|Originally Aired: September 18, 2006
More Cases of Contaminated Spinach Reported Across Country
|Over one-hundred people in at least twenty-one states have become sick by eating spinach contaminated with E. coli bacteria according to the Food and Drug Administration, which advised consumers not to eat any fresh spinach until further notice.|
MARGARET WARNER: The E. coli outbreak linked to spinach
spread to two more states today, bringing the total number of states with
reported cases to 21. One person has died in Wisconsin, and more than 100 have fallen ill
nationwide as a result of exposure to the bacteria. A second death, of a
2-year-old in Ohio,
is under investigation.
E. coli can cause cramps, bloody diarrhea, and in some cases
damaged kidneys. More than 50 people have been hospitalized, some with kidney
The Food and Drug Administration says it still hasn't
positively confirmed the cause of the outbreak but believes it's related to
consumption of fresh-bagged greens that include spinach.
All the cases so far have been linked to the products of one
company, California-based Natural Selection Foods. The company has recalled 34
brands of greens for which it provides freshly washed spinach, including
Earthbound Farm and Dole.
The bacteria can be killed if spinach is cooked properly,
but washing alone is not effective. According to the Agriculture Department,
Americans consumed over 450 million pounds of fresh spinach in 2000. About
three-quarters of that comes from California.
And for more on the outbreak and the investigation, we're
joined by Robert Brackett. He's director of the FDA's Center for Food Safety
and Applied Nutrition.
And, Mr. Brackett, welcome. Give us an update on the
investigation. Where are you in determining and pinpointing how this outbreak
ROBERT BRACKETT, Food and Drug Administration: Well, we're
getting closer. Originally when we observed the outbreak, we noticed that it
was just from spinach. But at that time, it looked like it was just consumer
salad-sized spinach, bags of spinach. We've now sort of expanded that a little
bit more to include all sources of fresh spinach, so this would be the consumer-sized
bags, but in addition also perhaps the salad bars and other sort of salad
brands that might contain spinach.
Now, the reason why we expanded this is because, originally,
we thought it was just the bags, but during our investigation we found that
some of the companies that produced the implicated spinach also produced food
service-sized containers, bags of spinach, and also that some food service --
that is restaurants and supermarkets -- were practicing the technique of using
bagged spinach to sort of supplement their salad bars and their bulk bins.
So we wanted to make sure we cast a wider net so that the
public would be protected.
Pinpointing the problem
MARGARET WARNER: Explain to us, though, where in the chain,
from the field to the bags, to the retail outlets, this spinach could become
contaminated. And explain also where E. coli comes from.
ROBERT BRACKETT: Sure. Well, first, where E. coli comes
from, typically we see this in association with the gut of animals, mammals,
specifically ruminant animals such cattle or deer. In this particular case, of
course, it's with produce, so the first thing people think about, that there
must be some association with animals, but we haven't been able to find that.
It could have been contaminated anywhere from the point at
which the product was in the ground right up actually to where a consumer could
eat it. But the fact that it's so widely distributed around the country sort of
indicates that it's somewhere near the beginning.
So it could have been contaminated during production, in
which case perhaps contaminated water or animals or during harvest where an
infected worker may have come in contact with some repeatedly. It could have
also occurred at the processing plant where the product was actually bagged,
such that contaminated equipment may have been routinely contaminating these
MARGARET WARNER: How specifically have you been able to
pinpoint -- for instance, are all the cases linked to this one huge supplier,
this Natural whatever foods it was, Natural Selection Foods? Is it all from one
field? Can you get that specific?
ROBERT BRACKETT: Well, we'd like to be able to get that
specific, but it's very, very difficult. All we know is from, first of all, to
go back how we put these all together, there is a system run by CDC called
PulseNet, which is really a network of genetic fingerprinting. So when there is
a case in one of the states, and they go identify the bacteria and they do a
genetic fingerprinting of it, they send that to CDC. CDC then compares that to
all the other fingerprints that happen to be coming in.
So where you might have had just one case in one state and
two cases in another state, when CDC sees it, they can see the aggregate across
the country and they can see the pattern. And so that's how this was
discovered, actually quite quickly.
MARGARET WARNER: And it is just from one locale?
ROBERT BRACKETT: Well, we don't know. So now the tricky part
comes in actually looking to find out which companies were involved. And we're
pretty certain that it's California
and just the Salinas Valley of California.
But when we go back to the processor, the problem comes, how
do you know which field it came from? The problem here is that each of these
companies may source their product from perhaps a dozen different farms on a
given day. When you go, you have to go back through each one of those lines,
MARGARET WARNER: Sort of the way grape growers do, say, with
ROBERT BRACKETT: Yes. And the same is true on the farm end,
is that a particular farm may sell to a variety of different processors, so you
have to cast a wide net in order to include them all.
In the clear
MARGARET WARNER: Have you ruled out -- first of all, is
there any distinction between organic and inorganic? Because I gather this
company does both. And, secondly, are all the other lettuce categories, greens
ROBERT BRACKETT: We have no indication that any of the other
categories have any problems at all at this point, except for those that
contain the spinach. The other question was organic versus conventionally
grown. And at this point, there doesn't appear to be any difference between the
two. They're both sort of under suspicion at this time, but there doesn't look
to be any greater risk with one versus the other.
MARGARET WARNER: Now, how confident is the FDA that all
spinach is now off the shelves and out of restaurants? And then what does that
mean for -- I mean, we keep hearing about new cases. Are new people falling
ill, or is the reporting now catching up with people who fell ill, you know, a
week a two ago?
ROBERT BRACKETT: Well, I'll answer the second part first. And
the second that's, in fact, what is true.
What we're seeing, when we see these confirmed cases, is
that the lab work has already been done on patients who have become ill some
time back, in the last week or two weeks ago. So what we're seeing with these
additional cases, we think, unless this continues on, are really cases that
were in the confirmation pipeline, as it were.
MARGARET WARNER: So if a person, just in terms of consumer
help here, if a person has not eaten spinach since you did the first recall
back, the 13th, so five days ago, are they pretty much in the clear?
ROBERT BRACKETT: Yes. The incubation period for E. coli is
about, on the short end, one day and up to about five days. So if it's been
more than a week, the likelihood that they're going to become ill is pretty
Taking the industry to task
MARGARET WARNER: And let me ask you finally about FDA
detection, monitoring, inspection. This is certainly not the first case of E.
coli on greens. I think you've had some 19 cases...
ROBERT BRACKETT: That's correct.
MARGARET WARNER: ... what, since 1995? And you wrote a
letter last November saying, in light of continuing outbreaks, it is clear that
more needs to be done. What were you talking about? And was more done?
ROBERT BRACKETT: Well, more has been done, and that was --
the reason we sent that letter to the industry out there is because we did see
this recurring amount of E. coli. And this is a tragic sort of situation like
this. In this particular case, it's a tragedy especially for the victims, for the
growers who are losing the production, and also for the consumers.
But what we asked the industry to do is go back, take a
very, very critical look at what you're doing. Where could it possibly come
from? And so what they have done is such things as, for instance, gone back and
developed commodity-specific guidelines for how products should be handled, as
opposed to sort of generic good agricultural practices for all agricultural
Also, to invest in research, to figure out how this organism
survives in their environment, how it could be transferred. These are the sorts
of things that we were looking for and to make faster progress than had been
done before that.
MARGARET WARNER: But would you say the fact that this has
happened suggests fast enough progress has not been made?
ROBERT BRACKETT: Well, I think that's true. I think fast
enough progress has not been made. The big part there is we're really going to
need a lot of research to do this. But, in fact, we're going to have to take a
much more aggressive look at protecting the public.
MARGARET WARNER: All right, Robert Brackett, thank you so
ROBERT BRACKETT: Thank you.