Killer bacteria hunted in fields of California
Pastor Dale Morgan
Killer bacteria hunted in fields of California*
Updated 9/19/2006 1:05 AM ET
By Dan Vergano and Judy Keen, USA TODAY
Elizabeth Rhodes, a 22-year-old senior at Morehead State University in
Kentucky, loves spinach. "I put it in everything," she says.
When she became violently ill in the early morning of Aug. 31, she
didn't suspect the spinach she'd had a couple of nights earlier. "I
noticed that the spinach tasted different, but I thought it was just the
dressing," she says.
A friend insisted on taking her to the emergency room. "But it was more
scary once the nurses were like, 'This is the worst we've seen; she's
really bad off,' " Rhodes says. "And this was after they had given me
morphine and I was still in such pain."
Rhodes was one of 114 people in 21 states who have been sickened since
Aug. 23 in a deadly outbreak of E. coli that claimed the life of a
Wisconsin woman. Federal officials are inspecting farms in California's
Salinas Valley, nicknamed "America's Salad Bowl," in an urgent search to
find the source of a deadly bacteria.
The cases include 18 cases of hemolytic uremic syndrome, which causes
kidney failure, and 60 hospitalizations, the FDA announced Monday night.
There's no evidence that bags of spinach believed to have carried the
deadly E. coli 0157:H7 bacterium were tampered with, says Susan Bro of
the Food and Drug Administration. The FDA is advising people not to eat
fresh spinach "until further notice."
The single confirmed fatality was Marion Graff, 77, of Manitowoc, Wis.,
who died of kidney failure Sept. 7 at a hospital in Green Bay. The FDA's
David Acheson said cases may continue to appear for three weeks, because
E. coli can take a week to infect patients and two weeks more to confirm.
The Wisconsin Department of Health and Family Services says the state
has 33 confirmed cases now, more than any other state. Twenty-six of the
Wisconsin victims are women. Federal officials have said 75% of the
victims nationwide are women, who surveys show eat more bagged produce
than men.
Officials in Ohio are investigating whether the death of a 23-month-old
girl is tied to the outbreak, says Jen Fannin, spokeswoman for the
Cambridge-Guernsey County Health Department. Four children from the same
family tested positive for E. coli, but the exact cause of the youngest
child's death Aug. 22 and a link to spinach have not been established,
Fannin says.
Investigators explored Salinas Valley spinach farms Monday, sampling
irrigation water and soils, as well as examining harvesting and
processing equipment. It will take at least a week for the findings to
come back, Acheson says.
But investigations of earlier E. coli outbreaks involving Salinas-grown
produce have proven inconclusive.
Suspicion has centered on packaged spinach sold by Natural Selection
Foods of San Juan Bautista, Calif. The company has recalled all of its
spinach packaged in bags, either alone or blended with other salad
greens, with "best if used by" dates from Aug. 17 to Oct. 1.
A second company, River Ranch Fresh Foods of Salinas, Calif., which
investigators found had bought mixed greens from Natural Selection,
issued a recall of three packaged salad mixes, Acheson says. The "spring
mix" brands containing spinach are: Farmers Market, Hy-Vee and Fresh and
Easy.
Barry Eisenberg of River Ranch says none of those brands has been linked
to the outbreak, "but we would rather play things safe."
In California, which has one confirmed case of E. coli, state health
department investigators are "looking at all possible points from the
field to the plate" where contamination could have occurred, says Patti
Roberts, spokeswoman for the California Department of Health Services.
Today, investigators fan out into fields. Their tasks include evaluating
day-to-day practices, looking for obvious sources of potential
contamination sources, reviewing the farm's history of flooding and
noting whether livestock are kept close to the spinach field.
"It's a complex investigation," Roberts says. "There's no smoking gun
because there isn't a bag of spinach we're able to test. This product's
shelf life is too short. It's like investigating a car crash two weeks
later when both cars are gone."
An outbreak is born
Because E. coli illnesses are not uncommon, public health officials
don't sound alarms until there are more cases than they expect to see.
Those bells began to sound on Sept. 8 when Wisconsin officials alerted
the Centers for Disease Control and Prevention (CDC) that it had a cluster.
A few days earlier, Wisconsin officials had learned of a cluster of five
E. coli cases, but they were not overly concerned because four of the
infected had attended the Manitowoc County Fair and had all visited
livestock barns. (Ultimately, only one case from that cluster turned out
to be spinach-based.)
But when reports started coming in from other counties, says Jason
Helgerson, spokesman for the Wisconsin Department of Health and Family
Services, "staff mobilized to take a very close look at a potentially
very significant event."
At the CDC headquarters in Atlanta, officials turned to the PulseNet
database. Created after an 1993 E. coli outbreak in undercooked
hamburger meat sickened hundreds and killed four people in Western
states, the database allows federal and state public health officials to
quickly compare the genetic fingerprint of E. coli. If the bug's DNA is
the same in different patients, they know they have a link.
When the bug is the same, officials look for similarities in food
consumption to pinpoint the culinary culprit. As Wisconsin officials
searched the memories of their victims about what they had eaten in the
past week, they were developing a hunch about spinach.
By Sept. 13, an Oregon health official who did not yet know about the
Wisconsin cases called the CDC to report five illnesses caused by E.
coli with the same DNA fingerprint. The next day, state epidemiologists
shared information on a conference call with the CDC and FDA, and
spinach became more than just a hunch. Before 7 a.m. the following day,
Sept. 14, the FDA issued its warning to consumers.
The earliest case appears to have cropped up Aug. 2 and the most recent
one on Sept. 9, Acheson said Monday.
A recurring problem
Coincidentally, experts from the FDA and California agriculture and
health officials met in Salinas on Aug. 24 with the Western Growers
Association and the California Lettuce Research Board to discuss ways to
reverse a rising trend in potentially deadly E. coli outbreaks.
Jerry Gillespie, director of Western Institute for Food Safety and
Security at the University of California, Davis, says the institute is
offering $300,000 for research into preventing outbreaks in vegetables.
Contamination of Salinas-grown spinach and lettuce was blamed for three
E. coli outbreaks between July 2002 and October 2003, but investigators
never found the bacteria's source. Those outbreaks killed an elderly
woman and sickened 114 others.
The Salinas Californian obtained health department reports through the
state's public records act and reported that investigators inspected
harvesting methods and processing and packaging plants but couldn't
determine whether the produce was contaminated before or after it was
shipped.
Even so, the state recommended that growers clean and sanitize
harvesting tools, make sure water used in fields is suitable and test
compost that contains manure. Growers told the Californian that they
were following those steps.
An investigation of an E. coli outbreak in October 2005 after 11 people
became ill in Minnesota was traced to bagged salad products from the
Salinas Valley, but it was also inconclusive.
Although the FDA linked those illnesses to the salad, tests of a partial
bag recovered from a store customer came up negative. Typically lettuce
and spinach go through three washes during processing, including two
that have chlorine designed to kill bacteria.
Food-borne illnesses kill about 5,000 people nationwide every year and
sicken an estimated 76 million, the CDC says. During her
hospitalization, Rhodes says, she was so sick that "at points I was
ready to just be gone." She's back in classes now but still experiences
cramping. Doctors have told her it will be a month before she's back to
full strength.
Experts say the very young, the elderly and people with weakened immune
systems are most at risk. "The numbers for food-borne illnesses in this
country are way too high," says food safety expert Douglas Powell of
Kansas State University in Manhattan, Kan.
Most often, a series of errors lead to contamination, Powell says.
First, a field is contaminated through manure used as fertilizer or
through dirty irrigation water. Then a processor uses weakly chlorinated
or non-chlorinated wash water to clean the produce. And last, the
processor doesn't control temperatures in the packing facility, creating
a hothouse for bacteria.
Michael Doyle, director of food safety at the University of Georgia and
an authority on E. coli 0157:H7, says outbreaks are increasing in number
in part because of the way big farms handle produce —for example, some
are bagging and cutting the spinach right in the field — which increases
the chance for contamination.
State officials have mobilized. But some cases may pass under the
states' radar. In Pennsylvania, where there are four confirmed cases,
the Department of Health's Richard McGarvey notes that if infected
people "don't get a test done or don't go to a doctor or hospital, we
don't find out about them. Those people wouldn't even know themselves."
Lawsuits are already being filed.
Drew Falkenstein of Marler Clark LLP in Seattle is representing 15 to 20
victims of the outbreak. The suits, against Dole and Natural Selection
Foods, include filings by Anna and Paul Zientek of Milwaukee, whose two
children were hospitalized after eating spinach; and Gwyn Wellborn, a
Salem, Ore., woman who became sick after eating Dole brand baby spinach.
She was hospitalized and received multiple transfusions, the suit says.
Contributing: Robert Davis, Emily Bazar, and Wendy Koch in Mclean, Va.;
John Ritter in San Francisco; The Associated Press