Sober warnings for salad lovers came from U.S. health officials as they struggled to pinpoint a E. coli outbreak that killed one person and sickened nearly 100 more in 19 states.
Bagged spinach — the triple-washed, cello-packed kind sold by the hundreds of millions of pounds each year — is the suspected source of the bacterial outbreak, Food and Drug Administration officials said Friday.
The FDA warned people nationwide not to eat the spinach. Washing will not get rid of the tenacious bug, though thorough cooking can kill it. Supermarkets across the country pulled spinach from shelves, and consumers tossed out the leafy green.
"We're waiting for the all-clear. In the meantime, Popeye the Sailor Man and this family will not be eating bagged spinach," said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University. The Tennessee university's medical center was treating a 17-year-old Kentucky girl for E. coli infection.
The FDA said late Friday that the outbreak had been linked to bagged spinach products distributed by Natural Selection Foods, based in San Juan Bautista, California. The company has agreed to recall its bagged spinach products and has stopped shipping them.
FDA officials stressed that the bacteria had not been isolated in products sold by Natural Selection Foods but that the link was established by patient accounts of what they had eaten before becoming ill.
An investigation was continuing.
By Friday, the outbreak had grown to include at least 20 states: California, Connecticut, Idaho, Indiana, Kentucky, Maine, Michigan, Minnesota, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington, Wisconsin and Wyoming, according to the Centers for Disease Control and Prevention.
Wisconsin accounted for 29 illnesses, about one-third of the cases, including the lone death.
The bug has sickened at least 94 people across the U.S., the CDC said. The agency added that 29 people have been hospitalized, 14 of them with kidney failure.
Initial suspicions focused on California's Monterey County. Farmers there grow more than half the United States' 500 million-pound spinach crop, according to the Agriculture Department.
"We're trying to get to the bottom of this and figure out what happened. Everybody is terribly concerned," said Dave Kranz, a spokesman for the California Farm Bureau Federation.
The FDA's top food expert stressed the importance of stopping the bacterium at its source, since rinsing spinach won't eliminate the risk. "If you wash it, it is not going to get rid of it," said Robert Brackett, director of the agency's Center for Food Safety and Nutrition.
E. coli lives in the intestines of cattle and other animals and typically is spread through contamination by fecal material. 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.
Local doctors began seeing the first of the ongoing E. coli poisoning cases in late August. The Centers for Disease Control and Prevention and Wisconsin health officials alerted the FDA about the outbreak at midweek.
Not all strains of E. coli cause illness: E. coli O157:H7, the strain involved in the current outbreak, was first recognized as a cause of illness in 1982. That strain causes an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to the CDC.
When ingested, the bug can cause 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.
Sources of the bacterium include uncooked produce, raw milk, unpasteurized juice, contaminated water and meat, especially undercooked or raw hamburger.