E. coli 0157 Illness

Posted by Judy Arbique Sep 16, 2006

A multi-state outbreak of E. coli 0157:H7 that began August 5, 2006 has been associated with contaminated fresh bagged spinach. Although the organism has not been recovered from the spinach, a strong epidemiologic link exists between bagged spinach distributed by Natural Selection Foods in San Juan Bautista, California, and sold under brands such as Dole, Earthbound Farms, Mann, O-organic, Ready Pac, Snoboy and

Trader Joe's. Natural Selection Foods has voluntarily removed its fresh bagged spinach from distribution until the source of the outbreak has been confirmed. Meanwhile, consumers are advised not to eat fresh bagged spinach, even after thorough washing. Canned spinach does not pose a risk as it is heated prior to canning and E. coli 0157:H7 is extremely sensitive to heat. Popeye can rest easy! Frozen spinach has not been identified as a risk at this time either.

As of September 15, 2006, 94 cases of illness had been reported to the Centers for Disease Control and Prevention (CDC) from 20 different states in the U.S. The highest number of reported cases was from Wisconsin (29) and Utah (11). E. coli 0157 causes illness 3-4 days following ingestion of contaminated food. Symptoms include diarrhea that is often bloody and abdominal cramps. Fever is usually not present and most cases of illness are self-limited, resolving within a week.

Some people who become infected may experience serious complications including hemolytic-uremic syndrome (HUS) - a type of kidney failure. The incidence of HUS is much higher in children under 5 years of age, immunocompromised and the elderly. The mortality rate associated with HUS in children is approximately 5%. Hey kids, that's a good enough reason not to have to eat spinach right there!

Although uncooked produce can be a source of E. coli 0157 contamination, it is not the usual source. Illness has most often been associated with undercooked or raw hamburger. Raw milk, unpasteurized juices, and contaminated water and meat may also be sources.

Of the 94 people who have become ill in the current outbreak, 29 required hospitalization, 14 developed HUS, and of these, a 77-year-old woman in Wisconsin died.