A California natural foods company was linked Friday to a nationwide E. coli outbreak that has killed one person and sickened nearly 100 others. Supermarkets across the country pulled spinach from shelves, and consumers tossed out the leafy green.
Food and Drug Administration officials said that they had received reports of illness in 19 states.
The outbreak was traced to Natural Selection Foods, based in San Juan Bautista, Calif., and the company has voluntarily recalled products containing spinach.
FDA officials stressed that the bacteria had not been isolated in products sold by Natural Selection Foods but that the link was established by patient accounts of what they had eaten before becoming ill.
An investigation was continuing.
"It is possible that the recall and the information will extend beyond Natural Selection Foods and involve other brands and other companies, at other dates," said Dr. David Acheson, the chief medical officer with the FDA's Center for Food Safety and Applied Nutrition.
Natural Selection Foods LLC said in a statement that it was cooperating with federal and state health officials to identify the source of the contamination and had stopped shipping all fresh spinach products. They are sold as Rave Spinach, Natural Selection Foods, Dole, Earthbound Farm, Trader Joe's, Ready Pac, Green Harvest, among other brand names.
State health officials received the first reports of illness on Aug. 25, and the FDA was informed on Wednesday, Acheson said.
The FDA warned people nationwide not to eat the spinach. Washing won't get rid of the tenacious bug, though thorough cooking can kill it.
"We're waiting for the all-clear. In the meantime, Popeye the Sailor Man and this family will not be eating bagged spinach," said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University. The Tennessee university's medical center was treating a 17-year-old Kentucky girl for E. coli infection. That case originally was listed as being from Tennessee, but federal health officials changed it to Kentucky.
Each year, consumers buy hundreds of millions of pounds of bagged spinach — triple-washed and packaged in cellophane bags and clamshell boxes.
"We will do whatever is necessary to help protect the health and safety of the public," Earthbound Farm spokeswoman Samantha Cabaluna said in a statement.
The company said consumers could call 800-690-3200 for a refund or replacement coupons for tossed-out spinach products.
Wisconsin accounted for 29 illnesses, about one-third of the cases, including the lone death.
Other states reporting cases were: California, Connecticut, Idaho, Indiana, Kentucky, Maine, Michigan, Minnesota, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington and Wyoming, according to the Centers for Disease Control and Prevention.
Wisconsin accounted for 29 illnesses, about one-third of the cases, including the lone death.
"We are telling everyone to get rid of fresh bagged spinach right now. Don't assume anything is over," Gov. Jim Doyle said.
The bug has sickened at least 94 people across the nation, the CDC said. The agency added that 29 people have been hospitalized, 14 of them with kidney failure.
FDA officials said they issued the nationwide consumer alert without waiting to identify the still-unknown source of the tainted spinach.
"Early is good," said Caroline Smith DeWaal, food safety director for the Center for Science in the Public Interest, adding that the alert may have prevented hundreds more cases.
An industry spokeswoman said public health concerns justified the blanket warning: "It needed to happen this way," said Kathy Means, a spokeswoman for the Produce Marketing Association. "Public health has to trump economics at this time."
More than half the nation's 500 million-pound spinach crop is grown in California's Monterey County, according to the Agriculture Department.
"We're trying to get to the bottom of this and figure out what happened. Everybody is terribly concerned," said Dave Kranz, a spokesman for the California Farm Bureau Federation.
Even before the latest outbreak, a joint state and federal effort has been under way in the California county to find and eliminate any possible sources of E. coli contamination.
"We need to strive to do even better so even one life is not lost," said Dr. Andrew von Eschenbach, FDA's acting commissioner.
The FDA's top food expert stressed the importance of stopping the bacterium at its source, since rinsing spinach won't eliminate the risk. "If you wash it, it is not going to get rid of it," said Robert Brackett, director of the agency's Center for Food Safety and Nutrition.
E. coli lives in the intestines of cattle and other animals and typically is spread through contamination by fecal material. Brackett said the use of manure as a fertilizer for produce typically consumed raw, such as spinach, is not in keeping with good agricultural practices. "It is something we don't want to see," he told a food policy conference.
Meanwhile, Wal-Mart Stores Inc., Safeway Inc., SuperValu Inc. and other major grocery chains stopped selling spinach, removing it from shelves and salad bars.
"We pulled everything that we have spinach in," said Dan Brettelle, manager of a Piggly Wiggly store in Columbia, S.C.
Consumer activist Barb Kowalcyk said fixing the nation's "fractured network" of food safety agencies could save lives. In 2001, her 2-year-old son, Kevin, died of E. coli, possibly after eating tainted ground beef.
"How can we improve communication between agencies? That needs to happen," the Loveland, Ohio, resident said.
Not all strains of E. coli cause illness: E. coli O157:H7, the strain involved in the current outbreak, was first recognized as a cause of illness in 1982. That strain causes an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to the CDC.
When ingested, the bug can cause diarrhea, often with bloody stools. Most healthy adults can recover completely within a week, although some people — including the very young and old — can develop a form of kidney failure that often leads to death.
Sources of the bacterium include uncooked produce, raw milk, unpasteurized juice, contaminated water and meat, especially undercooked or raw hamburger.
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