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An epidemic of E. Coli led the CDC to warn Americans to avoid romaine lettuce and JBS USA to recall nearly 100,000 pounds of ground beef.
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Lisa Dennis of Regent Square selects a green lettuce head from the vegetable shelves of the East End Food Co-op's federal credit union on Tuesday in Pittsburgh. Due to a recent consumer alert regarding an outbreak of E. Coli in several states, the cooperative has replaced fresh lettuce and bagged with blue signs stating: "The CDC issued a consumer alert for romaine lettuce because of a multi-state E.Coli trigger . " The most recent epidemic mainly affects women and girls, according to the CDC.(Photo: Jessie Wardarski, AP)

There is a striking aspect of the recent Epidemic of E. Coli tied to romaine lettuce: 66% of those affected are women.

Similarly, when the Roman was the cause of an epidemic of E. Earlier this year, 67% of the 210 people infected were women or girls, the same ratio as an outbreak of green leafy vegetables in late 2017.

Medical experts have wondered why women and girls seem to be more often victims of E. Coli only men and boys. Dr. Bruce Lee, Associate Professor of International Health at Johns Hopkins University, explains three possible reasons for this trend.

The most likely contributory factor is women's diets, which tend to include more vegetables. A 2012 study of nearly 15,000 men and women published in the medical journal Clinical Infectious Diseases found that men consumed more meat and poultry than women, but women ate fruit and vegetables in higher.

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This could explain why an epidemic of E. Coli caused by Cargill ground beef this summer affected men in 67% of cases, while an epidemic of alfalfa sprouts in 2016 affected women 73% of the time, according to CDC statistics. Yet women accounted for the majority of people affected by a 2015 outbreak of Costco Roast Chicken Salad. All of these outbreaks affected fewer people than this year's E. coli outbreaks.

British officials have also suggested that women's diets are the cause of the small number of E. coli infections. More women than men became ill during an outbreak of E. coli involving cucumbers, lettuce and tomatoes in 2011, The Guardian reported.

"We can not say with absolute certainty that women have been disproportionately affected," the British health protection director Bob Adak told the newspaper in 2011, "but in previous epidemics in the US, world associated with salad and adults more severely affected than men and children, so it is possible that this is an indicator of food preference. "

According to Lee, another factor could be the difference between how men and women report their symptoms to their doctor. The high number of women may be due to the fact that more women are passing on information to health professionals. Lee said studies show that men are less likely to report symptoms of any type of illness.

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Finally, it has been proposed that women respond more to E. coli because of differences in their gastrointestinal tract. However, Lee said there was no solid evidence to that effect. The different results according to sex and race, he added, are often dictated by social and behavioral differences and not by biological characteristics.

Lee, also chief executive of the Johns Hopkins Global Center for Prevention of Obesity, points out that this is not an excuse for not eating vegetables.

This story is an updated version of an article published on April 21, 2018.

Follow Sean Rossman on Twitter: @SeanRossman

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