida produce is safe. They also open their operations to FDA representatives periodically for inspections." 

How's Canada?
In Canada, Bamford Produce and Freshline Foods also made a statement regarding the E. coli outbreak. The Public Health Agency of Canada is also advising individuals in Ontario and Quebec to avoid eating romaine lettuce and salad mixes containing romaine lettuce until more is known about the outbreak and the cause of contamination. "At this point in time no recall has been issued. We will be advising and updating all our customers as the situation changes and if any further action is required."

"Effective immediately, Bamford Produce/ Freshline foods will cease shipments of ALL romaine products until further information is available." This includes Romaine 24 count, Romaine hearts, chopped romaine & spring mix/Mesculin Blend

Produce industry associations 
A group of open field produce industry associations made a statement regarding the E. coli outbreak as well. Arizona Leafy Greens Marketing Agreement, California Leafy Greens Marketing Agreement, Produce Marketing Association, United Fresh Produce Association, Western Growers, Yuma Safe Produce Council & Yuma Fresh Vegetable Association explained in a united statement why they are relying on producers and retail/restaurant customers to support the government health agency advisories and are urging an industry-wide voluntary withdrawal of all romaine currently in marketing channels and held in inventory.

"Food safety is the produce industry's top priority. We must take swift action to protect consumers", they state. "We believe a withdrawal of romaine lettuce is the fastest way to clear up the supply chain of any romaine that could be responsible for illnesses and to make a hard, convincing and clean break from harvesting and shipping romaine lettuce until this outbreak is declared over or the source of the implicated produce can be identified. Additionally, we are calling on handlers to clean and sanitize any equipment that may have been used in recent weeks to prevent cross-contamination of product during future harvest, processing and distribution activities." 

Geographic region 
They urge a group of food safety experts from the produce industry to come together as quickly as possible to closely examine information that may help pinpoint the specific source of the outbreak utilizing the extensive traceback information maintained by leafy greens producers. "The goal of this effort is to learn any information about the geographic region or specific farms that may be tied to this outbreak. Government agencies have indicated the E. coli isolate involved in this outbreak has been closely related by Whole Genome Sequencing data to two past outbreaks linked to leafy greens in 2016 and 2017. No one wants to get to the bottom of how these outbreaks are occurring faster than the producers of leafy greens. We absolutely must do everything possible to stop recurring outbreaks. We owe this to those whose lives have been tragically impacted by this outbreak and to all our consumers who trust us to grow safe food for their families." 

For more information on the consumer advisory, visit the CDC or FDA websites.

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Romaine Industry Adopts New Labels, Product To Return To Stores

Chris Koger November 26, 2018

Romaine will be returning to stores and foodservice operators after growers, shippers and processors of the lettuce agreed to put labels alerting customers and consumers where it was grown and when it was packed. ( File photo )

(UPDATED) The Food and Drug Administration says romaine lettuce is now safe to eat following the “purge” of product on the market, and will allow supplies to resume, after grower-shippers agreed to new labeling standards that will include where the lettuce is grown.

The agreement, negotiated by romaine grower-shippers, processors and industry associations, will be the new standard for romaine packed in the U.S. The standards follow an E. coli outbreak linked to 43 illnesses in the U.S. and 22 in Canada, as of Nov. 26.

 “A number of produce associations also have agreed to support this initiative and are recommending that all industry members throughout the supply chain follow this same labeling program,” according to the United Fresh Produce Association, in an e-mail alert to members Nov. 26 sent several hours before the FDA released a statement lifting the advisory that virtually banned romaine in the U.S.

According to the FDA statement, the new labels are voluntary, but its updated message to consumers suggests it’s against shippers’ interest to forego the label:

“Based on discussions with major producers and distributors, romaine lettuce entering the market will now be labeled with a harvest location and a harvest date,” according to the FDA. “Romaine lettuce entering the market can also be labeled as being hydroponically or greenhouse grown. If it does not have this information, you should not eat or use it.”

The FDA is advising retailers to display signs about the origin of romaine products when they’re not individually packaged, such as bulk displays of unwrapped heads of romaine.

In their investigation, federal, state and local health agencies focused on Central Coast growing region of Northern and Central California. Since the report of the illnesses, mid-October to early November, harvest has shifted to other areas, including California’s Imperial Valley, the Yuma, Ariz., region and Florida.

The FDA also singled out greenhouse and hydroponically grown romaine in its Nov. 26, growers of which have been critical of the decision to remove all romaine from the market Nov. 20.

“Hydroponically- and greenhouse-grown romaine also does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these sources,” according to the FDA statement.

United Fresh compiled a list of questions and answers relating to the new labels.

The industry and FDA have agreed to work together to improve tracking romaine through the supply chain, according to the United Fresh alert. The groups that worked on the labeling agreement also include:

  • Produce Marketing Association;

  • Western Growers;

  • Arizona and California Leafy Greens Marketing Agreements;

  • Grower-Shipper Association of Central California;

  • Florida Fruit & Vegetable Association;

  • Yuma Fresh Vegetable Association; and

  • Yuma Safe Produce Council.

 “Our associations are committed to working with FDA in a new effort with experts from within and outside the industry, together with government, to implement improved procedures that enhance the speed and accuracy of investigations,” according to United Fresh. “Moving forward, our efforts to enhance strong traceability systems will be most beneficial for consumers only if coupled with expert epidemiological methodology, accelerated investigations with sufficient resources, and government-industry expert collaboration that allow us all to pinpoint the source of contaminated product resulting in more targeted recalls.”

Post-purge return

Before the FDA released its statement, Commissioner Scott Gottlieb appeared on Fox News’ “The Daily Briefing” to talk with host Dana Perino about a variety of issues, including the E. coli outbreak linked to romaine.

“I understand the impact this has not just on consumers but growers, but we had clear evidence that there was an outbreak and that product that was contaminated was still in the marketplace, so it was important to purge the market of that produce —"

“Has the market been purged now?” Perino asked.

“We think it’s been done now, so we’re going to put out a statement a little later today saying that we think we’ve isolated the problem to produce grown in the coastal regions of California, of Central and Northern California, and that produce that’s grown in other parts of the country …  it’s probably safe to put back into commerce now.

“So what we wanted to do was purge the market of the produce that was probably contaminated, which has now been isolated, we think, to California, and now stores can start restocking with produce that’s being harvested from Florida or North Carolina or other parts of the country,” Gottlieb said.

Related Topics: Romaine Outbreak E. coli United Fresh

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More Than 200 Million Eggs Have Been Recalled For Possible Salmonella Contamination

More Than 200 Million Eggs Have Been Recalled For Possible Salmonella Contamination

By ALIX LANGONE 

April 15, 2018

An Indiana farm is recalling more than 200 million eggs due to possible salmonella contamination.

According to the U.S. Food and Drug Administration, 206,749,248 eggs are being voluntarily recalled by Rose Acre Farms based in Seymour, Ind.

So far, 22 cases of illness from the eggs have been reported, the FDA says. Salmonella Braenderup is a bacteria sometimes found in raw foods that can cause serious illness if ingested.

Rose Acre Farms issued the recall on its own after a handful of reports of salmonella poising on the East coast surfaced. The FDA opened an investigation into the matter shortly after.

The eggs were nationally distributed by the farm in Hyde County, N.C. and shipped to at least nine states: Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia and West Virginia.

The eggs were sold at Walmart and Food Lion stores, in addition to being sold under multiple brand names — Country Daybreak, Crystal Farms, Coburn Farms, Sunshine Farms, Glenview and Great Value, according to USA Today.

To check whether you’ve purchased any of the potentially contaminated eggs look for the stamp “P-1065 with the Julian date range of 011 through date of 102 printed on either the side portion or the principal side of the carton or package,” the FDA says.

If you did purchase any of the 200 million eggs you can bring them back for a full refund. You can also contact the company from 8 a.m to 5 p.m. ET at (855) 215-5730.

The Hyde County farm produces more than 2.3 million eggs a day from more than 3 million hens.

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