Food Poisoning Law Blog

Prompted 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

A 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. 

"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.

The 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).

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.

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.

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.

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.

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. . . ."

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.

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.

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.

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.

Since 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?

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.
  
  Continue Reading

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.

What 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.

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.

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.

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.

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).

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).

[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.

The 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.

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.

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:

It only takes a few little rods of E. coli O157:H7 bacteria to make a child seriously ill.

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.

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.

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.

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.

Continue Reading

An 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?

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.

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.