Washington E. coli Scare is Latest Produce-Related Outbreak

The recent Washington State E. coli O157:H7 outbreak that left 10 people ill, several requiring brief hospitalization, was officially linked to commercial romaine lettuce and is the most recent scare that has left people uncertain about the safety of leafy greens. 

High-profile lettuce-associated outbreaks in the past few years have helped to draw attention to the impact a produce-related outbreak can have.  A large outbreak in September, 2006 linked to Dole Pre-Packaged Spinach resulted in 205 confirmed cases and three deaths. 

The late 2006 outbreak at Taco Bell restaurants in Delaware, New Jersey, New York, and Pennsylvania was linked by the FDA to shredded iceberg lettuce.  The Taco Bell outbreak left 71 people confirmed ill, 53 hospitalized and 8 who developed the severe complication of hemolytic uremic syndrome.

In November and December of 2006, another E. coli O157:H7 oubreak at Taco John's left 81 sick in Minnesota and Wisconsin.  Twenty-six victims were hospitalized and two developed hemolytic uremic syndrome.  This outbreak was linked to iceberg lettuce grown on Wegis Ranch in Buttonwillow, California. 

As a consumer, the best thing to do to prevent produce related illness is to cook produce before it is consumed to ensure any pathogens are killed.  But as most people don't like cooked salad, all that can be done by the consumer is to thoroughly wash leafy greens with running water before they are consumed.  However, only 100-200 E. coli O157:H7 bacterium are required to cause infection, so it is highly unlikely that simple washing of produce can prevent the spread of infection.  For more information, please see our page on food poisoning prevention.

USDA Awards $5.5 Million for Research of E. coli O157:H7 in Fresh Produce

spinach-2.jpgPrompted by a number of E. coli outbreaks involving spinach and lettuce, the US Department of Agriculture (USDA) will provide nearly $5.5 million to support collaborative research to identify risk factors and preventive measures for E. coli O157:H7 contamination in fresh produce.

"This research will help producers identify the sources of E. coli O157:H7 and ways to avoid contamination," Johanns said. "Developing new research and prevention tactics for the grower will contribute to assuring produce safety for consumers."

USDA's Agricultural Research Service (ARS) and Cooperative State Research, Education, and Extension Service (CSRES) are providing the funding to ARS researcher Rob Mandrell and his collaborators at the University of California to continue their research in the Central Valley of California.  Over the next three years ARS will contribute $5 million and CSREES will contribute $470,999.

Mandrell will address where E. coli O157:H7 originates, how it survives on the plant, and what factors lead to an increase in produce-related outbreaks. Potential risk factors include animals, land practices, packing and processing processes, and wildlife.

Additionally, the project will feature workshops and publications to educate the animal operators, natural resource managers, and the public about  the following:
  • Animal diseases that can be transferred to humans
  • How animal waste can contaminate water sources
  • Beneficial management practices for maintaining and improving water runoff quality

No Criminal Charges Resulting from Spinach-Linked E. coli Outbreak

spinach-2.jpgThe U.S. Attorney General’s office has determined that criminal charges are not warranted in the 2006 E. coli outbreak linked to fresh, bagged California spinach. The outbreak was responsible for the deaths of at least 3 people, and hundreds of people were sickened, many with hemolytic uremic syndrome (HUS)

The investigation into the outbreak involved two processing plants and several farms. The outbreak was traced to a field where Mission Organics grew spinach for Natural Selection. The theory is that wild pigs brought the feces of nearby cattle into the field, contaminating the spinach.

Although it is rare that criminal charges are filed following a foodborne outbreak in the United States, in 1996, an E. coli outbreak linked to lettuce did lead to criminal charges for violating food-safety laws. In that case an E. coli outbreak in the Eastern United States was traced back to Fancy Cutt Farms in California. According to the criminal complaint, the lettuce was processed in unsanitary conditions that could lead to bacterial contamination. The company was rinsing lettuce in dirty, bacteria-laden water close to cattle. It was believed that dust-borne manure contaminated with E. coli got into the rinsing water.

Fred Pritzker and Family of E. coli Victim Speak out on Food Safety

spinach-2.jpgA recent story on WCCO Channel 4 in Minneapolis featured the family ofone of the victims of the 2006 E. coli outbreak linked to fresh spinach. The victim, a healthy, active woman, died just days after eating fresh spinach. 

Attorney Fred Pritzker, who represents the family, was quoted as saying:
"The pain that is produced by something like this is just off the charts," said Minneapolis attorney Fred Pritzker, who represents the family. Pritzker wants safety improvements in the food industry. "We have the technology, we have the understanding to make this a lot safer but yet no one has the will to do it," he said.
For the full story and a video of the interview, please click here.

Bill Aims to Prevent E. coli Outbreaks

The California Senate Agriculture Committee recently approved three bills whose aim is to lower the occurance of E. coli outbreaks associated with produce such as spinach, lettuce, and sprouts.  The senate wants to impose tougher safety standards that would regulate water, fertilizer and toilet use in fields; develop and implement systems to quickly trace, recall and quarantine contaminated produce; and require those who grow leafy greens to be licensed by the state.    

The bill was spurred by an outbreak of E. coli caused by contaminated spinach and lettuce last year that killed at least three people.  Although most people are familiar with E. coli being caused  by contaminated meat products, leafy greens are also a common source of E. coli infections.  Leafy greens can easily be contaminated by fertilizers or contaminated water. If contaminated leafy greens are not adequately cleaned or cooked, they can cause infection.  If the E. coli bacteria is within the leaf itself, no amount of washing will get rid of it.

For obvious reasons, the California Farm Bureau Federation and Western Growers Associations are against the bill, saying they are going to impose their own safety standards. 

But in cases of consumer health, it can be necessary for the government to step in and require that basic safety standards required in other industries are implemented by growers of leafy greens. 

Enforceable National Standards Needed to Prevent Future E. coli Outbreak

Fred even smaller for blog entries.jpgThe report entitled Investigation of an Escherichia coli O157:H7 Outbreak Associated with Dole Pre-Packaged Spinach has been issued by the California Department of Health Services and the U.S. Food and Drug Administration on March 21, 2007.

While the precise cause of the bacterial contamination was not identified, the report highlights a number of health hazards involving the fault of the landowner, grower, packer and distributor of the spinach implicated in the outbreak that sickened over 200 people and killed at least three people.   

The report shows there is plenty of fault to go around,  including the manner in which the spinach was grown, harvested, cooled and processed. For example, with regard to the growth of the spinach, the report raises serious questions about the wisdom of growing ready-to-eat crops in close proximity to livestock and livestock waste, especially in the absence of detailed risk assessments intended to identify health hazards in or adjacent to the particular field in which the spinach was grown. The report also points to the need for water testing to determine fecal contamination, adequate standards for well construction and inspection and appropriate measures to prevent cross contamination by wild animals (in this case, there was strong evidence that feral pigs living in close proximity to the surrounding cattle and cattle waste tramped through the fields and spread the bacteria-laden feces on to the adjoining ready-to-eat spinach crop).

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Consumer Survey During Spinach Recall

Below is an interesting press release from Rutgers University.  During the recent spinach recall, Rutgers conducted a survey to determine consumer understanding and behavior in relation to the recall. A surprising number of people knew of the recall and quit buying spinach.  However, about half of the consumers surveyed did not know that spinach was recalled due to possible E. coli contamination.

Rutgers Survey Examines Public Responses to the Recent Spinach Recall

New Brunswick, NJ--Every year, the Food and Drug Administration issues dozens of food-related recalls, withdrawals and advisories. But few receive the attention that the advisory regarding E.coli-contaminated spinach received in September 2006. The broad scale of the resulting recall and related media attention provided a unique opportunity for researchers at the Food Policy Institute (FPI) at Rutgers to study the U.S. food recall system. The results of this study were published today on FPI's web site, http://foodpolicyinstitute.org.

To investigate the public's reactions to this incident, a nationally representative sample of 1,200 Americans were interviewed by telephone from November 8 to 29, 2006. The results of the nationwide telephone survey describe the level of consumer awareness and knowledge of the recall and foodborne illness. The results also provide insight into consumer behavior during the recall and likely future behavior in response to the recall.

"We examined both the successes and of the failures of this particular recall," said William Hallman, Director of the Food Policy Institute. "Our survey not only provides data to improve communications about future food recalls, but also enables us to explore how our systems might work in the case of intentional food contamination."

The results of the survey show that the FDA's main message to consumers warning that bagged fresh spinach had been contaminated and should not be eaten was heard by 87% of Americans. More than eight in ten (84%) of those who had heard about the recall said that they had also talked about it with others. In addition, the data clearly indicate that the majority of consumers did stop eating spinach because of the recall.

"As a result, the main public health goal of the recall was met," said Hallman, "However, fewer Americans were aware of important details related to the recall. Many were confused about the types of spinach affected, where it was grown, the organism that caused the contamination, the symptoms of the resulting illness, and perhaps most significantly, whether or not the recall had ended."

While nearly all (95%) of those who had heard about the recall knew that bagged fresh spinach had been recalled, only about two-thirds (68%) knew that loose fresh spinach was also part of the recall. However, they were confused about the safety of frozen and canned spinach during the recall, as only 57% and 71%, respectively, knew they were not affected by the recall.

Only half (52%) knew that the contaminated spinach had been grown in California, and only half (52%) could identify E. coli as the contaminant that made people ill. In addition, while 87% of Americans correctly recognized that abdominal cramps are a common symptom of E. coli infection, only about two-thirds (64%) of Americans correctly recognized the key symptom, bloody diarrhea. Instead, Americans are more likely to incorrectly associate the symptoms of nausea (88%) and vomiting (87%) with an E. coli infection. Moreover, though not generally associated with E. coli infections, more than three-quarters (77%) of Americans identified fever as a symptom, and nearly one-quarter (22%) reported that rashes were a symptom despite the fact that they are not commonly associated with any foodborne illness.

"Most Americans know little about the symptoms of foodborne illnesses," said Hallman, "E. coli infections are no exception."

Although the recall caught the attention of the American public, not everyone followed the advice of the FDA. More than one-in-ten (13%) of those who ate spinach before the recall reported that they ate fresh spinach during the recall, and nearly three-quarters (74%) of them knew about the recall at the time.

Some Americans went to the other extreme, generalizing the warnings about spinach to other similar foods. Nearly one-fifth (18%) of those aware of the recall said they stopped buying other bagged produce because of the spinach recall. In addition, nearly half (48%) reported that the spinach recall caused them to wash their food more thoroughly.

"Clearly, the recall had a bigger effect on the public than just throwing away a few bags of spinach," Hallman notes, "Consumers confidence in the safety of other produce seems to have been affected."

While almost all Americans got the initial message that they should not eat fresh spinach, many fewer got the message that it is safe to eat it again. As of November 2006, many people were confused about the status of the recall. Thirteen percent believed that it was still in effect, and 18% said they did not know if it was still ongoing.

However, most spinach-eaters who knew about the recall said that they were already eating spinach again (44%) or may go back to eating spinach (47%), many within the next several months. Most Americans view their likelihood of getting sick from eating spinach as lower after the recall than during or even prior to the recall. Nonetheless, 5% of spinach-eaters who were aware of the recall said that they will never go back to eating spinach.

The authors of the study include Cara L. Cuite, Sarah C. Condry, Mary L. Nucci and William K. Hallman, all researchers at FPI. FPI is a research unit of Rutgers New Jersey Agricultural Experiment Station. The institute addresses important emerging food policy issues and supports public and private decision makers who shape aspects of the food system within which government, agriculture, industry and the consumer interact.

For information about E. coli lawsuits, please contact Pritzker | Ruohonen, a leading food poisoning litigation law firm, toll-free at 1-888-377-8900 or submit the firm's online consultation form for review by an attorney.

Bagged Lettuce and Spinach Outbreaks

After reviewing recent E. coli outbreaks traced to bagged spinach and lettuce, some scientists have come to the conclusion that the way the greens were packaged was the primary reason for the wide-spread nature of the outbreaks. When lettuce or spinach is cut and bagged, one contaminated head of lettuce or bunch of spinach can contaminated numerous bags.  

In particular, the centralized processing of fresh greens can increase the risk of more widespread contamination, just as tainted beef from one steer can find its way into hundreds of packages of ground meat, said Dr. David W.K. Acheson, chief medical officer at the U.S. Food and Drug Administration's Center for Food Safety and Applied Nutrition.

"If you have a single head of [tainted] lettuce that winds up in someone's home, makes the family sick, chances are it'll never get on the radar screen," Acheson said. "If you take the same lettuce, process it … one head may contaminate multiple bags. Then you've got an outbreak." (Los Angeles Times)

If you continue to buy bagged lettuce and spinach, be sure to wash it well.  To learn about E. coli, please visit the Pritzker | Ruohonen website, www.pritzkerlaw.com

Source: Mary Engel and Rong-Gong Lin II, Some food safety experts say the mixing of greens for packaging may increase the risk of contamination, Los Angeles Times, January 20, 2007.

Conversation with a Microbiologist about E. coli O157:H7

In a recent conversation with Dr. Laurie Achenbach, a microbiology professor at Southern Illinois University, she discussed her thoughts on contamination of lettuce and spinach with E. coli O157:H7. The following is a synopsis of some of her comments:
  1. If grazing cows are too close to a spinach or lettuce field, cow manure can easily contaminate the field with E. coli O157:H7. The manure can even get dry enough to become airborne and land on leaves or soil.
  2. Microscopic amounts of cow manure contaminated with E. coli O157:H7 can “hide” in the crevices of lettuce and spinach leaves. Even multiple commercial washings, where there is no friction used, will not get all of the microscopic amounts of manure off.
  3. Consumers should always wash off “pre-washed” lettuce and spinach under running water while gently rubbing the leaves. Each leaf should be washed separately. The combination of friction and running water will remove most of the E. coli-contaminated manure.
  4. People at risk of developing serious complications from an E. coli O157:H7 infection should probably not eat raw spinach and lettuce because there can be no guarantee that the leaves are not contaminated with E. coli O157:H7.
  5. Even though research has indicated that E. coli O157:H7 can reside in as well as on lettuce and spinach leaves, Dr. Achenbach thinks it is highly unlikely that the recent E. coli outbreaks linked to spinach and lettuce were a result of E. coli O157:H7 in the leaves.  E. coli O157H7 is not a plant pathogen and will not colonize inside of a lettuce or spinach leaf. E. coli O157:H7 on the leaves is the greatest danger, according to Dr. Achenbach.

Wild Boars Linked to E. coli Outbreak

Investigators are getting closer to finding out how the E. coli-tainted spinach that sickened over 200 people was contaminated. According to a story in CIDRAP News, a publication out of the University of Minnesota:

Six more samples of the Escherichia coli O157:H7 strain that killed 3 people and sickened more than 200 who ate raw spinach have been found on a ranch in California's Salinas Valley area, state and federal officials announced yesterday.

In a press conference, Kevin Reilly, deputy director of prevention services for the California Department of Health Services, said the newly identified matching samples are from creek water, a wild boar, and four pieces of cow manure. All samples are from the same farm where investigators had already found three manure samples with E coli that matched the outbreak strain, bringing the total to nine.

Health officials are looking at the wild boars as the means by which the E. coli bacteria got from the cow manure to the spinach.

Spinach-E. coli Outbreak: Two Maryland Children

State health officials have confirmed that two more Maryland children were sickened by the spinach-linked strain of E. coli that has sickened at least 200 people. Unlike other cases associated with the outbreak, however, these Maryland children may not have eaten spinach. According to a story on Southern Maryland Online, "In both cases the parents said the children did not eat spinach."

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Spinach-E. coli Cases in Illinois and Oklahoma

State and federal health officials continue to confirm cases of E. coli O157:H7 linked to fresh spinach. Two people, including a child, have been confirmed in Illinois. A 2-year-old and her family in Oklahoma have been tested and are awaiting the results. The 2-year-old, Eliza Schultz, has experienced E. coli-related kidney failure and needs a kidney transplant.

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Spinach-E. coli Outbreak and Produce Safety

The recent spinach-E. coli outbreak is the 20th E. coli outbreak linked to lettuce and spinach in the last few years. Health officials have suspected contamination on the fields but have never been able to prove it. The enormity of the recent outbreak--nearly 200 people sickened and 3 killed--led to an exhaustive investigation. As we reported last week, investigators have genetically matched an E coli O157:H7 strain found in manure from a California cattle ranch near spinach fields with the strain isolated from sick patients and their leftover spinach.

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Spinach-Linked E. coli Traced to Cattle Farm

The FDA and State of California announced today that cattle feces from one suspected ranch tested positive for the genetically-matched strain of E. coli O157:H7 has been linked to spinach, particularly bags of Dole baby spinach. This was part of the federal and state trace-back investigation, which is done to determine the exact source of a foodborne outbreak, an important step in preventing another spinach-related E. coli O157:H7 outbreak.

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Nebraska Death is Third in Spinach-E. coli Outbreak

Ruby Trautz, 81, of Bellevue, Nebraska, is the third confirmed death of the E. coli O157:H7 outbreak linked to fresh spinach that has sickened nearly 200 people. Ms. Trautz was misdiagnosed and died in August, according to news reports. Only after her family pressed for E. coli testing was the truth uncovered:

Dr. Thomas Safranek, epidemiologist for the Nebraska Department of Health and Human Services, was cited as saying the woman, Ruby Trautz, 81, died on Aug. 31 at a hospital in Omaha, after eating fresh spinach contaminated with the same strain of E. coli O157:H7 bacteria as the others.

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Criminal Investigation of Growers Express and Natural Selection Foods

The US Attorney's Office has announced that agents of the FBI and FDA Office of Criminal Investigations executed two search warrants today on Growers Express in Salinas, CA, and Natural Selection Foods in San Juan Batista, CA, in connection with the September 2006 outbreak of E. coli 0157:H7 that the FDA has traced to spinach grown in the Salinas area.

United States Attorney Kevin V. Ryan stated that "I want to reassure the public that there is no indication in this investigation that leaf spinach was deliberately or intentionally contaminated. We are investigating allegations that certain spinach growers and distributors may not have taken all necessary or appropriate steps to ensure that their spinach was safe before it was placed into interstate commerce. . . ."

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FDA Response to E. coli Outbreak

Even with the death and severe illness that has been associated with the E. coli outbreak linked to spinach, the FDA has decided not to further regulate the spinach and lettuce industry. The FDA is again calling on the industry to voluntarily follow guidelines. Voluntary guidelines have not worked. The entire industry--growers, packers, shippers and retailers--have to be subject to further regulation to prevent future outbreaks:

  1. Lettuce and spinach should not be allowed to be grown where there is any potential for contamination from cattle manure.
  2. Lettuce and spinach should not be allowed to be grown in areas where there is periodic flooding.
  3. Produce that has come in contact with flood waters should not be sold for human consumption.
  4. Labeling on all packaging, bags or otherwise, should have information regarding where the lettuce and spinach was grown, right down to the field.
  5. Lettuce and spinach should be separated from anything that could cause contamination when shipped, stored and displayed for sale.
  6. All surfaces that will come in contact with lettuce and spinach should be thoroughly washed with the assumption that E. coli bacteria are present and need to be killed.
  7. Fields, packaging facilities, transportation equipment and vehicles, storage facilities and retailers need to be regularly inspected.

In addition, before one more bag of lettuce or spinach is sold, significant, persuasive scientific evidence should be presented to the FDA proving that the packaging does not contribute to the growth of E. coli bacteria.

Idaho Child Died from E. coli-Related HUS

Two-year-old Kyle Allgood of Chubbuck, Idaho, died September 20 from hemolytic uremic syndrome (HUS), a type of kidney failure caused by E. coli bacteria. Tests have shown that he had an E. coli O157:H7 infection. Additional testing is being done to determine if the E. coli O157:H7 had the same "DNA fingerprint" as the E. coli O157:H7 linked to spinach that has sickened almost 200 people. Kyle had eaten a smoothie containing spinach before becoming ill.

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Dole E. coli

187 people from 26 states have contracted E. coli after eating spinach. Of these, one has died. According to the CDC, E. coli O157:H7 was isolated in 9 packages of Dole baby spinach supplied by E. coli patients in 7 states. The "DNA fingerprints" of all 9 of these E. coli match that of the spinach-related outbreak strain.

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CDC Detailed Report on Spinach and Escherichia coli Outbreak

Updated October 6, 2006.

The following is the CDC report on the spinach-related E. coli outbreak:

Ongoing Multistate Outbreak of Escherichia coli serotype O157:H7 Infections Associated with Consumption of Fresh Spinach --- United States, September 2006

As of 1 PM (ET) October 6, 2006, Friday, 199 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 26 states.

Among the ill persons, 102 (51%) were hospitalized and 31 (16%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS). One hundred forty-one (71%) were female and 22 (11%) were children under 5 years old. The proportion of persons who developed HUS was 29% in children (<18 years old), 8% in persons 18 to 59 years old, and 14% in persons 60 years old or older. Among ill persons who provided the date when their illnesses began, 80% became ill between August 19 and September 5. The peak time when illnesses began was August 30 to September 1 -- 31% of persons with the outbreak strain became ill on one of those 3 days.

Three deaths in confirmed cases have been associated with the outbreak. One was in an elderly woman from Wisconsin. Yesterday, Idaho confirmed that stool samples from a 2-year-old child with HUS who died on September 20 contained E. coli O157 with a "DNA fingerprint" pattern that matches the outbreak strain. Today, Nebraska reported the death of an elderly woman with an illness compatible with E. coli O157 infection who consumed raw spinach; E. coli O157 with the outbreak strain "DNA fingerprint" was detected in the remaining spinach.

Maryland is investigating a suspect case in an elderly woman who died on September 13 and had recently consumed fresh spinach. E. coli O157 was cultured from her stool, but "DNA fingerprinting" has not been possible.

E. coli O157 was isolated from 13 packages of spinach supplied by patients living in 10 states. Eleven of the packages had lot codes consistent with a single manufacturing facility on a particular day. Two packages did not have lot codes available but had the same brand name as the other packages. The "DNA fingerprints" ofall 13 of these E. coli match that of the outbreak strain.

FDA September 26 Update of Spinach-E. coli Outbreak

September 26, 2006, update of E. coli outbreak linked to spinach, including Dole baby spinach:

To date, 183 cases of illness due to E. coli O157:H7 infection have been reported to the Centers for Disease Control and Prevention (CDC), including 29 cases of Hemolytic Uremic Syndrome (HUS), 95 hospitalizations and one death.

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Letter from Rainer Mueller of Eric's ECHO

Rainer Mueller founded Eric's ECHO after his 13-year-old son died from E. coli poisoning after eating a contaminated hamburger in 1993. The organization is dedicated to helping victims of E. coli poisoning. We asked if he would provide us with some insight on the current E. coli outbreak that has sickened over 170 people and killed at least one person.

"As our family approaches the 13th anniversary of the death of my my 13 year old son Eric in 1993, I find that the wounds caused by his passing are now being re-opened by this latest E.coli outbreak. In 1993 it was ground beef that caused the terrible illnesses and death. At that time many people told me that they felt safe because they were vegetarians and only ate organic vegetables. Even then I warned them that this was a false sense of security." Read the full text of the letter from Rainer Mueller on the Pritzker | Ruohonen website.

Denver, Colorado: Mixed Greens with Spinach and E. coli

According to a story on KUSA Channel 9 News in Denver, Colorado, a truck driver from Oklahoma gave away 240 cases of mixed greens at a truck stop in Denver. The mixed greens, which came from Earthbound Farms, may have contained spinach contaminated with E. coli O157:H7 bacteria. The driver claims that King Soopers and its parent company, Kroger, told him he could give it away because it was improperly labeled.

Ken Palmer, the driver, told 9 News that King Soopers rejected a portion of his truck load because of improper labeling.

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FDA Update of Spinach-E. coli Outbreak

The FDA is providing daily updates on the E. coli O157:H7 outbreak that is linked to California spinach. Today, the FDA announced that Utah investigators found the spinach-E. coli outbreak strain of E. coli O157:H7 in a bag of Dole baby spinach. This is the second bag of Dole baby spinach found containing a matching strain of E. coli. New Mexico investigators found the first bag of contaminated Dole baby spinach. There are now 173 confirmed cases of illness, up from 171 yesterday. The FDA is still reporting one confirmed death. Two other deaths are being investigated.

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CDC Update of E. coli Outbreak Linked to Spinach

The following is the most recent CDC Update of the spinach-related E. coli O157:H7 outbreak:

As of 1 PM (ET) September 24, 2006, Sunday, 173 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 25 states.

Among the ill persons, 92 (53%) were hospitalized, 28 (16%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS), and an adult in Wisconsin died. One hundred twenty-five (72%) were female and 15 (9%) were children under 5 years old. The proportion of persons who developed HUS was 29% in children (<18 years old), 8% in persons 18 to 59 years old, and 16% in persons 60 years old or older. Among ill persons who provided the date when their illnesses began, 88% became ill between August 19 and September 5. The peak time when illnesses began was August 30 to September 1 -- 35% of persons with the outbreak strain became ill on one of those 3 days.

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A Lawyer's Perspective on the Spinach-Related E. coli Outbreak

Fred even smaller for blog entries.jpgSince 1995, 19 outbreaks of foodborne illness caused by Escherichia coli O157:H7 have been linked to bagged salads. These outbreaks injured over 400 people and resulted in two deaths. The current E. coli spinach outbreak, the twentieth, has so far injured 171 people in 25 states and taken the life of a 77-year-old Wisconsin woman. Many more people will be injured or even killed before this outbreak is contained. Why is this happening and what can be done to stop it?

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Maryland E. coli O157:H7 and Fresh Spinach

Maryland health officials have confirmed the state's first three E. coli O157:H7 cases linked to fresh spinach (Dole baby spinach and other brands). They are also investigating the death of an 86-year-old woman and 3 other E. coli cases in Maryland. The 3 confirmed cases are children.

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FDA Update of Spinach-Linked E. coli Outbreak

September 22, 2006, Update

  • To date, 166 cases of illness due to E. coli O167:H7 infection have been reported to the Centers for Disease Control and Prevention (CDC), including 27 cases of hemolytic uremic syndrome (HUS), 88 hospitalizations and one death.
  • To date, 25 states have reported cases of E. coli O157:H7 infection. The additional states as of today are Maryland and Tennessee.
  • FDA is working closely with CDC and the state of California. FDA has determined that the spinach implicated in the outbreak was grown in three counties (Monterey, San Benito and Santa Clara) in California.
  • Spinach grown in the rest of the United States has not been implicated in the current E. coli O157:H7 outbreak. The public can be confident that spinach grown in the non-implicated areas can be consumed. Other produce grown in these counties is not implicated in this outbreak. Processed spinach (e.g., frozen and canned spinach) is also not implicated in this outbreak.
  • Industry is working to get spinach from areas not implicated in the current E. coli O157:H7 outbreak back on the market.
  • Investigators from FDA, CDC and the state of California are working to narrow the area implicated in the current E. coli O157:H7 outbreak further.

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Tennessee Confirms Case of Spinach-Related E. coli

The Tennessee Department of Health announced today that a resident of Davidson County has been infected with E. coli O157:H7. This is the first confirmed case in Tennessee related to an outbreak of E. coli O157:H7 associated with fresh spinach that has sickened over 160 people. The Tennessee patient became ill on September 10. The patient was never hospitalized and has now recovered.

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Idaho Child Dies in Utah from Hemolytic Uremic Syndrome

Kyle Algood, 2, of Chubbuck, Idaho, died on September 20, 2006, in a Utah hospital. He had eaten packaged spinach. Tests are being done to determine if he had an E. coli O157:H7 infection associated with the E. coli outbreak linked to spinach that has sickened over 150 people in 23 states.

ecolitower1.jpgWhat is known about Kyle's death is that he died from complications of hemolytic uremic syndrome (HUS), the leading cause of kidney failure in children in the United States. Most cases of hemolytic uremic syndrome are caused by E. coli O157:H7 infections.

Two other toddlers died from E. coli-related HUS this month, one in Ohio and one in Alabama. E. coli O157:H7 is a silent killer that can't be seen, tasted or smelled. Parents can't know that what a child is eating might kill him.

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Virulent Strain of E. coli O157:H7 Results in More HUS Cases

As the case numbers for the E. coli O157:H7 outbreak linked to spinach grow, it appears that the strain of E. coli O157:H7 involved in the outbreak is particularly virulent. According to CDC statistics, about 2% to 7% of E. coli infections lead to hemolytic uremic syndrome (HUS), the leading cause of kidney failure in children in the United States. In this outbreak, however, about 17% of E. coli infections have lead to HUS.

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FDA Update on Spinach-Related E. coli Outbreak

The FDA is issuing daily updates on the nation-wide E. coli O157:H7 outbreak linked to fresh spinach. There are now 3 recalls associated with the outbreak. 146 people have been sickened by the outbreak. Of those, 76 were hospitalized, 23 developed hemolytic uremic syndrome (HUS) and one died. Two additional states, Arizona and Colorado, have confirmed cases of E. coli O157:H7 that genetically match the cases from the other states involved in the outbreak. The FDA also announced in its September 20 update that a "smoking gun" has been found. Investigators in New Mexico found the spinach-outbreak strain of E. coli O157:H7 in a bag of Dole spinach.

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West Virginia E. coli May be Linked to Spinach

A West Virginia resident is reported to have an E. coli O157:H7 infection, and health authorities are trying to determine whether the case is related to the nationwide outbreak connected with eating fresh spinach. The West Virginia resident is from Ohio County. If health officials confirm that this case is associated with the national E. coli outbreak linked to spinach, it will be the first case in West Virginia.

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E. coli a Widespread Problem in Salinas Valley

According to a story in the Los Angeles Times, E. coli appears to be a widespread problem in California's Salinas Valley, where the spinach was grown that has been linked to a nation-wide outbreak of E. coli O157:H7 infections. California and federal health and agriculture officials have known that parts of the Salinas Valley are prone to flooding and that those flood waters are contaminated with cattle and other livestock waste. Not only has spinach and lettuce continued to be grown in the flood areas, but it is sold to consumers without adequate testing for E. coli contamination.

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E. coli O157:H7 in Spinach - Arizona

There are 5 cases of E. coli O157:H7 infections in Arizona associated with the E. coli O157:H7 outbreak linked to spinach that has sickened over 140 people in 23 states. Other cases of E. coli O157:H7 infections in Arizona may be added to this number as investigators continue to test stool samples.

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Dole Spinach Lawsuit

The current E. coli O157:H7 outbreak that has sickened over 170 people and killed one was linked to Dole baby spinach. Although other brands of spinach have been implicated in the outbreak, investigators in New Mexico, Pennsylvania, and Utah have found E. coli O157:H7 in bags of Dole baby spinach that have the same "genetic fingerprinting" as the E. coli O157:H7 sickening people throughout the country. Lawsuits have been filed against Dole.

This is the second outbreak linked to a Dole product in a year. Last fall, an E. coli O157:H7 outbreak was linked to Dole bagged salads. Pritzker | Ruohonen was the first law firm to file a lawsuit against Dole.

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E. coli Found in Dole Bagged Baby Spinach

dolebabyspinach.gif
Yesterday the FDA announced that investigators in New Mexico had found E. coli O157:H7 in a bag of Dole baby spinach that matches the strain of E. coli O157:H7 that has sickened over 140 people in 23 states and killed at least one person. The discovery is being hailed by health officials as a "smoking gun," conclusive evidence that links specific spinach to the outbreak.

State and federal authorities traced the Dole baby spinach tested in New Mexico to one of three California counties -- Monterey, San Benito and Santa Clara, all south of San Francisco. Dr. David Acheson, chief medical officer for the Center for Food Safety and Applied Nutrition at the Food and Drug Administration, was quoted as saying, "Yesterday, we narrowed it [the E. coli outbreak] to California. Today we've got it down to three counties," he said. "We want it down to a salad bowl and eventually a spinach leaf."

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Genetic Testing Gives Idaho Edge in E. Coli Detective Work

The following is from a press release issued by the Idaho Department of Health and Welfare. The press release is about genetic testing, which helps find the source of an outbreak and determines whether a person's illness is associated with an outbreak.

Rapid identification of E. coli linked to fresh spinach in Idaho and across the nation can be credited to a genetic testing method and the linking of lab results between states and the Centers for Disease Control and Prevention (CDC).

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New Mexico Finds Smoking Gun in Spinach-E. coli Outbreak

New Mexico's public health laboratory has isolated E. coli O157:H7 from an opened package of spinach. The package came from the refrigerator of a patient who ate some of the spinach before becoming ill. The New Mexico laboratory completed "DNA fingerprinting" tests last night. New Mexico and CDC determined that the "DNA fingerprint" matches that of the strain of E. coli O157:H7 that has sickened at least 146 people in 23 states and killed a Wisconsin woman.

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September 20 CDC Update on Spinach-E. coli Outbreak

The following is the most recent CDC update on the E. coli O157:H7 outbreak linked to fresh spinach:

As of 1 PM (ET) September 20, 2006, Wednesday, 146 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 23 states.

Among the ill persons, 76 (52%) were hospitalized, 23 (16%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS), and an adult in Wisconsin died. One hundred three (71%) were female and 8 (5%) were children under 5 years old. Among ill persons who provided the date when their illnesses began, 93% became ill between August 19 and September 5. The case with the earliest illness onset known to be associated with consumption of fresh spinach began having symptoms on August 19.

The states that have reported cases are Arizona (4 cases), California (1), Colorado (1), Connecticut (3), Idaho (4), Illinois (1), Indiana (8), Kentucky (7), Maine (2), Michigan (4), Minnesota (2), Nebraska (7), New Mexico (5), Nevada (1), New York (9), Ohio (15), Oregon (5), Pennsylvania (7), Utah (16), Virginia (1), Washington (2), Wisconsin (40), and Wyoming (1).

Spinach-Related E. coli O157:H7 in Kentucky

The Kentucky Department for Public Health (DPH) today reported one additional case of E. coli O157:H7 to the Centers for Disease Control and Prevention (CDC) in relation to an outbreak of the illness in 23 states. The case was confirmed through testing by the Kentucky Public Health Laboratory in Frankfort.

This brings the total number of people in Kentucky with cases of E. coli potentially related to the national outbreak to seven. The newly reported case involves a male teenager from Kenton County who received outpatient medical treatment.

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E. coli and Bagged Salads -- by Fred Pritzker

[This was first published on September 15.]
Here we go again. Another outbreak of E. coli O157:H7 associated with the consumption of bagged salads.

Fred even smaller for blog entries.jpgThe FDA is warning consumers about an outbreak of E. coli O157:H7 in multiple states linked to bagged fresh spinach. To date, 131 cases of illness have been reported, including 20 cases of hemolytic uremic syndrome (HUS) and one death. According to news reports, genetic subtyping has confirmed that all of the victims have the same genetic outbreak pattern.

I represent people injured by E. coli O157:H7 and other foodborne pathogens. I know how the toxins from E. coli O157:H7 attack the human body and cause suffering and loss that no person should be forced to endure. And yet it continues to happen - another outbreak, more suffering, injury and death because bagged produce is not safe and continues to be sold to the American public.

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E. coli and Hemolytic Uremic Syndrome in Wisconsin Linked to Spinach

The number of confirmed cases of E. coli O157:H7 in Wisconsin linked to spinach continues to grow. As of 11:30 today, there are 40 confirmed cases of E. coli. Of those, 21 have been hospitalized, 8 developed hemolytic uremic syndrome (HUS), and one has died.

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6 Confirmed E. coli Cases in Nebraska Linked to Spinach

The Nebraska Health and Human Services System (HHSS) is investigating a total of 11 cases of E.coli (O157:H7) that may be connected to a nationwide outbreak linked to spinach. Of these, six cases have been confirmed by laboratory tests to have the same DNA fingerprint as other cases in the country.

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Wisconsin Hardest Hit in E. coli Outbreak Linked to Bagged Spinach

Wisconsin now has 40 confirmed cases of E. coli O157:H7 bacterial infection linked to spinach. These are not just statistics--these are people. An Associated Press story relates the suffering of one Wisconsin family:

Anne Grintjes, whose 6-year-old son and 3-year-old daughter fell ill during a multi-state E. coli outbreak linked to tainted spinach, can't even look at produce now without cringing.

The boy spent 10 days in Children's Hospital of Wisconsin, battling infection and kidney failure.

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Toddler dies from E.coli and Hemolytic Uremic Syndrome

Two-year-old Lily Lavender died in a Birmingham, Alabama, hospital on Saturday. She had an E. coli infection, which led to hemolytic uremic syndrome (HUS) and kidney failure. It is not known how she contracted the E. coli infection. Our thoughts and prayers are with the grieving family.

E. coli O157:H7 is a silent killer of children. It can't be detected in any way, not by smell, taste or sight. This is a picture of the microscopic killer:
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It only takes a few little rods of E. coli O157:H7 bacteria to make a child seriously ill.

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First Case of Spinach-Related E. coli in Colorado

Press Release - September 19, 2006
DENVER, COLORADO - The Laboratory Services Division of the Colorado Department of Public Health and Environment has confirmed the first case of spinach-related E.coli that is of the same strain - or DNA fingerprint - as the one associated with the national outbreak.

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E. coli Outbreak and Spinach: FDA Updates

The FDA has been reporting new cases of E. coli O157:H7 infections linked to spinach each day since it announced the nationwide outbreak. To date, 131 people have been sickened. Of those, 20 have developed hemolytic uremic syndrome (HUS), 66 have been hospitalized, and one has died. Pritzker | Ruohonen will update this entry each day to reflect new information from the FDA.

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CDC Update on the E. coli O157:H7 Outbreak in Spinach

Information from the CDC:
As of 1 PM (ET) September 19, 2006, Tuesday, 131 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 21 states.

Among the ill persons, 66 (50%) were hospitalized, 20 (15%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS), and an adult in Wisconsin died. Ninety-six (73%) were female and 6 (5%) were children under 5 years old. Among ill persons who provided the date when their illnesses began, 93% became ill between August 19 and September 5.

The states that have reported cases are California (1 case), Connecticut (2), Idaho (5), Illinois (1), Indiana (8), Kentucky (6), Maine (2), Michigan (4), Minnesota (2), Nebraska (6), New Mexico (5), Nevada (2), New York (9), Ohio (15), Oregon (5), Pennsylvania (6), Utah (16), Virginia (1), Washington (2), Wisconsin (32), and Wyoming (1).

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FDA Letter to Lettuce and Spinach Growers

Almost a year ago, the FDA warned California growers of lettuce and other leafy greens, including spinach, that the agency had serious concerns about the safety of their products. As of the date of the letter, November 4, 2005, the FDA was aware of 18 E. coli O157:H7 outbreaks linked to lettuce and 1 linked to spinach. Suggested actions included discarding any produce that comes into contact with floodwaters, which had not, evidently, been the practice. Areas of the Salinas Valley, where a bulk of the lettuce and spinach is grown, periodically flood. The floodwaters deposit animal waste in the soil and can contaminate lettuce and spinach.

Investigators have not yet determined how the spinach in the current E. coli O157:H7 outbreak became contaminated. They are investigating fields, packing plants, storage facilities and all locations where the contamination could have occured. The FDA letter is a reminder that measures need to be taken to protect our food supply at every level. Until now, most consumers assumed that more care was already being taken to ensure safe food products. Continue on to read the full text of the FDA letter.

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E. coli Outbreak and Spinach: Sept. 18 Updates

Federal and state health officials continue to investigate cases of E. coli O157:H7. Two additional states are now part of the outbreak, Illinois and Nebraska. To date, 114 people have been sickened. Of those, 18 have developed hemolytic uremic syndrome (HUS), 60 have been hospitalized, and one has died.

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Bagged-Spinach E. coli O157:H7 in Illinois

SPRINGFIELD, Ill. - An elderly woman from north-central Illinois is the first state resident whose E. coli O157:H7 isolate matches the national outbreak associated with spinach consumption. Her onset of illness was late August and she is hospitalized with hemolytic uremic syndrome (HUS), a form of kidney failure that is often associated with E. coli O157:H7, especially in the elderly and the very young. The woman frequently ate fresh spinach, including bagged baby spinach.

Dr. Eric E. Whitaker, Illinois public health director, warns about the outbreak of E. coli O157:H7 that may be associated with the consumption of bagged spinach. "We advise people to err on the side of caution and not eat fresh spinach or products containing spinach. Anyone who thinks they may have experienced symptoms of illness after eating fresh spinach or products containing spinach are urged to contact their health care provider and local health department," said Dr. Whitaker.

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Nebraska E. coli O157:H7 Linked to Spinach

The E. coli O157:H7 outbreak linked to fresh spinach is growing each day. Nebraska health officials have just confirmed Nebraska's first case of E. coli linked to spinach. According to a story in the Omaha World-Herald:

Tom Safranek, Nebraska state epidemiologist, was cited as saying tests have determined that a Nebraskan who became ill had eaten spinach and was infected with the same strain of E. coli responsible for the nationwide outbreak. . . .

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Why Did a 2-Year-Old Girl Die in Ohio?

Earlier this month, we posted an entry about a 2-year-old girl from Ohio who had died from complications of an E. coli infection. At the time, no one knew the source of the infection. Grieving parents were left to wonder why and how their little girl had died. According to a story in the New York Times, fresh spinach may have caused the girl's death:

In Ohio, state health officials said they were investigating the death of a 23-month-old girl who was sickened by E. coli to determine whether the case was related to the outbreak [the E. coli O157:H7 outbreak linked to spinach]. The girl's mother said she often buys bagged spinach and that she's frustrated by the lack of coordination among various county health departments in tracking the deadly bacteria.

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Investigation of E. coli Outbreak Linked to Spinach

Federal and state health and agriculture officials are looking at all possible sources of the E. coli O157:H7 outbreak that has sickened over 100 people and has killed at least one. We have knowledge of at least 2 other people who may have died as a result of this outbreak.

According to a story in the New York Times:

The cause of the outbreak is still not clear. It could be irrigation water . . . or it could be a processing problem in a factory. In the humid environment of a sealed bag of spinach or salad mix, E. coli can multiply rapidly if the bag is allowed to get too warm, [according to Dr. David Acheson, the chief medical officer with the FDA's Center for Food Safety and Applied Nutrition].

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E. coli O157:H7 Outbreak: Questions & FDA Answers

spinach_01.jpgAn outbreak of E. coli O157:H7 infection is being investigated by federal health officials. Currently the investigation indicates that fresh spinach and salad blends containing fresh spinach are a likely source for this outbreak. FDA advises at this time that people not eat any fresh spinach or salad blends containing fresh spinach that are consumed raw.

Natural Selection Foods, LLC, of San Juan Bautista, California is currently recalling all of its products that contain fresh spinach with "Best if Used by Dates" of August 17, 2006 through October 1, 2006. (See additional information about brands associated with Natural Selection Foods below). Other companies and brands of fresh spinach and fresh spinach containing products may also be involved in this outbreak; FDA and CDC continue to investigate this possibility.
Another company, River Ranch, of California, is currently recalling its spring mix containing spinach. River Ranch obtained bulk spring mix containing spinach from Natural Selections. The following brands are involved: Farmers Market, Hy Vee, Fresh and Easy.

To date, 109 cases of illness related to this outbreak have been reported to the Centers for Disease Control and Prevention (CDC) in 19 states including 16 cases involving a type of kidney failure called hemolytic uremic syndrome (HUS) and one death.

  1. What is E. coli O157:H7?
  2. What does FDA advise people to do?
  3. What is an outbreak?
  4. In what states have illnesses been reported?
  5. What company and brands are included in the current recall?
  6. When was the onset of the first illness related to this outbreak?
  7. What advice does FDA have for the industry?
  8. Who is working on this outbreak?
  9. Is the government conducting tests?
  10. What steps has FDA taken to reduce the potential for outbreaks, specifically E. coli O157:H7 outbreaks, associated with raw produce?
  11. Does the FDA's advice not to eat any fresh spinach or salad blends containing fresh spinach apply to both organic and non-organic products?
  12. Can people cook the fresh spinach or salad blends containing fresh spinach?
  13. Have there been previous outbreaks involving fresh spinach?
  14. When did FDA first receive information regarding the current outbreak?

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FDA: E. coli O157:H7 Outbreak in Spinach

The E. coli O157:H7 outbreak in spinach continues to grow. There are now 109 people who have been contracted E. coli O157:H7 after eating spinach, 16 of those have Hemolytic Uremic Syndrome (HUS) and one has died. Additional cases of E. coli O157:H7 infections have been reported to the CDC.

ecolitower1.jpg Low-temperature electron micrograph of a cluster of E. coli bacteria, magnified 10,000 times. Each individual bacterium is oblong shaped.

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Pennsylvania Investigating Cases of E. coli O157:H7 Linked to Spinach

HARRISBURG, PENNSYLVANIA - Press Release - [September 20, 2006, update: There are now 7 confirmed cases of spinach-related E. coli in Pennsylvania.] In accordance with an alert released earlier today by the U.S. Food and Drug Administration (FDA), state Health Secretary Dr. Calvin B. Johnson is urging Pennsylvanians to avoid eating bagged fresh spinach or any other bagged mixed greens that may contain fresh spinach until more information is known about the source of a multi-state E. coli outbreak.

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E. coli and Spinach: FDA Update

The multi-state E. coli outbreak linked to spinach was initially thought to involve only bagged spinach. The FDA has issued an update that warns consumers not to eat any fresh spinach or product with fresh spinach in it. The number of states involved in the E. coli outbreak has risen from 8 to 19, including the states of California, Connecticut, Idaho, Indiana, Kentucky, Maine, Michigan, Minnesota, Nevada, New Mexico, New York, Ohio, Oregon, Pennsylvania, Tennessee, Utah, Virginia, Washington, Wisconsin, and Wyoming.

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Spinach E. coli Outbreak: Indiana Update

Cases of E. coli in Indiana have been linked to fresh spinach. The Indiana Department of Health has issued an update on the E. coli outbreak.

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Spinach E. coli -- Dole, Emeril, Trader Joe's, and other Brands

Natural Selection Foods fresh spinach has been linked to the mulit-state E. coli O157:H7 outbreak that killed one person and has sickened almost 100. The brands involved are the following:

  • Dole
  • Natural Selection Foods
  • Pride of San Juan
  • Earthbound Farm
  • Bellissima
  • Rave Spinach
  • Emeril
  • Sysco
  • O Organic
  • Fresh Point
  • River Ranch
  • Superior
  • Nature's Basket
  • Pro-Mark
  • Compliments
  • Trader Joe's
  • Ready Pac, Jansal Valley
  • Cheney Brothers
  • Coastline
  • D'Arrigo Brothers
  • Green Harvest
  • Mann
  • Mills Family Farm
  • Premium Fresh
  • Snoboy
  • The Farmer's Market
  • Tanimura & Antle
  • President's Choice
  • Cross Valley
  • Riverside Farms

Do not eat this spinach. Do not cook it and eat it. It is highly dangerous, and we suspect before this outbreak is over that hundreds of people may be seriously ill with E. coli infections, which can lead to intestinal bleeding, severe dehydration, and hemolytic uremic syndrome.

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Oregon E. coli O157 Outbreak and Bagged Spinach

Oregon public health officials have joined those in at least eight other states in investigating an outbreak of E. coli O157:H7, a foodborne illness that has been identified in at least five people across Oregon. [September 20 update: There are now 23 states involved in the outbreak. 146 people have contracted E. coli infections after eating fresh spinach. Of those 76 have been hospitalized and 23 have experienced kidney failure as a result of developing hemolytic uremic syndrome (HUS).]

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Idaho and Washington E. coli: Bagged Spinach

Four people in Idaho and Washington have been sickened by the same strain of E. coli O157:H7 associated with bagged spinach that has sickened over 50 people in multiple states. The FDA and state officials in Idaho and Washington have not determined the brands of bagged spinach involved in the outbreak; however, Dole has been sued on behalf of an Oregon woman. Dole was also implicated in a 2005 E. coli outbreak that involved bagged, pre-washed salad. Pritzker | Ruohonen was the first law firm to file a suit for a victim of that outbreak.

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Connecticut E. coli: Bagged Spinach

E. coli Outbreak Alert: December 6, 2006 - Connecticut health officials are investigating illnesses that may be connected to the E. coli outbreak linked to Taco Bell restaurants. Please go to the Pritzker | Ruohonen website for information on the Taco Bell E. coli outbreak.

E. coli O157:H7 has sickened 2 people in Connecticut. These cases may be part of a larger, multi-state E. coli O157:H7 outbreak that has been linked to bagged salad. According to an Associated Press story:

Bill Gerrish, a spokesman for the state [Connecticut] Department of Public Health, said the two cases match the strain of E. coli being found in other parts of the country but wasn't sure whether it's associated with the outbreak.

"We're investigating the Connecticut cases and working closely with the federal health officials as well," Gerrish said. . . .

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E. coli in Wisconsin: Bagged Spinach

Wisconsin health officials have confirmed 20 cases of E. coli linked to fresh, bagged spinach. Tragically, one person has died. The FDA issued a warning advising consumers in Wisconsin and throughout the country not to eat fresh, bagged spinach. According to WSIN News Channel 12 (Milwaukee):

The city of Cudahy Health Department officials said they received an e-mail a week ago from the state warning them about the E. coli cases.
"They were requesting that physicians, when they see their patients and they are presenting symptoms of potentially some sort of intestinal type of disease, that they pay attention, that it could be potentially E. coli," said Carol Wantuch of the Cudahy Health Department.

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Fresh Baby Spinach

Health officials have linked fresh baby spinach to an E. coli O157:H7 outbreak that has sickened 50 people in eight states. One person has died and 8 others have developed hemolytic uremic syndrome (HUS). Fresh produce has become a major source of foodborne outbreaks in recent years, including the fall 2005 E. coli outbreak that was linked to Dole bagged lettuce.

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E. coli: Bagged, Fresh Spinach

Do not eat bagged, fresh spinach. The FDA has issued a warning that bagged spinach, including bagged baby spinach, may be responsible for an E. coli O157:H7 outbreak that has resulted in one death, 8 cases of hemolytic uremic syndrome and at least 41 other E. coli infections. To date, people have fallen ill in the states of Connecticut, Idaho, Indiana, Michigan, New Mexico, Oregon, Utah and Wisconsin, but consumers in all states should not eat bagged spinach until further notice is given. Do not rely on washing the spinach to remove the E. coli because E. coli can live within the spinach leaves. The only way to kill E. coli bacteria in spinach leaves is to cook it.

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