Sanitary conditions scrutinized in spinach-borne E. coli outbreakSep 20, 2006 | San Francisco Chronicle
State and federal investigators hit the ground in the Salinas Valley on Tuesday to find the source of a bacterial contamination in fresh spinach that has sickened dozens all over the country and killed one woman, but officials admitted they may never know exactly where the E. coli came from.
As of Tuesday morning, 131 people had been identified as having been infected with the E. coli strain, and of those interviewed by health officials about their recent eating habits, 80 percent had reported eating spinach. Only one case has been reported in California.
Officials with the state health department and the Food and Drug Administration have traced at least some of the cases in the week-old outbreak to Earthbound Farm's Natural Selection label. That's where about a dozen investigators started their field research Tuesday, at nine farms in Monterey County that have supplied spinach to the label. Farm research was expected to continue over the next several days, and investigators also are looking at processing plants where the spinach is cleaned and bagged.
Irrigation techniques are of particular interest to investigators, as the water supply is a common entry point for bacterial contaminations. But state and federal officials said Tuesday they would look at sanitary conditions across the board -- from bathroom and washing facilities for farmworkers to fertilization techniques and equipment cleaning practices in processing plants.
"In the past, we have found a number of issues that may have been contributory," said Kevin Reilly, deputy director of prevention services for the California Department of Health Services, suggesting possible points of contamination. "All those may have been possible risk factors, but none of them have the definitive link in most outbreaks."
Depending on what investigators find, state and federal officials may consider increased regulations to prevent such outbreaks in the future.
The outbreak is the 20th time in a decade that leafy greens from Monterey County have been contaminated with E. coli, and government officials already had warned growers and processors in the Salinas Valley to improve their conditions.
"Clearly we're not where we need to be. If we were, this outbreak wouldn't have happened," said Dr. David Acheson, chief medical officer with the federal Center for Food Safety and Applied Nutrition, part of the FDA. "I'm confident the industry is taking this seriously. But there is no question that more needs to be done."
All of the 131 cases in the current outbreak have been confirmed as involving the same strain of E. coli, O157:H7, a deadly form of the common bacteria that normally doesn't cause harm to humans. While most of those infected said they had eaten fresh spinach, federal and state investigators have yet to find traces of the bacteria on the bags or produce that consumers have turned in.
That's not necessarily surprising, Reilly said. E. coli can sicken a person with just small doses of 10 cells, and tracking down traces of it can prove almost impossible.
Officials with the FDA said they're hopeful that word about the tainted spinach has spread far enough that people have tossed the produce and are no longer being exposed to the bacteria. But they expect new cases to continue to be reported over the next two to three weeks, as those who already have been exposed show symptoms and are treated by doctors.
Of the cases so far, half have been hospitalized and 20 have developed a form of kidney failure known as hemolytic uremic syndrome.
While contaminated spinach can be cooked at temperatures high enough to kill the E. coli bacteria, federal and state health officials are recommending that consumers throw away all fresh spinach.
"If you handle it in the kitchen and it's contaminated, you'll cross-contaminate the kitchen with it," Acheson said. "You'll get it on your hands, on the counters, in the sink. That's just not a good idea. The recommendation is don't mess with it throw it away."