E. coli O157, spinach - USA (multistate)(03): alert

International Society for Infectious Diseases
<http://www.isid.org>

[1]
Source: FDA.gov [edited]
< http://www.fda.gov/bbs/topics/NEWS/2006/NEW01451.html>

To date, 94 cases of illness have been reported to the CDC, including
14 cases complicated by hemolytic uremic syndrome and 1 death. At
this time, the investigation is ongoing and states that have reported
illnesses to date include: California, Connecticut, Idaho, Indiana,
Kentucky, Maine, Michigan, Minnesota, Nevada, New Mexico, New York,
Ohio, Oregon, Pennsylvania, Tennessee, Utah, Virginia, Washington,
Wisconsin, and Wyoming.

The affected products were also distributed to Canada and Mexico.

The FDA is continuing to alert consumers about an outbreak of _E.
coli_ O157:H7 in multiple states that may be associated with the
consumption of fresh spinach and fresh spinach-containing products.

Based on current information, FDA advises that people not eat fresh
spinach or fresh spinach-containing products that are consumed raw.
Individuals who believe they may have experienced symptoms of illness
after consuming pre-packaged spinach are urged to contact their
health care provider.

At this time, Natural Selection Foods, LLC, of San Juan Bautista,
California, is recalling all of its products that contain spinach in
all the brands they pack with "Best if Used by Dates" of ***17 Aug
2006 through 1 Oct 2006***. FDA continues to investigate whether
other companies and brands are involved.

Natural Selection Foods, LLC brands include: Natural Selection Foods,
Pride of San Juan, Earthbound Farm, Bellissima, Dole, 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. These products include spinach and any salad
with spinach in a blend, both retail and food service products.

Products that do not contain spinach are not part of this recall.

FDA continues to work closely with the CDC and state and local
agencies to determine the cause and scope of the problem. As part of
our investigation, we will test packages of spinach from [the homes
of] confirmed cases of _E. coli_ infection.

Since the last post, the number of states reporting cases has
increased from 10 to 20, and the number of cases almost doubled as
well. Below is a post regarding a broader investigation of
California's "Salad Bowl", the Salinas Valley.

******
[2]
Source: Center for Infectious Disease Reseach and Policy [edited]
<http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/sep1406salinasvalley.html>


Outbreaks of _E. coli_ in recent years have spurred federal and
California officials to launch a broad investigation into farms and
processors of lettuce and other leafy greens in California's Salinas
Valley, according to the FDA and news sources.

Of 19 US outbreaks of _E. coli_ O157:H7 from lettuce and spinach
since 1995, 8 have been traced to Salinas Valley, dubbed the "Salad
Bowl of the World," according to an 11 Sep 2006 Los Angeles Times
article. These 8 outbreaks have affected 217 people in 8 states,
including 2 elderly patients from northern California who died in 2003.

In response to these outbreaks, the FDA announced its Lettuce Safety
Initiative on 23 Aug 2006. In its announcement, the FDA said it will,
in conjunction with California agencies, "visit farms and cooling and
packing facilities, and inspect processors, focusing on good
agricultural practices and good manufacturing practices," identifying
"practices that potentially lead to product contamination."

The initiative in Salinas Valley began 28 Aug 2006 and is scheduled
to wrap up in Oct 2006, a food safety official from the FDA's Center
for Food Safety and Applied Nutrition (CFSAN) told CIDRAP News via
e-mail. "We will be compiling the findings in the following months
and hope to have a summary by next spring," he said.

In addition to CFSAN, the Salinas Valley investigation involves the
FDA Office of Regulatory Affairs, the California Department of Health
Services, and the California Department of Food and Agriculture,
according to the official. He characterized the initiative as
cooperative: "This is an important example of industry, government,
and academia working together to understand a problem so that
meaningful interventions can be identified."

About 40 farms, packers, and processors will be visited, he said.

When asked about a likely source for the contamination, the official
responded, "There are many possible sources of the contamination.
There may not be one source, but a combination of sources [and]
factors." Craig Hedberg, PhD, a University of Minnesota expert on
foodborne disease, said of the outbreaks, "I would suspect there
might be a link between dairy production and lettuce contamination,
but what that might be is unknown." Hedberg, of Minneapolis, is an
associate professor of environmental and occupational health.

Past, smaller-scale investigations have identified a number of
possible sources of contamination in Salinas Valley. The valley,
located in Monterey County, grows nearly $1 billion in lettuce and
other leafy greens each year, according to a story yesterday from the
Monterey County Herald.

In a 4 Nov 2006, letter to California lettuce growers, packers,
processors, and shippers, CFSAN director Robert Brackett, PhD,
mentioned intermittent flooding from Salinas Valley creeks and rivers
as a possible source of contamination. He cited a 2005 report that
identified O157:H7 _E coli_ in the valley's watershed and stated that
any ready-to-eat crop that comes in contact with floodwaters is not
fit for human consumption.

In addition, in a January letter to the Western Growers Association,
California Public Health Officer Mark Horton, MD, MSPH, wrote that
his staff will be reassessing manure composting and septic system
regulations. In addition to citing the possible flooding problem, the
letter also specified assessment of workers' access to toilets and
hand-washing facilities, as well as adherence to other health-safety rules.

Other possible contamination sources listed in the Los Angeles Times
article include bird and other animal droppings and dust from nearby
cattle fields.