Now that we know tainted spinach has been bought and eaten in Pima County, the warning remains the same — eat no fresh spinach. Throw it away.
Arizona has joined the growing list of states — up to 23 — where cases of severe E. coli intestinal infection blamed on bad spinach have been found, with state test results announced Wednesday.
Five patients — including one 71-year-old Tucson man — were confirmed sick from eating spinach laced with the potent bacteria, with more cases likely to come, say state health officials.
All five — two adults and three children — were hospitalized with severe illness. Four have fully recovered, but one child remains in the hospital, in Maricopa County. Other affected counties are Yuma and Yavapai.
At least four other E. coli infections from Pima County are being tested at the state laboratory, to determine if they are the virulent O157 strain linked to the tainted spinach, and if they carry the specific genetic data to confirm that source.
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Since the nationwide outbreak of spinach-caused poisonings erupted a week ago, 146 people have been stricken in the 23 states, with half of those hospitalized, including several cases of kidney failure and one death.
Arizona and Colorado joined the list of states Wednesday.
But with all fresh spinach and spinach-containing salads pulled off grocery shelves and out of restaurants, the only concern now is people who still have the vegetable in their refrigerators and have not heard the warning.
"I really think the word is out there now. Wherever I go, it's all people are talking about — the spinach they can't eat," sad Dr. Michelle McDonald, Pima County's chief medical officer.
"So now we're on the list of states, but the message is no different — don't eat any fresh spinach, and throw away all bagged and fresh spinach you may still have, including mixed greens that contain it."
The elderly Pima County victim, who remains unidentified, had several open bags of fresh spinach in his refrigerator, which were purchased at different stores within the Tucson area, county investigators found.
"At this point, we are unable to determine which bag made him sick. So we can't yet identify where it was bought, or which brand it was," McDonald said.
However, in a break that could help isolate the source of the outbreak, New Mexico's state lab did identify E. coli in an opened bag of Dole brand baby spinach at the home of one of that state's victims.
That find could help narrow the hunt for the source of the contamination to a specific producer or processor. Dole is one of the 34 fresh spinach brands recalled by Natural Selection Foods, of California's Salinas Valley. Nearly 75 percent of the nation's fresh spinach crop is grown in that region, now under intense federal scrutiny.
FDA inspectors began visiting California farms this week, seeking signs of past flooding that may have contaminated irrigation water, or tainted surfaces that came in contact with crops. They are also looking for potential sources of bacteria inside packing plants.
What has health officials especially concerned is the potency of the spinach-linked strain of E. coli, which is hospitalizing victims at twice the rate of other E. coli outbreaks and causing kidney failure at triple the expected numbers, according to the Centers for Disease Control and Prevention.
The primary symptom of E. coli infection is watery and sometimes bloody diarrhea, also nausea, vomiting and abdominal cramps. Children younger than 5, the elderly and those with compromised immune systems are most at risk for severe illness.
Although case reports are still coming in around the U.S., most — including those in Arizona — occurred earlier this month and are only now being confirmed. Consumers are no longer being exposed to contaminated spinach, and no one appears to have fallen ill since Sept. 5, according to the CDC.
The Pima County patient became sick Sept. 3. The suspect case was reported to the Health Department on Sept. 8, when the investigation was begun.
In addition to Arizona and Colorado, other affected states are California, New Mexico, Utah, Nevada, Connecticut, Idaho, Illinois, Indiana, Kentucky, Maine, Michigan, Minnesota, Nebraska, New York, Ohio, Oregon, Pennsylvania, Virginia, Washington, Wisconsin (reporting most cases and the one death) and Wyoming.
On StarNet: View a photo slideshow documenting the recent E. coli outbreak at azstarnet.com/slideshows
Do not eat, but throw away all fresh, including bagged, mixed greens that may contain spinach.
l Wash all fruits and vegetables thoroughly, especially if they are eaten raw.
l Keep raw meats separated from ready-to-eat foods.
l Cook all ground beef thoroughly.
l Wash hands, food-preparation surfaces and utensils with hot, soapy water after contact with raw meat.
l Eat only ground beef or hamburger that has been cooked thoroughly.
l Drink only pasteurized milk, juice or cider.
