E. Coli Victims Now Total 109; CDC Joins Probe

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The number of people sickened by the E. coli outbreak linked to contaminated spinach from California's Salinas Valley has risen to 109 people in 19 states, while officials from the U.S. Centers for Disease Control and Prevention said they have joined the investigation.

CDC officials said Sunday that they've started an emergency operations center in Atlanta to assist state health agencies with testing for E. coli, which has also been blamed for the death of a 77-year-old woman in Wisconsin. The center is assisting state agencies that can't perform the tests or when a second opinion is needed, agency spokeswoman Lola Russell told the Associated Press.

Epidemiologists are helping test spinach samples and stool samples of those who have been infected, Russell said.

Meanwhile, the U.S. Food and Drug Administration has broadened its warning about eating spinach to include unpackaged, loose spinach or any product containing spinach as it continues to investigate other sources of the E. coli bacterium.

"FDA advises consumers to not eat fresh spinach or fresh spinach-containing products until further notice," the agency said in its latest update on its Web site.

On Saturday, the government identified a California produce company as a possible source of the tainted spinach as the outbreak of illness widened to 19 states, with more than 100 victims, many of them in Wisconsin.

Natural Selection Foods of San Juan Bautista began recalling all of its prepackaged spinach and its salad mix products that contain spinach in all brands packed with "Best If Used By" Dates of Aug. 17, 2006, through Oct. 1, 2006.

The investigation is continuing, the FDA said in a consumer alert on its Web site, and Natural Selection Foods may not be the only source of the E. coli O157:H7.

Fourteen of the victims have developed a form of kidney failure called Hemolytic Uremic Syndrome, the agency reported.

"We're clearly evolving, and it is very important to keep an open mind whether there are other products potentially implicated," Dr. David Acheson, the chief medical officer with the FDA's Center for Food Safety and Applied Nutrition, told the AP.

According to the FDA, Natural Selection Foods supplies its spinach to the following brands that package it:

Dole, Earthbound Farm, Natural Selection Foods, Pride of San Juan, Bellissima, Rave Spinach, Emeril, Sysco, O Organic, Fresh Point, River Ranch, Superior, Nature's Basket, Pro-Mark, Compliments, Trader Joe's, Ready Pac, Jansal Valley, Cheney Brothers, Coastline, D'Arrigo Brothers, Green Harvest, Mann, Mills Family Farm, Pro*Act, Premium Fresh, Snoboy, The Farmer's Market, Tanimura & Antle, President's Choice, Cross Valley and Riverside Farms.

Because the tainted spinach could have been included in packaged green salads that have spinach, the FDA is now warning that those products also might be contaminated.

Consumers should throw away any fresh packaged spinach they may have bought in the past few weeks and not buy more until the warning is lifted, the agency said. It also said that washing the spinach won't help because the bacteria is too tightly attached.

Natural Selection announced Sunday that its work with federal and state heath inspectors confirmed that the contamination did not come from its organic spinach. The company produces both organic and conventionally grown spinach in separate areas at its San Juan Bautista plant, the AP said.

The states reporting cases of illness now include: California, Connecticut, Idaho, Indiana, Kentucky, Maine, Michigan, Minnesota, Nevada, New Mexico, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington, Wisconsin, and Wyoming.

The affected products were also distributed to Canada and Mexico, the FDA said.

The one death occurred in Wisconsin, which has 29 cases statewide. Friday night, the AP reported, the victim was identified as Marion Graff, 77, of Manitowoc. Her son said she died of kidney failure Sept. 7.

"We are very, very upset about this," Natural Selection Foods spokeswoman Samantha Cabaluna told the AP. "What we do is produce food that we want to be healthy and safe for consumers, so this is a tragedy for us."

The company has supplied a phone number -- l-800-690-3200 -- for a refund or replacement coupons.

The FDA said the first cases of infection apparently surfaced on Aug. 23, and the most recent one was reported Sept. 3. But it wasn't until last Wednesday that the agency was able to identify bagged spinach as the possible cause.

Dr. Robert Brackett, director of the FDA's Center for Food Safety and Applied Nutrition, cautioned that anyone who believes he or she has the symptoms of E. coli poisoning should contact a doctor.

According to the U.S. Centers for Disease Control and Prevention, E. coli lives in the intestines of cattle and other animals and is linked to contamination by fecal material. It can be found in undercooked meats and other foods, such as spinach, sprouts, lettuce, unpasteurized milk and juice.

The primary symptom of E. coli contamination in humans is diarrhea, often with bloody stools. While most adults recover completely, the bacteria is particularly harmful to the very young, the very old, and those with compromised immune systems. In more serious cases, potentially fatal kidney failure can develop.

E. coli causes an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to CDC statistics.