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http://www.cnn.com/2006/HEALTH/09/15/tainted.spinach.ap/index.html
 
E. coli outbreak spreads to 10th state




POSTED: 1:22 p.m. EDT, September 15, 2006

WASHINGTON (AP) -- Federal health officials worked Friday to find the source of a multistate E. coli outbreak and warned consumers that even washing the suspect spinach won't kill the sometimes deadly bacteria.

One person died and dozens of others were sickened in the 10-state outbreak, linked by Food and Drug Administration officials to bagged spinach.

"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 warned people not to eat bagged spinach and said washing it wouldn't solve the problem because the bacteria is too tightly attached. (Watch CNN's Dr. Sanjay Gupta explain why this advisory is significant -- 2:07)

"If you wash it, it is not going to get rid of it," said Robert Brackett, director of the FDA's Center for Food Safety and Nutrition.

The original outbreak was reported Thursday with 50 cases in eight states. Ohio and Kentucky became the ninth and tenth Friday, with health officials reporting seven cases in Ohio and one in Kentucky.

Officials believes the spinach may have been grown in California, and federal and state health officials were there trying to pinpoint the source of the contamination.

E. coli is commonly present in animal manure.

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.

The death occurred in Wisconsin, where 20 people were reported ill, 11 of them in Milwaukee. (Watch how health officials are scrambling -- 1:11)

The outbreak has sickened others -- eight of them seriously -- in Connecticut, Idaho, Indiana, Michigan, New Mexico, Oregon and Utah. In California, state health officials said they were investigating a possible case there.

The outbreak has affected a mix of ages, but most of the cases have involved women, Acheson said. Further information on the person who died wasn't available.

The Centers for Disease Control and Prevention and Wisconsin health officials alerted the FDA about the outbreak at midweek.

The warning applied to consumers nationwide because of uncertainty over the origin of the tainted spinach and how widely it was distributed. Health officials did not know of any link to a specific growing region, grower, brand or supplier.

"Typically we would try to narrow it down as focused as we could," Brackett said in an interview. "The fact that it was distributed all over the country, the fact that people are getting seriously ill from this, warranted us to have an abundance of caution and just to say 'OK, stop now until we figure out exactly what's going on."'

Brackett noted that most of the spinach crop at this time of the year comes from California. A special effort is under way in the Salinas Valley of California, a major leafy-vegetable growing region, to look for any possible source of contamination there.

Amy Philpott, a spokeswoman for the United Fresh Produce Association, said that it's possible the cause of the outbreak won't be known for some time, even after its source is determined.

"Our industry is very concerned," she said. "We're taking this very seriously."

Reports of infections have been growing by the day, Acheson said. "We may be at the peak, we may not be," he said."

E. coli causes 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.

Anyone who has gotten sick after eating raw packaged spinach should contact a doctor, officials said.

Other bagged vegetables, including prepackaged salads, apparently are not affected. In general, however, washing all bagged vegetables is recommended. Thorough cooking kills the bacterium.

"We're telling people if they have bagged produce and they feel like it's a risk, throw it out," Michigan Department of Community Health spokesman T.J. Bucholz said. "If they feel like they have to eat it, wash it first in warm water."

E. coli lives in the intestines of cattle and other animals and typically is linked to contamination by fecal material. It causes an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to the federal Centers for Disease Control and Prevention.

Sources of the bacterium include uncooked produce, raw milk, unpasteurized juice, contaminated water and meat, especially undercooked or raw hamburger, the agency says on its Web site.

Last October, the FDA warned people not to eat certain Dole prepackaged salads that were connected to an outbreak of E. coli infections in Minnesota. At least 11 people were sickened.