You know that Escherichia coli O157:H7 outbreak that I reported on for Forbes early Thursday? Well, the Centers for Disease Control and Prevention (CDC) just lettuce know some more information. And it doesn’t look good for the romaine empire.

It was originally thought that a specific lot of Ready Pac Foods Bistro^® Chicken Caesar Salad was to blame for the outbreak. Ah, but that belief was so yesterday. This no longer seems to be just a fail Caesar salad situation. Instead, the contamination appears to be much broader. The CDC’s latest advice is to not sell or eat any romaine lettuce from the Salinas, California, growing region, whether it’s in your salad, on its own, in a box, with a fox, in your house, with a mouse, or under any other situation.

The reported size of the outbreak has not “romained” the same either. Yesterday now seems so far away. Since my previous report, the size of the outbreak has jumped from 17 reported cases to 40, and twice as many states (16 versus eight) are now involved. There have also been four-times as many hospitalizations (28 up from seven). Fortunately, no one seems to have died yet from the outbreak. However, already five have suffered hemolytic uremic syndrome (HUS). As I mentioned before, HUS is kidney failure that is a serious and potentially life-threatening complication of E. coli O157:H7 infection.

So toss your romaine if its from Salinas, before you toss your cookies or suffer even worse. And if you got your romaine from Missa Bay, LLC., ask for a refund. According to the U.S. Department of Agriculture (USDA), the company has issued a recall of approximately 75,233 pounds of its salad products due to concerns about E. coli O157:H7, contamination. Check to see if your salad products were produced from October 14 to October 16, 2019, and bear the establishment number “EST. 18502B.” These products went to a wide range of states, including Alabama, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Virginia and Wisconsin. That’s a poop-load of states.

If the romaine lettuce industry was hoping to recover from the 2018 E. coli O157:H7 outbreaks, this is certainly not the way to do it. Some in the twitterverse are now questioning the presence of romaine in their diets:

Of course, you don’t want to go too far with the concerns about romaine in general:

Nonetheless, last year’s and this year’s outbreaks do merit a closer look at how romaine is currently being grown, harvested, and monitored. @kategammon offered one potential explanation of why romaine may be a particular risk for E. coli O157:H7 contamination:

This doesn’t quite explain why there seems to have been more issues with romaine lettuce since 2017. In fact, as I have written over and over again, the past two years have seen a surge in reported food-borne infectious disease outbreaks in general. What exactly has happened to food safety monitoring and precautions since Donald Trump became President of the U.S.two and a half years ago? Well, in July of this year Emily Holden wrote an article for The Guardian entitled, “Enforcement of food and drug safety regulations nosedives under Trump,” which provided evidence supporting what the title said.

Can we really afford to leave be what’s happening to romaine and other food products? Food-borne outbreaks not only are costly but can pose significant harm to and even kill people. As they say, once may be an accident. Twice may still be a coincidence. But three times is a trend. Last year saw two romaine-associated E. coli O157:H7 outbreaks. This current one would make three in just two years.