What is E. coli by bluepastry Blog entry

Blog: Raw Foods is it for Everybody
by bluepastry

What is E. coli

Has FDA conducted outreach/education activities regarding fresh produce safety?

Date: 9/26/2006 5:30:07 PM ( 18 y ) ... viewed 1614 times

E. coli O157:H7 is a bacterium that causes diarrhea that is often bloody; the diarrhea can be accompanied by abdominal cramps. Fever may be absent or mild. Symptoms usually occur within 2-3 days following exposure, but may occur as soon as 1 day following exposure or up to one week following exposure. Healthy adults can typically recover completely from E. coli O157:H7 exposure within a week. However, some people, especially young children and the elderly, can develop Hemolytic Uremic Syndrome (HUS) as a result of exposure to E. coli O157:H7, a condition that can lead to serious kidney damage and even death.

What is FDA's new consumer advice regarding the consumption of spinach?
Spinach implicated in the current outbreak was grown in the California counties of Monterey, San Benito, and Santa Clara only. Spinach from the rest of the U.S. has not been implicated in the current E. coli O157:H7 outbreak. The public can be confident that spinach grown in the non-implicated areas can be consumed.

Processed spinach, including frozen and canned spinach, is not implicated in this outbreak.

What is the location of the three counties in California (Monterey, San Benito, and Santa Clara counties) where the contaminated spinach was grown? Are these three counties part of the Salinas Valley?
The Salinas Valley in California is located in its entirety in Monterey county. The California counties of San Benito and Santa Clara counties are located outside the perimeter of the Salinas Valley.

What should consumers do if they cannot determine where fresh spinach that is being held for sale was grown?
The FDA is advising consumers not to purchase or consume fresh spinach if they cannot verify that it was grown in areas other than the California counties of Monterey, San Benito and Santa Clara. The fresh spinach implicated in the current outbreak was grown in these three counties in California.

Are any other types of leafy greens included in this outbreak?
Any other type of leafy green (lettuce, collard greens, kale) is NOT implicated in this outbeak.

In what states have illnesses been reported?
To date, the states that have reported illnesses include: Arizona, California, Colorado, Connecticut, Idaho, Illinois, Indiana, Kentucky, Maine, Maryland, Michigan, Minnesota, Nebraska, Nevada, New Mexico, New York, Ohio, Oregon, Pennsylvania, Tennessee, Utah, Virginia, Washington, Wisconsin, and Wyoming. The implicated product was also distributed to Canada, Mexico, Taiwan, Hong Kong and Iceland. No illnesses have been reported from these countries.

This outbreak is ongoing, therefore the number of illnesses and states involved may continue to increase.

Has fresh spinach collected for analysis as part of the ongoing outbreak investigation been found to contain the same strain of E. coli O157:H7 as that associated with the current illnesses?
On 9/23/2006, public health officials from the Utah Department of Health (UDOH) and the Salt Lake Valley Health Department (SLVHD) announced that they have confirmed that E. coli O157:H7, the strain associated with the recent national outbreak, has been found in a bag of Dole baby spinach purchased in Utah. The Utah Public Health Laboratory (UPHL) conducted the tests which detected the E. coli. The Salt Lake Valley Health Department submitted the bag of spinach for testing as part of an investigation into an E. coli O157:H7 illness associated with the consumption of spinach which came from the bag. Testing confirmed that the strain of E. coli O157:H7 from the bag of spinach is the same as the strain associated with the national outbreak. The UPHL is the second laboratory in the country to confirm the presence of E. coli O157:H7 in spinach associated with the current national outbreak.

New Mexico's public health laboratory has also isolated E. coli O157:H7 from a package of spinach. The package came from the refrigerator of a patient who ate some of the spinach before becoming ill. The New Mexico laboratory completed "DNA fingerprinting" tests. New Mexico and CDC determined that the "DNA fingerprint" matches that of the outbreak strain.

Outbreak Related Q and As
What is an outbreak?
An outbreak is defined by the CDC as two (2) or more cases of the same disease related to a common exposure.

Where was the spinach implicated in this outbreak grown?
The FDA, in working closely with the CDC and the State of California, has determined that the spinach implicated in the outbreak was grown in the following California counties: Monterey, San Benito, and Santa Clara. Other produce grown in these counties is not implicated in this outbreak. Processed spinach (e.g., frozen and canned spinach) is also not implicated in this outbreak.

When was the onset of the first illness related to this outbreak?
The first illness associated with this outbreak occurred on August 2, 2006, although most illnesses reported to date cluster with onsets from August 26 - September 12, 2006.

When did FDA first receive information regarding the current outbreak?
FDA first became aware of the current outbreak on September 13, 2006. FDA will continue to release additional information as it becomes available.

Who is investigating the current outbreak?
FDA continues to work closely with the U.S. Centers for Disease Control and Prevention (CDC) and state and local health departments to determine the cause and scope of this outbreak.

Have there been previous outbreaks involving fresh spinach?
Yes. A previous outbreak involving fresh spinach occurred in California in October of 2003. Sixteen (16) cases of illness were reported and two (2) people died. The causative agent was E. coli O157:H7.

How is the cause or source of an E. coli O157:H7 outbreak determined?
In the current spinach E. coli O157:H7 outbreak, the fact that illnesses are so dispersed (over 25 states to date) suggests that the contamination likely happened early in the distribution chain. The investigation into the possible source and cause of contamination is ongoing, including on the farm and in processing plants.

Where in the farm to table continuum is fresh produce most likely to become contaminated? What are the potential sources for produce contamination?
FDA's 1998 Guide to Minimize Microbial Contamination of Fresh Fruits and Vegetables (also referred to as the Good Agricultural Practices (GAPs) guide) describes potential sources of microbial contamination in the field and packing house environments and makes broad scope recommendations for how to reduce or minimize opportunities for contamination.

According to the GAPs guide, areas that should be considered to minimize the potential for the microbial contamination of produce include: agricultural water (e.g., for irrigation or crop protection sprays); wild and domestic animals; worker health and hygiene; the production environment (use of manure, previous land use, and use of adjacent land); post harvest water quality (water used to wash or cool produce) and sanitation of facilities and equipment. Our experience in outbreak investigations since 1998 points to the importance of these areas as being significant to avoid contamination of fresh produce at the farm or packinghouse. We also know that there is still a substantial need for additional produce safety research.

FDA focused on the farm and packing facilities because of a need to raise awareness about food safety at these stages of the supply chain. FDA's 2004 Produce Safety Action Plan, however, recognizes that contamination can happen at any point in the supply chain.

Recall Q and A
What companies and brands are included in the voluntary recalls issued as a result of the current outbreak?
On 9/22/06, Pacific Coast Fruit Company of Portland, Oregon initiated a voluntary recall of its spinach salad products and pizza that may include spinach supplied by Natural Selections Foods, a California grower and processor. These products may be contaminated with E. coli O157:H7. Products recalled were distributed through various retail outlets in Alaska, Oregon, Washington and Idaho and include: Baby Spring Mix Salad Kit (4.6 lbs), Chef on the Run- Bacon Spinach Salad (9oz plus 2fl oz dressing), Chef on the Run-Spring Greens Salad (5oz plus 2fl oz dressing), Trader Joe's-Baby Spinach and Greens with Bleu Cheese, Candied Pecans and Cranberries with Raspberry Vinaigrette Dressing (10oz), Trader Joe's-Baby Greens and Spinach Salad with Wild Maine Blueberry Dressing (10oz), Mediterranean Veggie Blend Kit- 15lbs and My Brotheres Pizza Spinach and Garlic- 15oz and 36oz. Salad products were distributed on "clam shells" and will have a "USE BY DATE" of on or before September 20, 2006. Pizza products were distributed on "round cardboard bottoms with a plastic over wrap" and will have a "USE BY DATE" of on or before September 23, 2006. Pacific Coast Fruit Company discontinued making all products with spinach supplied from California on September 14, 2006.

On 9/22/06 Triple B Corporation, doing business as, S.T. Produce of Seattle, Washington initiated a northwest states voluntary recall of certain salad products that may contain spinach with a "Use By" date of 8/22/2006 thru 9/20/2006. Spinach used in these products may have been supplied from Natural Selections Foods, a California grower and processor, to S.T. Produce. This recall was initiated subsequent to an announcement by Natural Selections Foods of a nation-wide recall of all their products that contain spinach because they may be contaminated with E. coli 0157:H7. The recalled products were distributed in Washington, Oregon, Idaho and Montana to retail stores and delis. The salad products were sold in a hard plastic clamshell container with the "Use By" date located on the bottom of the container. The products being recalled include: NWG Spinach Salad (5 oz.), Spinach Salad, QFC (5 oz.), Charlie's Spinach Salad (5 oz.), Charlie's Tabouli & Goat Cheese Salad (10 oz.), NWG Tabouli & Goat Cheese Salad (10 oz.), Tabouli & Goat Cheese Salad, QFC (10 oz.), T/H Spring Mix Salad (5.5 oz.), T/H Mozzarella Spring Mix Salad (5.5 oz.), T/H Baby Spinach Salad (5.5 oz.), Walnut and Blue Cheese Salad w/ Grilled Chicken Breast (6.5 oz.), Larry's Market Tabouli & Goat Cheese Salad (10 oz.), Charlie's Seasonal Greens Salad (2.5 oz.), Charlie's Seasonal Greens Salad (4 oz.), Charlie's Baby Spinach Salad (6 oz.), Charlie's Baby Spinach Salad (5oz), and Caesar Bowtie Noodle Salad Kit with Grilled Chicken Breast (6.9lbs).

On 9/17/06, River Ranch, of California, announced a voluntary recall of spring mix containing spinach. River Ranch obtains bulk spring mix containing fresh spinach from Natural Selections for processing and packaging. The following brand names are included in the River Ranch recall: Fresh N' Easy Spring Mix and Hy-Vee Spring mix containing baby spinach, distributed to retailers in Texas, Iowa, New Mexico, Georgia and Ohio. The River Ranch product included in the recall is packed in 5 oz. bags and 5 oz. plastic trays.

On 9/19/06 RLB Food Distributors of West Caldwell, New Jersey, announced a voluntary recall that may contain spinach from Natural Selection Foods. All the products recalled by RLB have an "Enjoy Thru date of 9/20/06 or before." The products are: Balducci's Mesclun Mix, Balducci's Organic Baby Spinach, Balducci's Mixed Greens, FreshPro Mesclun Mix, FreshPro Organic Baby Spinach, FreshPro Mixed Greens, FreshPro Salad Mix with Italian Dressing, and FreshPro Salad Mix with Ranch Dressing. The recalled products were distributed in Connecticut, New York, New Jersey, Pennsylvania, Maryland, Delaware, Virginia and Washington DC.

On 9/15/06, Natural Selection Foods, LLC, of San Juan Bautista, California announced a voluntary recall of all products that contain fresh spinach with "Best if Used by Dates" of August 17, 2006 through October 1, 2006. (See additional information about brands associated with Natural Selection Foods below). Other companies and brands of fresh spinach and fresh spinach containing products may also be involved in this outbreak; FDA and CDC continue to investigate this possibility.

Natural Selection Foods, LLC 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, Compliments, Trader Joe's, Ready Pac, Jansal Valley, Cheney Brothers, D'Arrigo Brothers, Green Harvest, Mann, Mills Family Farm, Premium Fresh, Pro-Mark, Snoboy, The Farmer's Market, Tanimura & Antle, President's Choice, Cross Valley, and Riverside Farms.

Government Activities Relative to Produce Safety Q and As
Is the government conducting investigations and tests?
Yes. The federal (principally CDC and the FDA) and state governments are working together to analyze samples from ill persons and product samples in an attempt to quickly identify the source(s) of the outbreak.

The outbreak strain of E. coli O157:H7 from ill persons is being "fingerprinted" at public health laboratories around the country, as part of PulseNet (the network of public health laboratories that sub-type bacteria). All E. coli O157:H7 strains associated with this outbreak have the same "fingerprint" (DNA pattern).

Farm investigations are in progress, focusing on fields associated with the production lots/brands implicated in illnesses as identified from available epidemiological data. Numerous samples have been collected to date including water, soil, sediment and other materials of environmental interest. These samples are being analyzed by FDA and state laboratories.

What steps has FDA taken to reduce the potential for outbreaks, specifically E. coli O157:H7 outbreaks, associated with raw produce?
The FDA developed the Lettuce Safety Initiative in response to recurring outbreaks of E. coli O157:H7 in lettuce. The primary goals of the initiative are to reduce public health risks by focusing on the product, agents and areas of greatest concern and to alert consumers early and respond rapidly in the event of an outbreak. On August 24, 2006, the State of California Department of Health Services and Department of Food and Agriculture and the FDA met with industry and academia to further clarify the goals, objectives and the next steps for the Lettuce Safety Initiative. This meeting was facilitated by the Western Institute for Food Safety and Security. This initiative is based on the 2004 Produce Safety Action Plan, intended to minimize the incidence of food borne illness associated with the consumption of fresh produce.

Since 1995, there have been 19 outbreaks of foodborne illness caused by E. coli O157:H7 for which lettuce or leafy greens were implicated as the outbreak vehicle. Although tracebacks to growers were not conducted (or "not conclusive") in all of the outbreak investigations, a majority of the outbreaks, including the recent outbreak in September of 2005, traced product back to California, many of which were from the Salinas Valley, though not exclusively.

Does FDA issue assignments to sample and test domestic and foreign produce?
FDA regularly issues assignments to sample both domestic and foreign fresh produce items. Reports of those assignments are posted on FDA's website.

Has FDA conducted outreach/education activities regarding fresh produce safety?
FDA has the lead for foreign GAPs education/outreach and has been working with a number of food safety partners in other countries, and in the U.S., on a variety of programs targeted at the safety of fresh produce. FDA's produce safety action plan, instituted in 2004 and ongoing, contains four main objectives and many specific milestones to address produce safety, including outreach and education activities. Additionally, FDA has been distributing information materials in English and Spanish on the safe handling of raw produce and fruit and vegetable juices to health educators and state and local health agencies. FDA in conjunction with the Produce Marketing Association and the Partnership for Food Safety Education developed a multi-faceted national produce handling education campaign. Launched two years ago, this education program utilizes the media, food safety advocates and Partnership members to communicate safe handling recommendations about produce to consumers.