Over the last three years, five outbreaks of E. coli have been linked to domestically grown romaine lettuce contaminated with cow manure. Genetic tests show that the latest outbreak, linked to romaine grown in Salinas, California, was the fifth in three years caused by the same strain of E. coli.

The FDA has admitted that they have identified a single common grower of the romaine that caused most of the illnesses last year — but, they will not release the name of that grower to the public. The FDA wants to protect the grower from public outrage. This seems a little backward to me.

The most recent outbreak, which began in September 2019, was declared over not because the outbreak was stopped, but because the romaine growing season in California came to an end and there was no more lettuce from there left on shelves.

Before it ended, 167 people became seriously ill, 85 of them were hospitalized and 15 people developed hemolytic uremic syndrome (HUS), a form of kidney failure associated with E. coli infections.

While that is a lot of people, the numbers really don't tell the stories of how bad these infections are. The food safety legal team I lead has seen the devastating results firsthand. Our clients from just the 2019 outbreaks include:

• A 4-year-old boy who was hospitalized with a serious infection for nearly a week.

A 14-year-old girl with HUS who has already undergone seven rounds of dialysis, with more likely to come.

• A 25-year-old woman who developed HUS, requiring multiple rounds of dialysis during her monthlong hospital stay. Her invasive infection ended up in her brain, leading to cognitive impairment, memory loss and balance problems that may be permanent.

• A family with four children, all under the age of 10, three of whom developed HUS and needed dialysis, and the family's 8-year-old daughter, who also suffered a brain infection and has since been unable to speak and must relearn how to walk.

If you knew the salad you were buying was linked to a grower who repeatedly could not control E.-coli-laced manure from getting on their product, would you want to buy it? Or are we supposed to be OK with salads that might cause kidney failure and brain damage?

The FDA's approach to consumer information this time around was to issue a warning about Salinas-grown romaine and tell consumers to avoid it. But a warning is not a recall, and a warning is certainly not something that stops the disease at its source. There were infections occurring for weeks after the warning was first issued.

After the 2018 nationwide romaine E. coli outbreak and recall, the FDA proposed new safeguards, recommending growers modify their operations to prevent contamination from cow manure on adjacent farms, improve record-keeping to facilitate quick trace-back investigations when outbreaks do occur and include comprehensive growing region information on product labels.

Notice that the FDA "proposed" and "recommended" safeguards and rules — it did not "require" and "enforce" them. So, one year later the outbreaks happened again.

Instead of putting the industry it is supposedly regulating first, the FDA needs to start putting the American consumer it is supposedly protecting first. If the FDA knows a grower has sold contaminated product, it needs to let the public know, too. And, it's long past time for the FDA's "suggested" safeguards to become mandatory. When a consumer buys prepackaged lettuce, the package should include the origin and distribution of every component within the package. This would allow for instant identification of the grower, processors, distributors and retailers. It would help to identify and end outbreaks far more quickly and hold responsible those who violate food-safety laws. And, the improved safety would benefit all the responsible growers who sell us healthy uncontaminated food. We should not have to wait until the end of the growing season to declare "victory" over disease.

Fred Pritzker is founder and president of Pritzker Hageman, a national food-safety law firm headquartered in Minneapolis. On Twitter: @PritzkerHageman.