Sep 20, 2006 (CIDRAP News) – Fifteen more cases were identified today in a nationwide Escherichia coli O157:H7 outbreak traced to fresh spinach, raising the total to 146, and investigators have identified the first contaminated spinach sample from a bag submitted by a patient, the US Food and Drug Administration (FDA) said today.
At a press briefing, David Acheson, MD, chief medical officer for the FDA's Center for Food Safety and Applied Nutrition, said three more patients developed hemolytic uremic syndrome (HUS), a serious complication of the infection, bringing HUS cases to 23. Seventy-six people were hospitalized in the outbreak. The death toll remains at 1, but the number of states affected by the outbreak grew by two, to 23.
The FDA said the first spinach sample to test positive for the outbreak E coli strain was from a package that one of five infected patients in New Mexico ate from before becoming sick. A lab from the New Mexico Department of Health (NMDH) determined that the strain they found in the spinach matched the strain from patients. The spinach was from a bag of Dole baby spinach, a nonorganic brand from Natural Selection Foods, one of the companies that have recalled fresh spinach. The spinach had a use-by date of Aug 30.
David Mills, director of the NMDH's scientific lab division, said in a press release today, "It is another piece of the puzzle that associated the disease causing organism with the outbreak."
A third company announced a spinach recall late yesterday. RLB Food Distributors, of West Caldwell, N.J., recalled eight products because they contain spinach from Natural Selections Foods, which on Sep 17 recalled all fresh spinach products with use-by dates between Aug 17 and Oct 1. Natural Selections Foods is a major supplier of fresh spinach to other companies, including River Ranch, which recalled spinach-containing products yesterday. The RLB recall involves fresh spinach products that have a use-by date of Aug 20.
In another new development, Acheson said FDA has narrowed its investigation to fresh spinach grown in California, particularly on farms in the greater Salinas Valley area. He said clues so far point to farms in Monterey, San Benito, and Santa Clara counties. "That doesn't mean all of the farms in those counties are involved, it means we're narrowing our investigation," Acheson said.
Homing in on a specific geographic area means the FDA can now plan how to quickly allow spinach from uninvolved growing areas to be returned to store shelves, Acheson said. "However, the message tonight is still to not consume fresh spinach," he said.
The CDC said this 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 be tested for E coli O157:H7.
Sep 20 FDA press release
Sep 19 RLB press release on spinach recall
New Mexico Department of Health press release on positive spinach sample
CIDRAP overview of pathogenic E coli