CDC Health Advisory Notices & Announcements
CDC Update on Current E. coli Situation, September 26
By Center for Disease Control and Prevention
Sep 27, 2006, 07:56

Update on Multi-State Outbreak of E. coli O157:H7 Infections From Fresh Spinach, September 26, 2006

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As of 1 PM (ET) September 26, 2006, Tuesday, 183 persons infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 26 states.

Among the ill persons, 95 (52%) were hospitalized, 29 (16%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS), and an adult in Wisconsin died. One hundred thirty-one (72%) were female and 17 (9%) were children under 5 years old. The proportion of persons who developed HUS was 30% in children (<18 years old), 8% in persons 18 to 59 years old, and 15% in persons 60 years old or older. Among ill persons who provided the date when their illnesses began, 85% became ill between August 19 and September 5. The peak time when illnesses began was August 30 to September 1 -- 33% of persons with the outbreak strain became ill on one of those 3 days.

View enlarged map to see the number of persons reported with the outbreak strain from each state

Two deaths among suspect cases have been reported. Suspect cases are not known to have been infected with the outbreak strain, so are not included in the confirmed case count. Idaho is investigating a suspect case in a 2-year-old child with HUS who died on September 20 and reportedly had recently consumed fresh spinach. E. coli O157 has not been detected in the child. Maryland is investigating a suspect case in an elderly woman who died on September 13 and had recently consumed fresh spinach. E. coli O157 was cultured from her stool, but “DNA fingerprinting” to determine whether it is the outbreak strain has not been possible.

E. coli O157 was isolated by state public health laboratories in Pennsylvania, Illinois, and Ohio from three more opened packages of spinach. The “DNA fingerprint”of the strain isolated in Pennsylvania matches that of the outbreak strain. “DNA fingerprinting” is underway on the strains isolated in Illinois and Ohio.

CDC Advice for Consumers

The following is advice for consumers about this outbreak:

• Currently, we are advising consumers to not eat any fresh spinach or salad blends containing spinach grown in the three counties in California implicated in the current E. coli O157:H7 outbreak -- Monterey County, San Benito County, and Santa Clara County (see map of affected counties). Fresh spinach grown outside these counties can be safely eaten. Spinach grown in these counties is often packaged in other areas of the country. If consumers cannot tell where fresh spinach was grown, they are advised not to purchase or consume the fresh spinach. Frozen and canned spinach can be safely eaten.
  
  
• E. coli O157:H7 in spinach can be killed by cooking at 160° Fahrenheit for 15 seconds. (Water boils at 212° Fahrenheit.) If spinach is cooked in a frying pan, and all parts do not reach 160° Fahrenheit, all bacteria may not be killed. If consumers choose to cook the spinach, they should not allow the raw spinach to contaminate other foods and food contact surfaces, and they should wash hands, utensils, and surfaces with hot, soapy water before and after handling the spinach.
  
  
• Persons who develop diarrhea after consuming fresh spinach or salad blends containing fresh spinach are urged to contact their health care provider and ask that their stool specimen be tested for E. coli O157.
  
  
• Persons who ate fresh spinach or salad blends and feel well do not need to see a health-care provider.

More Information

For more information about the outbreak, about the investigation, and for prevention guidance, see E. coli O157:H7 Outbreak from Fresh Spinach.