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Consumers Warned on Spinach as 10 States Report E. coli Outbreak

Packaged fresh spinach suspected in 1 fatality, 8 cases of kidney failure, with more than 50 incidences reported

FRIDAY, Sept. 15, 2006 (HealthDay News) -- U.S. health officials have issued a nationwide consumer warning on fresh bagged spinach as they probe a dangerous bacterial outbreak that has caused one death and sickened scores of people in at least 10 states.

The U.S. Food and Drug Administration reported late Thursday that 49 cases of E. coli 0157:H7 infection had been reported in eight states -- Connecticut, Idaho, Indiana, Michigan, New Mexico, Oregon, Utah and Wisconsin.

On Friday, two more states joined the list as health officials in Ohio reported seven cases of infection, while Kentucky reported one, according to the Associated Press.

The death occurred in Wisconsin, which has 20 cases statewide, including 11 in Milwaukee.

The FDA said the first cases of infection apparently surfaced on Aug. 23, and the most recent one was reported Sept. 3. But it wasn't until Wednesday that the agency was able to identify bagged spinach as the possible cause, Dr. David Acheson, chief medical officer for the FDA's Center for Food Safety and Applied Nutrition, told a press conference Thursday night.

"It [the outbreak] is increasing by the day. We may be at the peak, we may not. And that's why we're watching it and we're giving preliminary, early data," Acheson said.

Acheson said Connecticut has reported one case in the latest outbreak; Idaho, three; Indiana, four; Michigan, three; Oregon, five; New Mexico, two; Utah, 11; and Wisconsin, 20. Eight of the victims reportedly have kidney failure.

Acheson said the FDA has not yet been able to link the E. coli contamination to a particular grower, brand, or even a specific area of country where the spinach may have come from.

"Given the severity of this illness and the seriousness of the outbreak, FDA believes that a warning to consumers is needed," Dr. Robert Brackett, director of the FDA's Center for Food Safety and Applied Nutrition, said in a prepared statement.

The FDA is advising consumers not to eat any bagged spinach until the source of the bacterium is found. The agency also said that washing the spinach won't help because the bacteria is too tightly attached.

And, Brackett cautioned, anyone who believes he or she has the symptoms of E. coli poisoning should contact a doctor.

According to the U.S. Centers for Disease Control and Prevention, E. coli lives in the intestines of cattle and other animals and is linked to contamination by fecal material. It can be found in undercooked meats and other foods, such as spinach, sprouts, lettuce, unpasteurized milk and juice.

The primary symptom of E. coli contamination in humans is diarrhea, often with bloody stools. While most adults recover completely, the bacteria is particularly harmful to the very young, the very old, and those with compromised immune systems. In more serious cases, potentially fatal kidney failure can develop.

Dr. Pascal James Imperato, chairman of the department of preventive medicine at SUNY Downstate Medical Center in New York City and former New York City Health Commissioner, is issuing advice that's stronger than the FDA's -- don't buy any bags of pre-cut salads because they may contain spinach.

Normaly, people between 20 and 60 years of age don't have much of a reaction to E. coli. But, this outbreak seems to have affected people in that age group, indicating it might be a particularly virulent strain of bacteria, Imperato said in a prepared statement.

But the FDA's Acheson said Thursday night that there have been no signs "to implicate bagged salad" in the outbreak.

Amy Philpott, a spokeswoman for the United Fresh Produce Association, said, "Our industry is very concerned. We're taking this very seriously."

E. coli causes an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to CDC statistics.

The last publicly reported outbreaks of E. coli were in 2005. In October, laboratory tests found the bacteria in two bags of lettuce, suspected as the cause of an outbreak in Minnesota that sickened 17 people, eight of whom had to be hospitalized. In December, an E. coli outbreak in the state of Washington sickened at least eight children. That was traced to unpasteurized milk from a dairy.

More information

The CDC has more on E. coli.

SOURCES: Sept. 14, 2006, teleconference with David Acheson, chief medical officer, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration; FDA Web site, Associated Press; Pascal James Imperato, M.D., chairman, department of preventive medicine, SUNY Downstate Medical Center, New York City, and former New York City Health Commissioner
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