E. Coli Cases Hit 131 in 21 States

66 victims are hospitalized; U.S. health officials still searching for source of tainted spinach

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By Steven Reinberg
HealthDay Reporter

TUESDAY, Sept. 19, 2006 (HealthDay News) -- U.S. and state health officials continued to scour California's Salinas Valley spinach fields Tuesday for the source of a massive outbreak of E. coli contamination, as the number of victims rose to 131 in 21 states.

Dr. David Acheson, chief medical officer of the U.S. Food and Drug Administration's Center for Food Safety and Applied Nutrition, told a news conference Tuesday night, "The anticipation is that cases will continue to come in. We expect new cases to come in for the next few days."

Sixty-six people have been hospitalized, 20 of them with hemolytic uremic syndrome, which causes kidney failure, according to Acheson.

Acheson pointed out that the number of hospitalizations is unusually high for an E. coli outbreak. "It is possible that this is a particularly virulent strain of E. coli," he said. "It is also possible that not all cases have been reported, which could also affect the numbers."

Investigators from the FDA, the U.S. Centers for Disease Control and Prevention and California health officials are now inspecting and collecting samples from farms in California, Acheson said.

"At this time, we don't have any confirmed positives," he added. "It is too early to have findings just yet. We anticipate that it is going to take another three to four days before we have confirmed positives."

The massive recall of spinach remains in effect, Acheson said. "However, we have not ruled out other recall expansions," he added.

U.S. health officials on Monday continued their warning to consumers not to eat any fresh spinach at all as the recall by two California produce companies continued.

River Ranch Fresh Foods recalled its brands of mixed salads containing spinach Sunday, after FDA inspectors found that the company had bought spinach from Natural Selection Foods, the focal point of the investigation.

According to the San Jose Mercury News, the recall now involves 37 brands of bagged salad with spinach -- 34 from Natural Selection in San Juan Batista and three from River Ranch, which operates in Salinas and El Centro. Seventy-five percent of the nation's spinach supply comes from the Salinas Valley, a crop estimated to be worth $200 million.

The FDA on Monday also dismissed a claim by Natural Selection Foods that its organic spinach products had been cleared of suspicion, according to the Associated Press. The company, one of the largest in the business, produces both organic and conventionally grown spinach in separate areas at its plant.

"The FDA has not cleared any products from the list and continues to recommend consumers avoid eating fresh spinach products," spokeswoman Susan Bro said.

On Saturday, the government had identified Natural Selection Foods as the focal point of the outbreak. The company 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.

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.

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 FDA said. It also said that washing the spinach won't help because the bacteria is too tightly attached.

On Monday, Michigan and Nevada reported their first confirmed cases. They joined 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.

Health officials continued to caution that anyone who believes he or she has the symptoms of E. coli infection should contact a doctor.

Natural Selection Foods 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. But it wasn't until Sept. 13 that the agency was able to identify bagged spinach as the possible cause.

The AP reported that nearly a year ago, the FDA had told California farmers to improve produce safety in a pointed warning letter. This is the 20th food-poisoning episode since 1995 that has been linked to spinach or lettuce, according to the wire service.

According to the CDC, 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.

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

More information

You can read the FDA's latest updates on the E. coli outbreak at its Web site.

SOURCES: Sept. 19, 2006, news conference with David Acheson, M.D., chief medical officer, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration; Associated Press; San Jose Mercury News

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