Thanksgiving is many Americans favorite holiday because it is a time when family, friends, neighbors and strangers come together to share their favorite foods. Before you prepare your favorite dishes, take a moment to review the food recalls and illness outbreaks identified by the US Centers for Disease Control and Prevention.

Romaine lettuce
Just two days before Thanksgiving, the CDC warned US consumers to not eat romaine lettuce, as it may be contaminated with E. coli.
Thirty-two people, including 13 who have been hospitalized, have been infected with the outbreak strain in 11 states, according to the CDC. One of the hospitalized people developed hemolytic uremic syndrome, a potentially life-threatening form of kidney failure. No deaths have been reported.

People have become sick in California, Connecticut, Illinois, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio and Wisconsin.

The Public Health Agency of Canada has identified an additional 18 people who have become sick with the same strain of E. coli in ontario and Quebec.

The US Food and Drug Administration, which is also investigating the outbreak, cautions that if you have any romaine lettuce at home, you should throw it away, even if you have eaten some and did not get sick.

No one distributor or source has been identified, so the FDA is warning consumers to avoid all types and brands of romaine lettuce. Consumers should not eat any romaine lettuce product, including "whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, such as spring mix and Caesar salad.

Retailers and restaurants also should not serve or sell any until more is known about the outbreak.

Illnesses in the current outbreak started in October, and it is not related to another multistate outbreak linked to romaine lettuce this summer.

Turkey products
The US Department of Agricultures Food Safety and Inspection Service has recalled turkey products linked to a salmonella outbreak. The CDC announced the outbreak linked to raw turkey products in July, but more people have gotten sick, bringing the total to at least 164 in 35 states. One person in California has died, and 63 people have been hospitalized.

Jennie-O Turkey Store Sales LLC recalled 91,388 pounds of raw ground turkey products after the USDA found that a sample of the products tested positive for salmonella reading matching the outbreak strain. The samples were from a September 11 production, and according to the USDA, the rest of the products shipped nationwide.

The outbreak started in November 2017. Its unclear wher the turkey at the center of this outbreak came from, as there doesnt appear to be one centralized distributor, the agency said. This could mean that "it might be widespread in the turkey industry."

Lab tests show that the salmonella came from a variety of products, including ground turkey and turkey patties. Tests showed that its also been in live turkeys and pet food.

The CDC said that if you plan to handle raw turkey, make sure you are extra careful: Wash your hands after touching it. Cook products thoroughly to avoid getting sick. Thaw turkeys in the refrigerator, not on the counter.

Raw chicken
In another ongoing investigation, 92 people have been infected with salmonella infantis in 29 states, linked to raw chicken products from a variety of sources, according to the CDC. No deaths have been reported, though 21 people have been hospitalized, the public health agency reports. The USDA is continuing to monitor this outbreak.

People who have become sick report eating different types and brands of chicken products purchased in many locations. The CDC has identified salmonella in samples taken from raw chicken products, live chickens and raw chicken pet food. Because the strain is present in live chickens as well as many types of raw chicken products, this is an indication that contamination might be widespread in the chicken industry, according to the CDC.

However, the CDC does not advise consumers to avoid eating properly cooked chicken or retailers to stop selling raw chicken products.

Instead, you need to handle raw chicken carefully and cook it thoroughly to prevent food poisoning, the agency recommends. Wash your hands before and after preparing or eating food, and sanitize your kitchen and preparation area. Chicken breasts, whole chickens and ground poultry, including chicken burgers and chicken sausage, should always be cooked to an internal temperature of 165 degrees Fahrenheit to kill harmful germs. Leftovers should also be reheated to that temperature.

Ground beef
Do not eat, serve or sell recalled beef products that were recalled by JBS Tolleson Inc. of Tolleson, Arizona, because they may be contaminated with salmonella, the CDC advises. As of Thursday, 246 people have been infected with the outbreak strain of salmonella newport in 25 states, the CDC reports. No deaths have been reported, but 59 people have been hospitalized.

Check your freezer for recalled beef, the CDC recommends. The company recalled 6.9 million pounds of beef products in early October, all produced and packaged between July 26 and September 7. It was shipped to more than 100 retailers across the nation under many brand names, and the establishment number "EST. 267" can be found inside the USDA mark of inspection (but may be found elsewher on the package), according to the CDC. The list of retailers wher these products were sold can be found on the USDA website.

Cook ground beef thoroughly, the CDC recommends, and handle beef products safely to prevent foodborne illness. Never eat raw or undercooked ground beef. To kill germs, it needs to reach an internal temperature of 160 degrees Fahrenheit. Wash your hands and any item that came into contact with raw beef, including countertops, utensils, dishes and cutting boards, with soap and water, the CDC advises.

Duncan Hines cake mix
A recall was issued for four types of Duncan Hines cake mix due to possible salmonella contamination, the US Food and Drug Administration said on November 5.

The recall was issued by Conagra Brands due to "a positive finding of Salmonella in a retail sample of Duncan Hines Classic White cake mix that may be linked to a Salmonella outbreak that is currently being investigated by CDC and FDA," Conagra said in a statement.

The DNA fingerprint found in that sample of cake mix matches the DNA fingerprint identified by the CDC in five cases of salmonella illness, according to the FDA.

The illnesses were reported in Maryland, Ohio and Wisconsin, the CDC said Wednesday.

Several of the individuals who are sick told health investigators that they consumed cake mix before their symptoms began, according to Conagra.
"Two ill people reported eating cake in the week before their illness began and one reported eating raw cake mix, but brand information was not available," according to the CDC, which added that it is "working with state health departments and FDA to determine if these ill people ate cake or raw cake mix produced by Duncan Hines."

Whos at risk, and what are the symptoms of foodborne illness?
People of all ages are at risk of becoming sick due to foodborne illness, though when it comes to infections with salmonella, children are the most likely to get sick, according to the FDA. Children under 5, adults older than 65 and people with weakened immune systems, such as people with chronic diseases, are more likely to develop severe illness, but even healthy children and adults can become seriously ill.

Symptoms of salmonella illness usually begin 12 to 72 hours after consuming something tainted with the organism and last about four to seven days.

They include diarrhea, fever and abdominal cramps. Most people recover without treatment. In some patients the diarrhea can be so severe that hospitalization and antibiotic treatment are required to prevent the illness from spreading from the intestines to the blood stream and elsewher in the body.

Symptoms of E. coli infection, which usually begin about three or four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting, according to the CDC. Most people infected by the bacteria get better within five to seven days, though this particular strain of E. coli tends to cause more severe illness.