FDA considers labeling spinach to ease E. coli fear

In Lucas County, a 26-year-old man became Ohio's 20th victim in the nationwide outbreak of E. coli infections stemming from contaminated spinach, the Toledo-Lucas County health department announced yesterday.

WASHINGTON - Federal health officials are considering place-of-origin labels on spinach to reassure shoppers jittery about an E. coli bacterial outbreak linked to leafy greens grown in California.

More explicit labeling was just one proposal under consideration for allowing fresh spinach back on the market, officials said yesterday. Others include stepped-up regulation of how spinach is grown and processed.

"Clearly, we do not want to deny consumers access to spinach," said Dr. David Acheson of the Food and Drug Administration's Center for Food Safety and Applied Nutrition. "Wherever it's grown, our responsibility is to make sure whatever does end up on the shelf is safe."

The outbreak had sickened 157 people, killing one, according to the Centers for Disease Control and Prevention. Idaho officials were investigating the death of a 2-year-old on Wednesday, reportedly after eating spinach, the CDC said.

In Lucas County, a 26-year-old man became Ohio's 20th victim in the nationwide outbreak of E. coli infections stemming from contaminated spinach, the Toledo-Lucas County health department announced yesterday.

Health officials said the man began experiencing symptoms of an Escherichia coli O157:H7 infection some 14 days before the national outbreak made news.

He is the first Lucas County resident with a confirmed infection and the third in northwest Ohio. Both Wood and Allen counties have had a single confirmed infection.

The man bought spinach Aug. 21 or 22, and was sick by Aug. 30. Symptoms of E. coli infections can include severe diarrhea, stomach cramps, gas, vomiting, and fever, and can sometimes lead to kidney failure and death.

On Aug. 2, the man went to a local emergency room. He was not admitted to the hospital, but treated by his physician, said Larry Vasko, deputy health director of the Toledo-Lucas County health department.

It is the only confirmed case in the county, Mr. Vasko said.

"We sent more than one lab specimen, so potentially, we could get a couple more. That wouldn't totally surprise me," he said.

Health officials became aware of the suspected E. coli case in the stepped-up surveillance that followed the national alert about contaminated spinach. The Lucas County infection was confirmed by DNA testing this week.

The county health department continues to monitor stores and restaurants to make sure raw spinach stays off the shelves, Mr. Vasko said.

E. coli bacteria are commonly found in the intestines of healthy humans and other mammals. The dangerous O157:H7 strain, however, produces a toxin and sickens some 150 people in Ohio each year.

Since the FDA announced the E. coli outbreak a week ago, the agency has urged people not to eat fresh, raw spinach.

Federal and state officials have traced the outbreak to contaminated spinach from California's Monterey, San Benito, and Santa Clara counties. The region produces more than half the nation's spinach crop.

A nationwide embargo on fresh spinach remains, enraging producers.

Dr. Acheson said it could take days to figure out a way to allow spinach from outside California's greater Salinas Valley back in stores and restaurants.

If labeling is the answer, one problem would be how to communicate to shoppers that the spinach came from an area not implicated in the outbreak, Dr. Acheson said.

A bag of tainted spinach in the refrigerator of a New Mexico patient was a "smoking gun" that allowed investigators to zero in on farms in the Salinas Valley.