FRIDAY, Sept. 29, 2006 (HealthDay News) -- California health officials said Thursday that they still hoped to locate the source of the E. coli spinach contamination that has sickened at least 187 people in 26 states, killing one.
And, the officials stressed, the state's farmers must due a much better job of adhering to so-called safe agriculture practices to prevent future E. coli outbreaks. Those practices include making sure produce doesn't come into contact with the E. coli bacteria from irrigation water, fertilizer, animal droppings or unclean human hands, the Associated Press reported.
"Good agricultural practices are pretty well understood," said Dr. Kevin Reilly, deputy director of the prevention services branch of the California health department. "The key is going to be consistency and doing that 100 percent of the time in 100 percent of the farms. One breakdown of that process can create the next outbreak."
As of late Thursday, 97 (52 percent) of the infected people had been hospitalized, 29 (16 percent) had developed a type of kidney failure called hemolytic-uremic syndrome, and a 77-year-old Wisconsin woman had died, according to the U.S. Centers for Disease Control and Prevention.
A second tainted bag of spinach, found in Utah over the weekend, helped health officials pinpoint E. coli contamination in one specific batch of fresh spinach in a California processing plant. State health officials said the Utah bag of Dole baby spinach and another of the same brand found in New Mexico last week were both processed during the same shift on Aug. 15 at Natural Selection Foods' San Juan Batista plant in the Salinas Valley.
On Thursday, Natural Selection said it was taking steps to improve its food-safety inspections. The company also said it was ready to pay the medical expenses of consumers sickened by contaminated spinach.
Natural Selection processes fresh spinach for more than two dozen brands, including Earthbound Farm, Dole and Ready Pac. It hasn't been determined whether the spinach was contaminated at the company's plant, or on farms where it was grown, The New York Times said.
Earlier this week, four more bags of fresh spinach in three other states tested positive for E. coli contamination. And the U.S. Food and Drug Administration announced that Canada had confirmed its first case of E. coli O157:H7 in a person who ate bagged spinach.
On Tuesday, Pennsylvania health officials said that a lab identified the deadly strain in a bag of Dole baby spinach purchased on or around Sept. 8 in the western part of the state, the AP said.
Also Tuesday, the CDC said E. coli had been isolated by state public health labs in Illinois and Ohio from three more opened packages of spinach.
The investigation of the E. coli O157:H7 outbreak has been focused on three counties in the California's Salinas Valley, where more than half the country's spinach crop is grown.
The Utah Department of Health and the Salt Lake Valley Health Department confirmed Monday that E. coli had been found in a bag of Dole baby spinach purchased in Utah with a use-by-date of Aug. 30, 2006, according to the FDA.
The discovery followed the Sept. 20 breakthrough New Mexico lab test that confirmed the E. coli strain in a partly eaten fresh spinach package from one victim.
FDA officials said last week that produce other than spinach grown in the Salinas Valley region was not implicated in the E. coli outbreak. They also said processed spinach, either frozen or canned, was not suspect.
And late last week, the FDA said consumers could resume eating fresh spinach, as long as agriculture industry officials came up with a way to label the products that didn't come from the Salinas Valley.
The E. coli outbreak has prompted federal officials to consider tighter regulation of the growing and processing of fresh spinach. Some consumer groups and agriculture experts have been critical of the regulatory process, citing what they called lax oversight of the agriculture industry.
On Tuesday, three top national environmental organizations -- the Natural Resources Defense Council (NRDC), the Sierra Club and the Environmental Integrity Project -- warned that bacterial pollution from livestock and poultry factory farms poses a major threat to public health. They were to meet with U.S. Environmental Protection Agency officials to urge strengthened regulations for farm pollution, according to a statement issued by the three groups.
The earliest onset of illness known to be linked to spinach consumption was on Aug. 19.
The 26 affected states are: Arizona, California, Colorado, Connecticut, Idaho, Illinois, Indiana, Kentucky, Maine, Maryland, Michigan, Minnesota, Nebraska, Nevada, New Mexico, New York, Ohio, Oregon, Pennsylvania, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Wisconsin has the largest number of reported cases, and the one death. Two other deaths, in Idaho and Maryland, are still under investigation.
Natural Selection recalled all of its prepackaged fresh spinach and salad mix products containing spinach on Sept. 16, a recall that covered more than 30 brands, including Dole.
Four other companies, citing Natural Selection as their source of spinach, recalled assorted spinach products as well: River Ranch Fresh Foods, which operates in Salinas and El Centro, Calif.; RLB Food Distributors, based in West Caldwell, N.J.; Pacific Coast Fruit Company, based in Portland, Ore., and Triple B Corp. in Seattle.
According to the CDC, E. coli lives in the intestines of cattle and other animals and can be found in undercooked meats; vegetables like spinach, sprouts and lettuce, and unpasteurized milk and juice.
The primary symptom of E. coli contamination in humans is diarrhea, often with bloody stools. There are an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to CDC statistics.
For the latest E. coli updates, visit the CDC.