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The New York Times
September 15, 2006
F.D.A. Warns Against Eating Bag Spinach
By GARDINER HARRIS
WASHINGTON, Sept. 14 — Consumers should avoid eating fresh bagged spinach after an outbreak of E. coli in eight states killed one person and sickened at least 49, federal health officials announced Thursday night.
The outbreak involves a virulent strain of E. coli known as 0157:H7, which produces a toxin that can lead to bloody diarrhea, kidney failure and, in rare cases, death.
State and federal health officials have used genetic screening tools to confirm that all 50 people sickened by the disease suffered from the same bacteria, said Dr. David Acheson of the Center for Food Safety and Applied Nutrition at the F.D.A.
But health officials still have no idea which food manufacturer may be to blame. The first case was reported on Aug. 23 and the most recent on Sept. 3, Dr. Acheson said.
“It’s increasing by the day,” Dr. Acheson said. “We may be at the peak, we may not. We’re giving preliminary data here.”
Dr. Acheson said the F.D.A. became aware of a possible outbreak on Wednesday. But delays are common as information is gathered and compared, he said.
“It takes quite some time for someone to be exposed, get sick, get sick enough to see the doctor, have it examined, have a sample sent to a lab, have it confirmed positive and have it be put in the public health system,” Dr. Acheson said.
Dr. Acheson described the outbreak as “significant.” It is broadly distributed across the country. Twenty cases — including the only confirmed death — occurred in Wisconsin. There were 11 cases in Utah, 5 in Oregon, 4 in Indiana, 3 each in Idaho and Michigan, 2 in New Mexico and 1 in Connecticut, he said.
Most of those affected have been women. Although this strain of E. coli commonly affects children, many patients have been older than 20, Dr. Acheson said.
Health officials are by no means certain that bagged spinach is the culprit. When patients have a confirmed case of the disease, health officials ask the victims many questions about what they ate over the previous weeks. Bagged fresh spinach is the only food that patients so far have had in common, Dr. Acheson said.
Asked if consumers should also avoid bagged salads, Dr. Acheson answered somewhat tentatively, saying, “At this point, there is nothing to implicate bagged salad.”
E. coli 0157:H7 is a dangerous strain of a type of bacteria that live in the intestines of humans and other animals. There are hundreds of E. coli strains, most of them harmless, but 0157:H7 makes a toxin that can cause severe illness — bloody diarrhea, anemia and, in 2 percent to 7 percent of cases, kidney failure. Children under 5 and the elderly are the most likely to become gravely ill.
The Centers for Disease Control and Prevention estimates that the 0157:H7 strain causes 73,000 infections and 61 deaths a year in the United States.
The bacteria can live in cows’ intestines without making the animals sick, and most infections in people come from eating undercooked hamburgers (cooking to at least 160 degrees Fahrenheit destroys the bacteria and the toxin they produce). In 2002, 19 million pounds of raw beef were recalled because of 0157:H7 contamination.
In a notorious outbreak in 1993, four children died from the infection after eating contaminated Jack in the Box hamburgers. Raw milk and unpasteurized cheese can also spread the bacteria. Outbreaks have been linked to petting zoos where children touched farm animals that carried the bacteria.
Produce can also become contaminated by animal wastes or unsanitary water, and outbreaks have been caused by sprouts, lettuce and unpasteurized fruit juice or cider. In 1996, one child died and 66 others became ill after drinking unpasteurized Odwalla apple juice.
Thorough washing should make it safe to eat most produce raw, except for alfalfa sprouts.
But Dr. Acheson advised consumers to avoid bagged spinach altogether, although he noted that thorough cooking killed the bacteria.
Denise Grady contributed reporting from New York.
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