2006 North American E. coli O157:H7 outbreak in spinach

The 2006 North American E. coli outbreak was an Escherichia coli O157:H7 outbreak from organic spinach.[1] The outbreak occurred in September 2006 and its probable origin was an Angus cattle ranch that had leased land to spinach grower.[2] At least 276 consumer illnesses and 3 deaths have been attributed to the tainted produce.[3][4]

History

In September 2006, there was an outbreak of food-borne illness caused by Escherichia coli (E. coli) bacteria found in uncooked spinach[5] in 26 U.S. states.[3]

By October 6, 2006, 199 people had been infected, including three people who died and 31 who suffered a type of kidney failure called hemolytic uremic syndrome[3] after eating spinach contaminated with the E. coli O157:H7, a potentially deadly bacterium that causes bloody diarrhea and dehydration.[6] This strain is more potent than in any other food poisoning scares. Federal health officials said half of those reported sick have been hospitalized, compared to 25 to 30 percent in past outbreaks.[7]

The U.S. Food and Drug Administration (FDA) called for bagged fresh spinach to be removed from shelves and warned people not to eat any kind of fresh spinach or fresh spinach-containing products.[6][8] The FDA has also speculated that washing the spinach is insufficient to sanitize it because the bacteria is systemic, meaning that it is not just on the outside of the spinach, but that it has been absorbed through the roots and is now inside the spinach. This hypothesis has since been deemed only hypothetical as there is no evidence that this can happen in spinach. The FDA has since reduced its warning to certain brands with specific dates.

The Canadian Food Inspection Agency has advised consumers not to eat fresh spinach from the U.S., including bagged, loose in bulk or in salad blends.[9]

Cause
Angus Cattle
The probable origin of the first outbreak was an Angus cattle ranch that had leased land to a spinach grower.

The outbreak was traced to organic bagged fresh spinach—sold as conventional produce—grown on a 50-acre (200,000 m2) farm in San Benito County, California. Investigators with the Centers for Disease Control initially speculated that the dangerous strain of bacteria, E. coli O157:H7, originated from irrigation water contaminated with cattle feces or from grazing deer.[10]

A follow-up report by the CDC[11] and a joint report by the California Department of Health Services (CDHS) and U.S. FDA[2][12] concluded that the probable source of the outbreak was Paicines Ranch, an Angus cattle ranch that had leased land to spinach grower Mission Organics. The report found 26 samples of E. coli "indistinguishable from the outbreak strain" in water and cattle manure on the San Benito County ranch, some within a mile from the tainted spinach fields. Although officials could not definitively say how the spinach became contaminated, both reports named the presence of wild pigs on the ranch and the proximity of surface waterways to irrigation wells as "potential environmental risk factors."[11] The reports also noted that flaws in the spinach producer's transportation and processing systems could have further spread contamination. Paicines Ranch is not under investigation for its alleged role in the outbreak.

Soon after the reports were released, California's farm industry announced that it will adopt a set of "good agricultural practices" to reduce the risk of E. coli contamination for leafy green vegetables.[13] Those participating in the voluntary program will be eligible for product seal of approval.

Two companies in California voluntarily recalled spinach and spinach-containing products: Natural Selection Foods LLC,[14] based in San Juan Bautista, and River Ranch Fresh Foods.[8][14][15] Natural Selection 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, Jansal Valley, Cheney Brothers, D'Arrigo Brothers, Green Harvest, Mann, Mills Family Farm, Premium Fresh, Snoboy, The Farmer's Market, Tanimura & Antle, President's Choice, Cross Valley, and Riverside Farms. Affected brands from River Ranch include Hy-Vee, Farmer's Market and Fresh and Easy. Later, a third company, RLB Food Distributors, issued a multiple East Coast states recall of spinach-containing salad products for possible E. coli contamination.[16] Natural Selection Foods announced on September 18, 2006 that its organic produce had been cleared of contamination by an independent agency, but did not lift the recalls on any of its organic brands.[17] On September 22, Earthbound Farm announced that the FDA and the CDHS confirmed that its organic spinach had not been contaminated with E. coli.

Impact
States and provinces affected by the E. coli outbreak are marked in red

26 states were affected, with at least 200 cases[3] of the disease being reported as of December 23, 2006. Three deaths were confirmed to be from the outbreak source with an elderly woman in Wisconsin, a two-year-old in Idaho, and an elderly woman in Nebraska. A fourth death of an elderly woman in Maryland is still under investigation to determine if it is linked to this outbreak. Spinach has also been distributed to Canada and Mexico; one case has been reported in Canada.[18] There have been over 400 produce-related outbreaks in North America since 1990.[19]

The areas reported to be affected are:[20]

Economic impact

In California, where three-quarters of all domestically grown spinach is harvested, farmers could face up to $74 million in losses due to the E. coli outbreak. In 2005, the spinach crop in California was valued at $258.3 million, and each acre lost amounts to a roughly $3,500 loss for the farmer.[21]

Online Help

The PulseNet system, part of the Association of Public Health Laboratories and coordinated by CDC, detected clusters of infection in two states, Oregon and Wisconsin, which initiated investigations in each state. The first cluster was detected on Friday September 8 in one state, and the second cluster emerged in the second state on Wednesday September 13, by which time PulseNet had also identified potential associated cases in other states.[22]

The OutbreakNet, a group of state public health officers who investigate foodborne infection outbreaks, shared information with CDC that indicated that Oregon and Wisconsin were considering the same hypothesis: fresh spinach was the possible vehicle of infection. The group tracked and updated the increasing case count and exposure information. During a multistate call on Thursday, September 14, the group noted that the data strongly suggested that fresh spinach was a likely source. Within 24 hours of the outbreak, the data indicated that the outbreak was probably ongoing.[22]

CDC made communication to the public a priority by developing press releases, coordinating with FDA on press documents, conducting interviews with major media, and sending out notices on Thursday September 14 to the public health community via the Health Alert Network (HAN) and the Epidemic Information Exchange (Epi-X). By the next morning, the news media warned the U.S. population not to eat bagged spinach, with remarkable coverage.[22]

Timeline

September

On September 14, 2006, the FDA warned consumers about an E. coli outbreak that was tied to bags of fresh spinach. The FDA reported that they received complaints from 19 states in the United States.[5][15] The FDA advised "that consumers not eat bagged fresh spinach."[5] Three days later, their updated warning said not to eat "fresh spinach or fresh spinach-containing products."[8] On September 17, the United States expanded the warning to avoid all fresh spinach.[6] The Centers for Disease Control issued an official Health Alert, the highest category of alert message, on September 14[23] and started to investigate the E. coli outbreak. Wisconsin Governor Jim Doyle formally requested federal aid on September 15. His office said the CDC will help assess the causes and the magnitude of the outbreak in his state.[24]

On September 17, just three days after the initial warning, the FDA issued an updated warning stating that the public should "not eat fresh spinach or fresh spinach containing products."[8]

On September 18, Illinois and Nebraska reported their first cases of E. coli infection due to spinach, bringing the total number of affected states to 21. Ohio public health officials are investigating a 2-year-old's death that may also be linked.[25]

By September 18, the number of people sickened by the E. coli laced fresh spinach reached 111.[26]

On September 19, it was reported that there may be a link to a further death in Ohio and irrigation water is being investigated as a possible source.[27]

This is the 9th outbreak traced to the Salinas Valley in California and the 25th leafy green E. coli outbreak (spinach or lettuce) in the United States since 1993.[28]

On September 20, the CDC announced that the genetic fingerprint, a PFGE pattern, of E. coli O157 isolated from an opened package of "Dole Baby Spinach, Best if Used by August 30" packed by Natural Selection in the refrigerator of an ill New Mexico resident matched that of the outbreak strain.[29] On September 25, consumer advocates and lawmakers began urging tougher rules for fields and processing plants.[30]

On September 27, a Pittsford woman filed a lawsuit concerning this matter, stating that the tainted spinach has made her ill. See Pittsford Woman Files Tainted Spinach Lawsuit. This source also stated that additional lawsuits were being filed nationwide.

On September 29, the FDA downgraded the warning, now only warning against specific brands packaged on specific dates, instead of just fresh spinach in general.[31]

October

On October 5, 2006, the FBI has launched a criminal investigation into this matter.[32][33][34]

On October 9, 2006, a popular brand of lettuce grown in California's Salinas Valley, the region at the center of the nationwide spinach scare has been recalled over concerns about E. coli contamination.

On October 26, 2006, some of the largest grocery chains, including Vons, Albertsons, Ralphs and others, sent a letter to the farmer's associations, giving them 6 weeks to come up with a plan to prevent problems like the E. coli outbreak from happening again.

Overall toll

The overall toll of the spinach incident was 199 people in 28 states being infected, resulting in 141 hospitalizations, 31 people having kidney failure, and three deaths.[35]

See also

References
  1. Subcommittee of the PHLS Advisory Committee on Gastrointestinal Infections (2000). "Guidelines for the control of infection with Vero cytotoxin producing Escherichia coli (VTEC)". Communicable Dis Public Health; 3: 14–23. Archived December 20, 2010, at WebCite
  2. Raine, George (March 23, 2007). "San Benito County ranch source of tainted spinach". San Francisco Chronicle. Archived from the original on December 20, 2010.
  3. "Update on Multi-State Outbreak of E. coli O157:H7 Infections From Fresh Spinach". Centers for Disease Control and Prevention. October 3, 2006. Archived from the original on December 20, 2010. Retrieved October 6, 2006.
  4. Libby Sander (October 13, 2006). "Source of Deadly E. coli Is Found". The New York Times. Retrieved October 10, 2011. Cattle manure collected from a California ranch under investigation by federal and state authorities contains the same strain of E. coli that killed three people and sickened nearly 200 in a recent outbreak linked to tainted spinach, federal and state food safety officials said Thursday. ...
  5. "FDA Warning on Serious Foodborne E.coli O157:H7 Outbreak". Food and Drug Administration (United States). September 14, 2006. Archived from the original on December 20, 2010. Retrieved November 23, 2009.
  6. "U.S. expands warning to cover all fresh spinach". Reuters. September 17, 2006. Archived from the original on March 5, 2007. Retrieved September 18, 2018.
  7. "E. coli On Spinach May Have Been Extra Potent". WFSB. September 20, 2006. Archived from the original on December 20, 2010.
  8. "FDA Statement on Foodborne E. coli O157:H7 Outbreak in Spinach". Food and Drug Administration (United States). September 17, 2006. Archived from the original on December 20, 2010.
  9. "Expanded health hazad alert. Various brands of imported fresh spinach may contain E. coli 0157:H7 bacteria". CFIA. September 18, 2006. Archived from the original on September 25, 2006. Retrieved September 26, 2006.
  10. "The truth about the E. coli outbreak". Salon.com. September 22, 2006. Retrieved September 25, 2006.
  11. "Inside the CDC's report on the deadly E. coli spinach outbreak". Santa Cruz Sentinel. March 24, 2007. Archived from the original on September 30, 2007. Retrieved April 6, 2007.
  12. "Source of tainted spinach finally pinpointed". NBC News. March 23, 2007. Retrieved April 6, 2007.
  13. "Tainted spinach linked to Paicines Ranch: Officials say San Juan Bautista plant though failed to follow its own safety procedures". Santa Cruz Sentinel. March 24, 2007. Archived from the original on September 30, 2007.
  14. Natural Selection Foods Archived December 20, 2010, at WebCite
  15. "FDA: E. coli linked to Natural Selection Foods". CNN. September 15, 2006. Archived from the original on September 21, 2006.
  16. "RLB Food Distributors Issues a Multiple East Coast States Recall of Fresh Spinach Salad Products for Possible E. coli Contamination". Food and Drug Administration (United States). September 20, 2006. Archived from the original on December 20, 2010.
  17. "Company says organic spinach OK, but E. coli recall still in effect". USA Today. September 18, 2006. Archived from the original on December 20, 2010.
  18. "First case of contaminated spinach recorded in Canada". CBC News. September 25, 2006. Archived from the original on December 20, 2010.
  19. "A selection of North American produce related outbreaks from 1990–2005" (PDF). Food safety network. May 3, 2006. Archived from the original (PDF) on February 23, 2006.
  20. "E. coli O157:H7 Outbreak Case Counts by State". CDC. Archived from the original on December 20, 2010. Retrieved October 4, 2006.
  21. October 2, 2006 and in October 4, 2006 AP story reported on NBC News
  22. CDC | E. coli Outbreak From Spinach | What CDC and Other Agencies Are Doing – Sep. 16, 2006 Archived December 20, 2010, at WebCite
  23. CDC: Multiple States Investigating a Large Outbreak of E. coli O157:H7 Infections, September 14, 2006 Archived December 20, 2010, at WebCite
  24. "CDC Starts To Investigate E. coli Outbreak In Wisconsin". WISC-TV. September 16, 2006. Archived from the original on December 20, 2010.
  25. "Ohio tot's death may be linked to tainted spinach". Dayton Daily News. September 18, 2006. Archived from the original on December 20, 2010.
  26. "E. coli spinach scare increases to 21 states". CNN. September 19, 2006. Archived from the original on December 20, 2010.
  27. "Farm water is suspected in outbreak". Mercury News. September 19, 2006. Archived from the original on December 20, 2010.
  28. "Outbreaks of foodborne illness linked to fresh lettuce and spinach since 1993". Food Safety Network. September 18, 2006. Archived from the original on September 27, 2006.
  29. "Update on Multi-State Outbreak of E. coli O157:H7 Infections From Fresh Spinach, September 20, 2006". CDC. September 20, 2006. Archived from the original on December 20, 2010.
  30. Ritter, John (October 5, 2006). "Safety advocates, growers debate produce rules". USA Today. Archived from the original on December 20, 2010. Retrieved April 22, 2010.
  31. (Reuters)
  32. Criminal Probe launched into the Spinach E. coli incident Archived December 20, 2010, at WebCite
  33. FBI investigates Spinach E. coli incident as a criminal matter
  34. CBS News: Feds investigate outbreak Archived December 20, 2010, at WebCite
  35. Surak, John G. "A Recipe for Safe Food: ISO 22000 and HACCP". Quality Progress. October 2007. p. 21.
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