Q: The E. coli spinach outbreak really caught my attention. What exactly is E. coli O157:H7?

A: E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli.

Although most strains are harmless and live in the intestines of healthy humans and animals, this strain produces a powerful toxin and can cause severe illness. E. coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of severe bloody diarrhea; the outbreak was traced to contaminated hamburgers. Since then, most infections have come from eating undercooked ground beef.

The E. coli O157:H7 bacterium 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 one 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. An estimated 73,000 cases of E. coli O157:H7 infection and 61 deaths occur in the United States each year.

Q: What is the source of E. coli O157:H7 and what other foods are typically involved in E. coli outbreaks?

A: The source of E. coli O157:H7 is animals (particularly found in the intestinal tracts of cattle and humans) and raw, unpasteurized milk. Foods typically involved in E. coli O157:H7 outbreaks include raw and undercooked ground beef, unpasteurized milk and apple cider/juice, beef, improperly cured dry salami, spinach, lettuce, nonchlorinated water and alfalfa sprouts.

Q: When did the first illness related to this latest outbreak occur?

A: The first illness connected to this outbreak thus far began Aug. 2, although most illnesses reported to date cluster with onsets from Aug. 26 to Sept. 9.

Q: So does that mean we should stop eating bagged spinach?

A: Right now, the Food and Drug Administration advises that people not eat any fresh spinach or salad blends containing fresh spinach that are consumed raw.

As you probably read in the Journal-World on Sept. 18, Natural Selection Foods LLC, of San Juan Bautista, Calif., is recalling all of its products that contain fresh spinach in all the brands they pack with “Best if Used by Dates” of Aug. 17 through Oct. 1. Products include fresh spinach and any salad blend containing fresh spinach. Products that do not contain fresh spinach are not part of this recall.

Another company, River Ranch, of California, is currently recalling its spring mix containing spinach. River Ranch obtained bulk spring mix containing spinach from Natural Selections. Individuals who believe they may have experienced symptoms of illness after consuming fresh spinach or salad blends containing fresh spinach are urged to contact their health care provider. However, in the long run … the nutritional benefits of eating any leafy greens outweigh the risks. Always practice good food handling practices such as:

¢ Wash your hands before handling food.

¢ Avoid cross contamination with raw meats/juices.

¢ On bagged salads, pay attention to the sell-by dates. These do not last forever, so if the date has passed, toss it.

¢ If the salad is turning brown, slimy, has an off odor, toss it.

¢ While these salads are ready-to-eat, it doesn’t hurt to wash them again at home before using. That is a consumer choice.

Q: Can we still eat “organic” bagged fresh spinach or salad blends containing fresh spinach?

A: No, the advice “not to eat any fresh spinach or salad blends containing fresh spinach” applies to both organic and nonorganic bagged products.

Q: If we currently have bagged fresh spinach in the frig, can’t we just wash it?

A: Washing with running water has been proven to be effective in removing dirt and bacteria. However, heat is the best method of killing bacteria. E. coli O157:H7 in spinach can be killed by cooking at 160 degrees for 15 seconds. If consumers choose to cook the spinach they should follow these cooking instructions and also remember to take steps to avoid cross-contamination of the fresh spinach with other foods and food contact surfaces and to wash hands, utensils and surfaces with hot, soapy water before and after handling the spinach.

Q: What steps has FDA taken to reduce the potential for outbreaks, specifically E. coli O157:H7 outbreaks, associated with raw produce?

A: 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. 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.