FDA clears some spinach as E coli cases grow to 175

Sep 25, 2006 (CIDRAP News) – The case count in a national outbreak of Escherichia coli O157:H7 infections linked to fresh spinach rose to 175 today, but federal officials signaled that it's safe to eat spinach from places other than three counties in California's Salinas Valley.

The 175 cases reported by the Centers for Disease Control and Prevention (CDC) represent an increase of 9 since Sep 22. Ninety-three people (53%) were hospitalized, and 28 suffered the serious kidney condition known as hemolytic uremic syndrome (HUS), the CDC said. The number of states stayed the same today at 25, as did the number of deaths: one confirmed and two suspected.

Health officials are awaiting test results to determine if two patients who died of known or suspected E coli infections last week, an elderly Maryland woman and a 2-year-old Idaho boy, have the strain linked to the outbreak.

A second bag of E coli–contaminated spinach has been identified, this time by Utah health officials, according to a press release yesterday from the US Food and Drug Administration (FDA). The contaminated spinach was the same brand and type as the contaminated bag found last week in New Mexico: Dole baby spinach. Both bags had a use-by date of Aug 30.

The FDA said two more companies voluntarily recalled their products: Triple B Corp., doing business as S.T. Produce, of Seattle, Wash., and Pacific Coast Fruit Co. of Portland, Ore. Triple B's recall involves its fresh spinach salad products with a use-by date between Aug 22 and Sep 20, because they have may have contained spinach supplied by Natural Selections Foods, a major spinach supplier that was the first to recall its products. Triple B products were distributed in Washington, Oregon, Idaho, and Montana.

Products from Pacific Coast Fruit Co. also may have contained spinach supplied by Natural Selections Foods. Their recall involves salad products with a use-by date on or before Sep 20 and pizza products with a use-by date of Sep 14. The products were distributed in Alaska, Oregon, Washington, and Idaho.

The FDA is now indicating it is safe to eat fresh spinach that was not grown in the three counties implicated in the outbreak. In tracing tainted spinach, the FDA said last week it had narrowed its investigation to farms in Monterey, San Benito, and Santa Clara counties, all in the greater Salinas Valley.

"Consumers are advised not to purchase or consume fresh spinach if they cannot verify that it was grown in areas other than the three California counties implicated in the outbreak," the FDA said. Other produce grown in the three counties is not implicated in the outbreak, nor is frozen or canned spinach.

The CDC said that cooking spinach at 160ºF for 15 seconds will kill E coli O157:H7, but consumers need to make sure all parts of the spinach reach that temperature, particularly if they cook it in a frying pan.

Last week produce industry representatives met with federal and state health officials to determine how to safely get fresh spinach from uninvolved areas back on the market. One option they discussed was adding region-of-origin labels to products that contain fresh spinach.

The E coli case count has grown steadily since the FDA issued its initial spinach advisory on Sep 14, when the Centers for Disease Control and Prevention (CDC) announced that 50 patients in eight states had been diagnosed with E coli infections and that fresh or raw spinach was the food most of them had in common.

The CDC said last week that people who experience diarrhea after eating fresh spinach or salad blends containing fresh spinach should contact their healthcare provider and ask to have a stool sample tested for E coli O157:H7.

See also:

Sep 25 CDC statement

Sep 24 FDA press release

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