PHILADELPHIA (WPVI) -- Pennsylvania health officials say there have been 20 confirmed cases of E. coli related to contaminated romaine lettuce.
Of those, 12 people have been hospitalized and two people have suffered kidney failure.
It's a specific strain of E.coli causing this: o157:H7.
It is a bad actor.
Because of it, we are being told to avoid romaine lettuce from Yuma, Arizona
It is a bug we have confronted before. Its symptoms start with nausea, vomiting and diarrhea.
"If not caught in time, dehydration and toxins it uniquely expresses can cause kidney failure," said Dr. Neil Nandi of Drexel Medicine.
RELATED: Everything you need to know about E. coli
Nandi is describing what an E.coli infection can do to a person.
Contamination can come from many directions: touching animals in petting zoos, to the commercial food chain that supplies restaurants and supermarkets.
Beef can be contaminated from contact with cattle feces at the slaughterhouse.
Vegetables such as lettuce can be contaminated from dirty irrigation water or workers who did not wash their hands.
"The lettuce is grown close to the ground, close to the soil. That's where urine and stool droppings are going to," said Nandi.
Nandi says there are industry safeguards but they are not foolproof.
So what should consumers do?
"Beef, for instance: you should invest in a good digital thermometer. Stick it in, make sure you cook it to the right temperature. Most products with tell you with beef it is 145 degrees," said Nandi.
As for lettuce...
"First thing you do is you remove the leaves. You need you cut the base of the stem off, and then you let it soak in a bowl of water. It allows the sediment, the dirt that is infected with E. coli, to settle to the bottom. One more rinse then it is ready for consumption," Nandi said.
It's all about good food handling and sanitation in your kitchen
Wash your hands, cook meat thoroughly, and wash cutting boards and platters between pre-cooking and post-cooking.
As for lettuce, a quick rinse is not enough. Instead, it needs a thorough soak in clean water in a clean bowl.
Think of it this way: an ounce of prevention is worth a pound of cure.
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20 confirmed E. coli cases in Pennsylvania linked to romaine lettuce