SUNDAY, Sept. 17, 2006 (HealthDay News) -- The U.S. Food and Drug Administration has broadened its warning about eating spinach to include unpackaged, loose spinach or any product containing spinach as it continues to investigate other sources of the E. coli bacterium that has caused one death and illness across the nation.
"FDA advises consumers to not eat fresh spinach or fresh spinach-containing products until further notice," the agency says in its latest update on its Web site.
On Saturday, the government identified a California produce company as one possible source of the tainted spinach as the outbreak of illness widened to 19 states, with more than 100 victims.
Natural Selection Foods of San Juan Bautista began recalling all of its prepackaged spinach and its salad mix products that contain spinach in all brands packed with Best If Used by Dates of Aug. 17, 2006 through Oct. 1, 2006.
The investigation is continuing, the FDA said in a consumer alert on its Web site, and Natural Selection Foods may not be the only source of the E. coli O157:H7 that has so far has sickened 102 people. Fourteen of the victims have developed a form of kidney failure called Hemolytic Uremic Syndrome, the agency reported.
"We're clearly evolving, and it is very important to keep an open mind whether there are other products potentially implicated," Dr. David Acheson, the chief medical officer with the FDA's Center for Food Safety and Applied Nutrition, told the Associated Press.
According to the FDA, Natural Selection Foods supplies its spinach to the following brands that package it:
Dole, Earthbound Farm, Natural Selection Foods, Pride of San Juan, Bellissima, 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, Pro*Act, Premium Fresh, Snoboy, The Farmer's Market, Tanimura & Antle, President's Choice, Cross Valley and Riverside Farms.
Because the tainted spinach could have been included in packaged green salads that have spinach, the FDA is now warning that those products also might be contaminated.
Consumers should throw away any fresh packaged spinach they may have bought in the past few weeks and not buy more until the warning is lifted, the agency said. It also said that washing the spinach won't help because the bacteria is too tightly attached.
The states reporting cases of illness now include: California, Connecticut, Idaho, Indiana, Kentucky, Maine, Michigan, Minnesota, Nevada, New Mexico, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington, Wisconsin, and Wyoming.
The affected products were also distributed to Canada and Mexico, the FDA said.
The one death occurred in Wisconsin, which has 29 cases statewide. Friday night, the AP reported, the victim was identified as Marion Graff, 77, of Manitowoc. Her son said she died of kidney failure Sept. 7.
"We are very, very upset about this," Natural Selection Foods spokeswoman Samantha Cabaluna told the AP Friday. "What we do is produce food that we want to be healthy and safe for consumers, so this is a tragedy for us."
The company has supplied a phone number -- l-800-690-3200 -- for a refund or replacement coupons.
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, Acheson told a press conference Thursday night.
Dr. Robert Brackett, director of the FDA's Center for Food Safety and Applied Nutrition, cautioned that 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, said that normally, people between 20 and 60 years of age don't have much of a reaction to E. coli.
But, he added in a prepared statement, this outbreak seems to have affected people in that age group, indicating it might be a particularly virulent strain of bacteria.
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.
You can read the FDA's latest updates on the E. coli outbreak at its Web site.