3. 2006. THE SPINACH E coli CRISIS

Readers of this guest series on the three seminal moments (in my opinion) in food safety in the U.S. will note that this moment occurred 100 years after the publishing of Upton Sinclair’s The Jungle. It created a crisis of confidence in produce safety and forever changed our thinking about sources of foodborne illnesses.

State health officials in Oregon and Wisconsin notified the CDC on Sept. 8 and 13, 2006, that they had E. coli O157:H7 outbreaks from an unknown source. The two states had identical strains noted by PFGE testing, that new lab aid created as a result of the Jack in the Box disaster. The first reported consumption of tainted lettuce was Aug. 19, and the majority of illnesses presented between Aug. 30 and Sept. 1.

With two states so geographically separated, it was immediately apparent this could not be caused by fresh ground beef, and no infected persons reported eating frozen ground beef. Another source was needed to be identified if this was to be controlled quickly.

The outbreak quickly grew to over 200 persons in 26 states, ranging from California to Maine, with an unusually high total of 51% hospitalized. Three deaths would eventually be confirmed and 31 (16%) would develop hemolytic uremic syndrome, which may lead to chronic renal failure.

On Sept. 15, the FDA warned citizens “don’t eat any bagged spinach,” a very unusually quick and far-reaching move for that agency. The culprit had been quickly found, but the exact source would not be identified until Sept. 29 — still an amazingly rapid feat accomplished with the help of PFGE.

The location turned out to be 50 acres in the Salinas Valley of California, leased to a spinach grower by an Angus cattle ranch. The cattle were located uphill from the row crops with potential for run off. Cattle manure, wild pig feces, a creek running between the feed lot and the spinach all tested positive for the exact E. coli strain as in the infected humans. The location became the epicenter of a national disaster in the making.

There had been nine leafy greens-associated foodborne illness outbreaks linked to the Salinas Valley growers since 1995, but none were this serious, and none gathered the public’s attention nor that of Congress. Like The Jungle and Jack in the Box forced changes, this outbreak would also create massive changes in the produce industry.

In 2005, it was common thinking that an E. coli O157:H7 outbreak was probably linked to ground beef. In fact, 47% of E. coli outbreaks that year were linked to beef, and only 21% for produce and 25% “unknown."

In 2014, CDC reported beef and row crops as being equal contributors to E. coli O157:H7 foodborne illness outbreaks at 41% each.

In 2021 CDC reporting, 62% of E. coli outbreaks were associated with leafy greens, and only 20% with ground beef.

These changes are no doubt partially attributed to changes made in the beef industry and FSIS inspection practices after the Jack in the Box outbreak in 1993; but they also are indicative of improved investigating of foodborne illness outbreaks and increased awareness of other sources.

Sandra Eskin is now the current Deputy Undersecretary for Food Safety at the USDA, but in 2006 she was doing food safety at the Pew Charitable Trust. At that time, she said, “You look up at that hill, and I think the problem is staring right at you.”

My favorite quote, however, comes from Nancy Donlin, who was the Executive Director of STOP when I was at the USDA. Nancy lost her only son to an E. coli O157:H7 infection and is passionate about the need to make our food safer. She said:

“When you investigate an E. coli O157:H7 outbreak long enough, and hard enough, you will eventually bump into a cow.”

Three Seminal Moments in Food Safety in the U.S., Part 3

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