At E. Coli Hunt's End, A Safety Standards Gap

It took exactly 14 days from the time state health officials in Wisconsin noticed five cases of E. coli O157:H7 in the same county until investigators arrived Wednesday at a field in California's Salinas Valley in search of the bacteria that ended up in bagged spinach and sickened 157 people in 23 states.

The outbreak -- the largest, in terms of victims, caused by fresh produce -- has exposed strengths and weaknesses in the highly fragmented U.S. food safety system. And the extent of it has federal officials talking about imposing tougher regulation.

"There are good agricultural practices out there. . . . The question that will be addressed is: Are they adequate? Are they being followed? Does the industry need to be further regulated to be safe?" said David W. Acheson, a top Food and Drug Administration food safety official.

Even as public health officials have gotten better at identifying the onset of illness borne by raw fruits and vegetables, the rules and procedures to prevent those outbreaks remain weaker than those for meat and poultry, consumer advocates and food safety experts said. And their enforcement relies on the voluntary efforts of growers and processors, and on the FDA, which has responsibility for much of the food supply but nowhere near the authority or resources devoted to the monitoring of meat and poultry.

"The FDA is acting like the fire department after the fire has already started," said Caroline Smith DeWaal, director of food safety for the Center for Science in the Public Interest.

Public health officials have sought to contain E. coli O157:H7, which over the past 20 years has turned up in hamburgers, alfalfa sprouts, apple juice, cheese and lettuce. Escherichia Coli is normally found in the digestive tracts of humans and warm-blooded animals, but the rare and particularly toxic strain, E. coli O157:H7, damages the intestinal lining, leading to internal bleeding and organ failure. It can be fatal, especially for the very young and old. The latest outbreak killed a 77-year-old woman in Wisconsin.

Wisconsin public health officials were the first to sound the alarm on the current outbreak and call in the federal government, after receiving a report on Sept. 5 of five E. coli cases in Manitowoc County, located between Green Bay and Milwaukee. It later turned out that only one of those cases was linked to the tainted spinach; the others were traced to a local fair. But the initial cluster helped put state epidemiologists on high alert two days later when they learned of five more cases in the southeastern part of the state.

In those five, all of the victims had come down with Hemolytic Uremic Syndrome, a condition caused by E. coli that leads to kidney failure. On Sept. 8, Wisconsin officials notified the Centers for Disease Control and Prevention in Altanta and shared the DNA fingerprint of the E. coli strain with PulseNet, an 11-year-old network of public health labs operated by the CDC that has become instrumental in uncovering outbreaks of food-borne illness.

By Sept. 13, detailed interviews with seven of the victims led Wisconsin officials to believe there was a link with spinach, Department of Health and Family Services spokesman Jason Helgerson said. Through the CDC, they learned Oregon officials had reached the same conclusion. With spinach suspected as the culprit, the CDC called in the FDA.

On Sept. 14, the CDC held a conference call with several states reporting cases of E. Coli O157:H7. That evening, the FDA issued its initial warning to consumers not to eat bagged fresh spinach.

The next day, last Friday, the FDA, based on information gathered from victims, narrowed down the search to Natural Selection Foods, which processes spinach used by 30 different brands, and broadened its warning to include all fresh spinach, loose and bagged.

Using supplier and distribution records at Natural Selection, the FDA confirmed California as the source of the contamination on Tuesday. The next day, about a dozen FDA and California state investigators descended on a farm in the Salinas Valley, the first of nine farms they had singled out through records.