Spinach E. coli Outbreak Still Growing

Sept. 19, 2006 -- The FDA is advising consumers not to eat any fresh spinach or products containing fresh spinach until further notice, due to a multistate E. coli outbreak tied to at least one death and more than 100 cases of illness.

The warning includes loose fresh spinach, as well as packaged items. "It's fresh spinach and products containing fresh spinach," FDA spokeswoman Laura Alvey tells WebMD via email.

As of Sept. 19, the CDC had gotten reports of 131 people -- including six children under 5 years old -- infected with the E. coli 0157:H7 strain in 21 states.

Those people included a Wisconsin adult who died of hemolytic-uremic syndrome (HUS), a type of kidney failurekidney failure caused by E. coli infection.

The outbreak has landed 66 people in the hospital, 20 of whom had HUS, according to the CDC.

States that have reported cases are California, Connecticut, Idaho, Illinois, Indiana, Kentucky, Maine, Michigan, Minnesota, Nebraska, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington, Wisconsin, and Wyoming.

Among patients who provided the date when their illnesses began, 92% became ill between Aug. 19 and Sept. 5, according to the CDC.

Product Recalls

The FDA reports that on Sept. 15, Natural Selection Foods of San Juan Batista, Calif., is recalling all its products containing spinach in all brands the company packs with "Best if Used by Dates" of Aug. 17, 2006 through Oct. 1, 2006.

The recalled products include spinach and any salad with spinach in the blend. Products that don't include spinach aren't part of this recall.

Natural Selection Foods' brands include: Natural Selection Foods, Pride of San Juan, Earthbound Farm, Bellissima, Dole, 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, and Riverside Farms.

On Sept. 17, another California company, River Ranch, recalled packages of spring mix containing spinach.

River Ranch obtained bulk spring mix containing spinach from Natural Selections, according to the FDA. The following brands are involved: Fresh N' Easy Spring Mix and Hy-Vee Spring mix containing baby spinach, distributed to retailers in Texas, Iowa, and New Mexico. The produce was packed in 5-ounce bags and 5-ounce plastic trays. Products that do not contain spinach are not part of this recall.

Affected products were also distributed to Canada, Mexico, and Taiwan. No illnesses from these countries have been reported.

The FDA continues to investigate whether other companies and brands are involved.

CDC's Advice

The following advice for consumers is posted on the CDC's web site:

Currently, the FDA's advice is to not eat any fresh spinach or salad blends containing fresh spinach that are consumed raw.

• E. coli O157:H7 in spinach can be killed by cooking at 160 degrees Fahrenheit for 15 seconds. (Water boils at 212 degrees Fahrenheit.) If spinach is cooked in a frying pan, and all parts do not reach 160 degrees Fahrenheit, all bacteria may not be killed. If consumers choose to cook the spinach, they should avoid cross-contamination of the fresh spinach with other foods and food contact surfaces, and wash hands, utensils, and surfaces with hot, soapy water before and after handling the spinach.
• Persons who develop diarrhea after consuming fresh spinach or salad blends containing fresh spinach are urged to contact their health care provider and ask that their stool specimen be tested for E. coli O157:H7.
• Persons who ate fresh spinach or salad blends and feel well do not need to see a health care provider.

SOURCES: News release, FDA. News release, CDC.