So Keene also called Braden, the CDC's top food-borne illness epidemiologist. Wisconsin's Davis was patched in, and the three men began comparing what they knew. "At that point, Phase One of the investigation was over," Keene says. Wisconsin and Oregon had shown the outbreak was O157:H7 from spinach. Within 24 hours, the rest of the nation would know as well.
That day, June Dunning died in Maryland.
That night the CDC asked all 50 state public health departments if anyone else was seeing E. coli cases. The next morning, Sept. 14, the CDC had heard from eight states reporting 50 cases. It was looking like a nationwide problem.
By noon, CDC and FDA officials were having their own conference call with their state counterparts. The CDC asked each of the eight states to list the number of cases, the number of hospitalizations, how many kids, how many with HUS and how many dead. The FDA's chief medical officer, David Acheson, took notes.
"I'm writing this all down, and I get to page three and I'm thinking, 'Oh dear,' " he says. For every reported case, he knew there would be many more that hadn't yet been reported or noticed by state health officials.
Some states had sick consumers reporting eating lettuce; some said strawberries. But more said spinach, even bagged spinach with household-brand names on it, including Dole.
Indeed, 80% of the consumer cases at that time recalled eating spinach, an incredibly high number to be coincidental as only about 17% of the U.S. population routinely eats spinach.
The call lasted at least two hours. At the end of it, "We were looking at each other saying, 'This was big,' " Acheson says.
The FDA team met in what would become their war room, a slightly worn conference room on the 12th floor of the Office of Emergency Operations at the agency's Rockville, Md., offices.
In the next two hours, the 10 or so people in that room would decide to tell the American people to stop eating a single product. Not a brand. Not a lot number. Not a production day. An entire product — bagged spinach.
The FDA, concerned that consumers may not know if bagged spinach was dumped out of bags and into loose-leaf bins at grocery stores, expanded the advisory the next day, Sept. 15, to cover all fresh spinach.
The pronouncement was so big that FDA lawyers questioned the agency's press officer, Julie Zawisza. She remembers them asking: "Do you realize that you're saying, 'Don't eat any raw spinach from any source, anywhere, anytime?' "
The FDA did, Zawisza responded, and the media onslaught began.
Acheson was driving home when he got a call: CNN wanted to do a phone interview. When would he be home? He finally dropped off to sleep shortly before midnight. One of his lingering thoughts: "Could this have been deliberate?"
The news hit the processors and growers of America's $3.5 billion packaged-salad market hard. In California's Salinas Valley, nicknamed "America's salad bowl," producers of leafy greens gaped at CNN as they listened to the FDA's warning that an E. coli outbreak was likely underway.
Executives — scattered on Sept. 14 — quickly got back to their offices. Dole Fresh Vegetables President Eric Schwartz was on the East Coast for a business trip. Natural Selection President Charles Sweat was in San Diego visiting customers. Both immediately caught flights home.