To date, 199 cases of illness due to E. coli O157:H7 infection have been reported to CDC, including 31 cases of Hemolytic Uremic Syndrome (HUS), 102 hospitalizations and three deaths.
The first death was an elderly woman in Wisconsin. The second death of a two-year-old in Idaho and the third death of an elderly woman in Nebraska were confirmed by CDC today as posted at http://www.cdc.gov/foodborne/ecolispinach/100606.htm.
States Affected
The 26 affected states and numbers of illnesses in each state are: Arizona (8), California (2), Colorado (1), Connecticut (3), Idaho (7), Illinois (2), Indiana (10), Kentucky (8), Maine (3), Maryland (3), Michigan (4), Minnesota (2), Nebraska (11), Nevada (2), New Mexico (5), New York (11), Ohio (25), Oregon (6), Pennsylvania (10), Tennessee (1), Utah (19), Virginia (2), Washington (3), West Virginia (1), Wisconsin (49), and Wyoming (1). In addition, Canada has one confirmed case.
Status
On October 4, 2006, U.S. Attorney Kevin V. Ryan of the Northern District of California issued a statement on the execution of two search warrants on Growers Express in Salinas, California, and Natural Selection Foods in San Bautista, California, in connection with the outbreak. The statement is available online at http://www.usdoj.gov/usao/can/press/2006/2006_10_04_spinachsearches.press.html.
FDA, the State of California, the Centers for Disease Control and Prevention (CDC) and the United States Department of Agriculture (USDA) continue to investigate the cause of this outbreak. This includes continued inspections and sample collection in facilities, the environment and water, as well as studies of animal management, water use, and the environment.
FDA announced on September 29, 2006 that all spinach implicated in the current outbreak has traced back to Natural Selection Foods LLC of San Juan Bautista, California. This determination is based on epidemiological and laboratory evidence obtained by multiple states and coordinated by CDC. Natural Selection Foods issued a recall of all implicated products on September 15, 2006. Four other companies have issued secondary recalls because they received the recalled product from Natural Selections. See below for a complete list of brand names that are subject of the recalls. Spinach processed by other manufacturers has not been implicated in the outbreak.
Next Steps
There has been a long history of E. coli O157:H7 outbreaks involving leafy greens from the central California region. Spinach processed by other manufacturers has not been implicated in this outbreak, but based on discussions with industry, and given the past E. coli O157:H7 outbreaks, FDA and the State of California still expect the industry to develop a comprehensive plan which is designed to minimize the risk of another outbreak due to E. coli O157:H7 in spinach grown in central California. While this plan is under development, FDA and the State of California reiterate previous concerns and advise firms to review their current operations in light of the agency's guidance for minimizing microbial food safety hazards.
FDA and the State of California have previously expressed serious concern with the continuing outbreaks of foodborne illness associated with the consumption of fresh and fresh-cut lettuce and other leafy greens. After discussions with industry, FDA and the State of California, as part of a longer term strategy, now expect industry to develop a plan to minimize the risk of another outbreak due to E. coli O157:H7 in all leafy greens, including lettuce.
The Grower Shipper Association of Central California, the Produce Marketing Association, the United Fresh Produce Association, and the Western Growers Association said, "We are committed to working together as one industry to learn everything we can from this tragedy, and will redouble our efforts to do everything in our power to reduce the potential risk of foodborne illness. As we have in the past, we will work aggressively with the Food and Drug Administration and state regulatory authorities to ensure the industry's growing and processing practices continue to be based on the very best scientific information available, and that we are doing everything possible to provide the nation with safe and healthy produce."
Implementation of these plans will be voluntary, but FDA and the State of California are not excluding the possibility of regulatory requirements in the future. FDA will be holding a public meeting to address the larger issue of food borne illness linked to leafy greens later in the year once the current investigation is complete.
Advice to Retailers, Food Service Operators and Consumers
FDA is still reminding the public that Natural Selection Foods has recalled all spinach products under multiple brand names with a date code of October 1, 2006 or earlier. There have been four other recalls from different companies because they received Natural Selection Foods spinach. See below for a complete list of brand names that are subject of the recalls.
In order to protect consumers, retailers and food service operators should not sell raw spinach or blends that may contain spinach that was processed by Natural Selection Foods and all other brands subject to the recalls.
Consumers are advised that proper storage of fresh produce can affect both quality and safety. To maintain quality of fresh produce, certain perishable fresh fruits and vegetables (like strawberries, lettuce, herbs, and mushrooms) can be best maintained by storing in a clean refrigerator at a temperature of 40° F or below. All produce that is purchased pre-cut or peeled should be refrigerated to maintain both quality and safety.
Many precut, bagged produce items like spinach and lettuce are pre-washed. If so, it will be stated on the packaging. This pre-washed, bagged produce can be used without further washing.
Processed spinach (e.g., frozen and canned spinach) is not implicated in this outbreak.
Laboratory Findings
There are now a total of 13 confirmed product samples that contain the E. coli O157:H7 outbreak strain.
The Colorado Department of Public Health and Environment has confirmed the presence of the outbreak strain of E. coli O157:H7 in a sample of Dole spinach with a lot code of P227A02, and a "best if used by" date of August 30, 2006.
- The Ohio Department of Health confirmed the isolation of E. coli O157:H7, matching the outbreak strain, from a package of Dole Baby Spinach.
- The Wisconsin Department of Health and Family Services has confirmed that E. coli O157:H7, the same strain as that associated with the outbreak, has been found in 2 bags of Dole Baby Spinach with lot codes of P227A.
- The Nevada Department of Health and Human Services has reported a confirmed finding of E. coli O157:H7 in bagged spinach, with a lot code of P227A03, matching the outbreak strain. The Nevada sample was analyzed by FDA Pacific Regional Lab NW.
- The Pennsylvania Department of Health has confirmed that E. coli O157:H7, the same strain as that associated with the outbreak, has been found in 2 individual bags of Dole spinach purchased in Pennsylvania with a "best if used by" date of August 30, 2006, and a lot code of P227A01.
- The Utah Department of Health (UDOH) and the Salt Lake Valley Health Department (SLVHD) have confirmed that E. coli O157:H7, the same strain as that associated with the outbreak, has been found in a bag of Dole Baby Spinach purchased in Utah, with a lot code of P227A01. Laboratory tests were conducted by the Utah Public Health Laboratory (UPHL).
- The New Mexico Department of Health announced on September 20, 2006, that it had linked a sample from a package of Dole Baby Spinach with the outbreak strain of E. coli O157:H7. DNA fingerprinting tests determined that the strain from the spinach matches the strain from patients in the outbreak. The package of spinach that tested positive was Dole Baby Spinach, with a lot code of P227A03.
- The Illinois Department of Public Health has confirmed that E. coli O157:H7, matching the outbreak strain, has been found in a package of Dole Fresh Spinach with a lot code of P227A02, and a "best if used by" date of August 30.
- The Arizona Department of Health Services reported a confirmed finding of E. coli O157:H7 in Dole bagged spinach, with a lot code of P227A03, and a "best if used by" date of August 30, 2006, matching the outbreak strain.
- The Nebraska Health and Human Services System reported a confirmed finding of E. coli O157:H7 in Dole bagged baby spinach, with a lot code of P227A01, and a “best if used by” date of August 30, 2006, matching the outbreak strain.
- The Utah Department of Health reported a confirmed finding of E. coli O157:H7 in Dole bagged baby spinach, with a lot code of P227A01, matching the outbreak strain.
Product Recalls (6)
To date, 6 firms have initiated recalls: