Spinach-associated Escherichia coli O157:H7 Outbreak, Utah and New Mexico, 2006

Source of Article: http://www.cdc.gov/ncidod/eid/

Juliana Grant, Aaron M. Wendelboe,1 Arthur Wendel, Barbara Jepson, Paul Torres, Chad Smelser, and Robert T. Rolfs

Author affiliations: Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA (J. Grant); Centers for Disease Control and Prevention, Atlanta (A.M. Wendelboe, A. Wendel); Wisconsin Department of Health and Human Services , Madison, Wisconsin, USA (A. Wendel); New Mexico Department of Health, Santa Fe, New Mexico, USA (A.M. Wendelboe, P. Torres, C. Smelser); and Utah Department of Health, Salt Lake City, Utah, USA (B. Jepson, R.T. Rolfs) 1Current affiliation: University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

In 2006, Utah and New Mexico health departments investigated a multistate cluster of Escherichia coli O157:H7. A case–control study of 22 case-patients found that consuming bagged spinach was significantly associated with illness (p<0.01). The outbreak strain was isolated from 3 bags of 1 brand of spinach. Nationally, 205 persons were ill with the outbreak strain.

On September 13, 2006, health officials from several states independently notified the Centers for Disease Control and Prevention (CDC) about clusters of Escherichia coli O157:H7 infections and a suspected association with spinach. E. coli O157:H7 expresses 1 of 2 types of Shiga toxin and can cause severe gastrointestinal infections and hemolytic uremic syndrome (HUS).

A multistate outbreak investigation, involving 26 states, was initiated on September 14. The US Food and Drug Administration (FDA) and CDC advised consumers not to eat bagged spinach (1,2). The Utah (UDOH) and New Mexico Departments of Health conducted a case-control study to characterize the outbreak and a laboratory investigation to test spinach eaten by case-patients for contamination. This report focuses on the investigation conducted in the 2 states.

The case definition for a laboratory-confirmed illness was culture-confirmed E. coli O157:H7 infection in a Utah or New Mexico resident with illness onset during August 1, 2006–October 1, 2006, and a pattern of Xba EXHX01.0124 shown by pulsed-field gel electrophoresis (PFGE). This urgent outbreak investigation did not require institutional review board approval.

Read whole article: http://www.cdc.gov/eid/content/14/10/pdfs/07-1341.pdf

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