3 Children In Md. Sick With E. Coli From Spinach

Hagerstown Woman's Death Is Investigated

An unidentified produce employee restocks the shelf of bagged lettuce at a grocery store in Berkeley, Calif. on Wednesday, Sept. 20, 2006. Amid a nationwide E. coli outbreak from bagged spinach, food safety experts say the advent of prewashed, packaged salad may encourage people to eat more leafy greens but could also create another avenue for illness-inducing bacteria. (AP Photo/Benjamin Sklar) (Benjamin Sklar - AP)

Maryland state health officials have attributed three cases of E. coli illness to a spinach-borne outbreak of the deadly bacterium and are investigating the death of an 86-year old Hagerstown woman who became ill with E. coli after eating bagged spinach.

The three confirmed victims are children, all of whom are recovering, Michelle A. Gourdine, an official of the Maryland Department of Health and Mental Hygiene, said yesterday. Gourdine would not identify the children or say where they live, citing confidentiality concerns. Virginia reported a second case of E. coli yesterday, but state health officials there declined to provide further details.

The outbreak of E. coli O157:H7, which has sickened 166 people in 25 states, has been traced to three counties in and around the Salinas Valley in California. Yesterday, the Food and Drug Administration said spinach from the rest of the country was safe to eat and that it was working on getting it back on store shelves.

"Spinach grown in other parts of the United States has not been implicated," said David W. Acheson, a food-safety official with the Food and Drug Administration.

For now, the FDA continues to warn people not to eat any fresh spinach until the agency and the industry figure out how to label spinach so that it is clear that it is not from the three California counties.

June E. Dunning, 86, of Hagerstown died last week of E. coli after eating bagged fresh spinach. But state health officials have not been able to conclusively connect her death with the national outbreak because of problems with completing a genetic test on the bacterium she was infected with.

"That DNA fingerprint is unavailable . . . It may not be possible to get more information on that elderly resident," Gourdine said. "That case may never be confirmed."

In the Salinas Valley, federal and state health officials continued their hunt for the source of the outbreak, which has been narrowed to a few growers identified through supplier and distribution records provided by Natural Selection Foods LLC, a produce processor. Natural Selection and two other companies recalled products containing fresh spinach.

Mark Roh, acting FDA director for the Pacific region, said five teams of four inspectors each have been to 10 California fields representing at least six growers, and to three processing plants.

They have collected 188 samples of water, soil, spinach and bird droppings, and swabs from processing plants in their attempt to find the source of the contamination.

Every year, Escherichia coli is responsible for about 75,000 cases of illness, and about 50 deaths, according to the U.S. Centers for Disease Control. In Maryland, 20 to 30 E. coli cases are reported each year, the state health department said. So far this year, 23 cases have been confirmed in the state.

In the past 10 years, there have been 20 outbreaks of E. coli associated with fresh produce. The current outbreak, the second linked to spinach, is far more extensive than earlier ones. Of the 166 people with reported illnesses, 27 have developed complications that can lead to kidney failure, 88 have been hospitalized and one death has been confirmed.

Maryland health officials have identified a total of 10 cases of E. coli 0157 since Aug. 1. Investigators believe the spinach implicated in the outbreak was eaten from Aug. 2 and Sept. 9.

Of those, three reported cases were linked to the nationwide outbreak through DNA tests. Three other cases were found to be genetically unrelated to the outbreak.

Four more cases, including Dunning's, remain under investigation.

"There is no evidence to conclusively link the remaining four, one of which involves a death, to spinach," the state health department said in a written statement. It will continue to study those cases to see if links can be established, the department said.

Outside Dunning's home last night, her son-in-law Warren Swartz declined to comment.

Earlier, he confirmed an account in the Hagerstown Herald-Mail that Dunning fell ill Sept. 1. She developed bloody diarrhea, a common symptom of E. coli O157:H7 infection, after eating bagged spinach that day and the day before.

On Sept. 2, Dunning was hospitalized. Three days later, doctors removed part of her colon. On Sept. 7, E. coli illness was diagnosed. By then, she had fallen into a coma. She died on Sept 13.

The next day, the FDA issued its first warning not to eat bagged spinach.

Staff writer Dan Morse contributed to this report.