In the past week, nine states have reported a total of 50 cases of severe diarrhea caused by Escherichia coli 0157:H7. Eight of the cases have led to a severe complication that causes kidney failure.

Interviews with victims, who have ranged from children to the elderly, point to washed and bagged spinach as a common source, said David Acheson of the FDA's Center for Food Safety and Applied Nutrition. No farm, brand, distributor or retail store has been identified as associated with the presumably contaminated product.

"Based on what we know, we advise consumers that they not eat bagged fresh spinach at this time," Acheson told reporters during a telephone news conference last night.

The FDA learned of the outbreak from epidemiologists at the Centers for Disease Control and Prevention on Wednesday, he said. The first person became ill on Aug. 23, he said.

E. coli causes about 75,000 cases of diarrhea (often severe and bloody) annually in the United States, with about 50 deaths, said Christopher Braden, an epidemiologist at the CDC's National Center for Infectious Diseases.

The fatal case during this outbreak occurred in Wisconsin. Neither the age nor sex of the victim was available.

Although not the largest, this outbreak is worrisome because it is unusually widespread and the number of cases is still growing.

"We can't say how large it is at this point," Braden said. "But we are getting reports rapidly from many different states indicating that it is ongoing. We're concerned that contaminated product could still be in the market place."

It takes about a week for a suspected case to be confirmed by the collection of fecal samples and genetic analysis of the E. coli bacterium, if it is found. There are reports of many other unconfirmed cases.

"I think we will see quite a few more cases. And I think we will see them from other states," Braden said.

Wisconsin, with 20 cases, has reported more than any other state. The other states and case numbers: Utah, 11; Oregon, five; Idaho, three; Indiana, four; Michigan, three; New Mexico, two; Connecticut, one; and Washington state, one.

The E. coli infection is most often associated with ground beef, although it has been caused by dozens of other kinds of food.

The bacterium is carried in the intestine of cattle, and meat can become contaminated with feces during slaughter. Crops such as spinach could conceivably be contaminated by liquid fertilizer sprayed on fields.

"Where cattle manure goes, E. coli 0157:H7 may go," Acheson said.

Although most infected people recover, a few develop a severe complication called hemolytic uremic syndrome. It causes anemia, low platelet count and kidney failure.

While this complication is most often seen in children, this outbreak is unusual in that many of the eight cases of hemolytic uremic syndrome recorded have been in adults, Braden said.

The genetic fingerprint of the bacteria is identical in all cases in this outbreak. But that does not necessarily mean the contamination is from the same source, he said.

The outbreak was identified quickly because of a network called PulseNet, in which state health department labs deposit the results of their genetic fingerprinting in a database housed at the CDC.

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Hi, thanks, posted.

Brian

Milk Infects 3 SoCal Children With E. Coli

10.12.2006
DD#4344

> LETTUCE RECALLED OVER E. COLI FEARS

Less than a week after the Food and Drug Administration lifted its warning on
fresh spinach grown in California's Salinas Valley, a popular brand of lettuce
grown there has been recalled over concerns about E. coli contamination.


Lettuce recalled over E. coli fears

POSTED: 7:16 a.m. EDT, October 9, 2006

SAN FRANCISCO, California (AP) -- Less than a week after the Food and Drug Administration lifted its warning on fresh spinach grown in California's Salinas Valley, a popular brand of lettuce grown there has been recalled over concerns about E. coli contamination.

The lettuce does not appear to have caused any illnesses, the president of Salinas-based Nunes Co. Inc. said.

The lettuce scare comes amid other federal warnings that some brands of spinach, bottled carrot juice and recent shipments of beef could cause grave health risks -- including paralysis, respiratory failure and death.

Executives ordered the recall after learning that irrigation water may have been contaminated with E. coli, said Tom Nunes Jr., president of the company.

So far, company investigators have not found E. coli bacteria in the lettuce itself, Nunes stressed.

"We're just reacting to a water test only. We know there's generic E. coli on it, but we're not sure what that means," he said. "We're being extra careful. This is precautionary."

The recall covers green leaf lettuce purchased in grocery stores October 3-6 in Arizona, California, Nevada, Washington, Oregon, Idaho and Montana. It was also sold to distributors in those states who may have sold it to restaurants or institutions.

The recalled lettuce was packaged as "Green Leaf 24 Count, waxed carton," and "Green Leaf 18 Count, cellophane sleeve, returnable carton." Packaging is stamped with lot code 6SL0024.

FDA spokeswoman Julie Zawisza said the agency is aware of the voluntary recall but had no details.

"As a standard course of action, we would expect the firm to identify the source of the contamination and take steps to ... ensure that it doesn't happen again," Zawisza wrote in an e-mail.

It's unlikely that the bacteria in the lettuce fields share the source of the E. coli found in spinach that has sickened nearly 200 people and has been linked to three deaths nationwide, Nunes said.

Pathogenic Escherichia coli bacteria, or E. coli, can proliferate in uncooked produce, raw milk, unpasteurized juice, contaminated water and meat. When consumed, it may cause diarrhea and bloody stools.

Although most healthy adults recover within a week without long-term side effects, some people may develop a form of kidney failure.

That illness is most likely to occur in young children, senior citizens and people with compromised immune systems. In extreme cases, it can lead to kidney damage or death.

The recall at Nunes Co., a family-owned business with more than 20,000 acres of cropland in Arizona and California, comes days after federal agents searched two Salinas Valley produce companies connected to the nationwide spinach scare.

Epidemiologists also warned consumers last week to stay away from some bottled carrot juice after a Florida woman was paralyzed and three people in Lucida Grande experienced respiratory failure, apparently because of botulism poisoning.

Also on Friday, an Iowa company announced that it was recalling 5,200 pounds of ground beef suspected of having E. coli. The government said no illnesses have been reported from consumption of the beef.

The outbreaks have sparked demands to create a new federal agency in charge of food safety. Sens. Charles Schumer and Hillary Rodham Clinton, both New York Democrats, are sponsoring legislation authored by Sen. Richard Durbin, D-Ill., to create the unified Food Safety Agency.

"This recent outbreak must be a wake-up call to get our food safety house in order, because right now it's in pure disarray," Schumer said at his Manhattan office. "We need to have one agency take charge to ensure the next outbreak isn't far worse."

The outbreaks have also devastated the economy of Salinas Valley, the self-proclaimed "Salad Bowl to the World."

Farmers in the area, about 100 miles south of San Francisco, began plowing spinach crops under and laying off workers last month, as government inspectors examined fields and packing houses for the source of the deadly outbreak.

Nunes said he upgraded safety inspection protocols in wake of the spinach scare.

"There's a high level of urgency in our industry, and we're being very proactive," Nunes said. "It's obviously based upon recent events in the produce industry and concern for customers. We just don't want anything to happen."




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Thanks, posted.

Brian

10.12.2006