This outbreak was home-grown, unlike the most recent spate of food-safety scares involving products from China, which have re-ignited concerns about the nations' food-safety defenses. State and federal health officials say they will respond more forcefully because of the lessons learned in the E. coli outbreak.
Since last fall, companies have taken thousands of acres out of leafy-green production because they've been deemed too close to pastures, wildlife or other risk factors — and they've added miles of fencing, including on the Paicines Ranch.
Processors in California, where the bulk of the nation's leafy greens are grown, have also agreed not to buy from growers who don't meet a defined set of safety standards — an industry first.
Some companies are improving their ability to track a bag of produce back to where it was grown. That will aid investigators and help limit the size of recalls. Dole is implementing a high-tech system that it says will enable it within minutes to track a contaminated bag back to within 30 feet of where the product was grown in the field.
Companies are also doing more testing for E. coli and salmonella in raw, leafy greens and, for the first time, in the finished product, too.
While some companies say such testing may provide a false sense of security because such a small percentage of the product is actually tested, just such a system late last month may have prevented another illness outbreak caused by contaminated spinach.
California's Metz Fresh retrieved more than 90% of 8,118 cases of potentially salmonella-contaminated bagged spinach before they got to consumers. Metz had tested the bagged produce as it came off the processing line and detected salmonella, leading to a recall.
In the past, the salmonella may never have been detected until someone got sick. No illnesses were reported, the company says.
Parts of the industry — and some lawmakers — have advocated that the FDA, which already regulates processing plants, start to oversee growers. The FDA's Brackett says the establishment of mandatory federal rules for growers has been discussed as one of several options related to produce safety.
For some, this will never be over.
Milwaukee's Jillian Kohl has resumed her graduate studies in art therapy, which were interrupted in their first week by her hospitalization. Her kidney function is normal now, but her doctors say there is a 30% chance that in the next 10 to 20 years they could fail again
"By the time I am 40 to 45 years old, I could be laying in a bed hooked up to dialysis machines again. I know death is inevitable, but sometimes it feels like quite a load to carry, knowing a rough timeline has potentially been put on my life," she says.
Kyle Allgood's family decided not to sue Dole. "We really trust in God," his mom, Robyn, says. "We felt that if he'd meant for Kyle to stay, he would have helped him fight it."
Natural Selection's Sweat says he learned of Kyle's death on the eve of his 45th birthday. "That was the one that took me to my knees," he says. "I was on my knees, in my home."
After Kyle died, the Allgoods' neighbors held a bake sale to buy benches in Kyle's name for a park in which he and his little sister played. Robyn wasn't sure she could walk past that park with her oldest daughter when school started this year. It was just too painful. But two weeks ago she did and was buoyed by what the benches represented.
"It's all the love there. I just don't think people understand what that meant to us."
For Zientek, grocery shopping is a different experience today. "We were somewhere, and my children naturally reached for some lettuce that was there and I had to stop myself from saying, 'No, put that down,' as if it was something really bad." She sighs. "I don't want them to grow up like that."
While the kids are healthy today, they, too, carry a greater risk for kidney disease and will need to be tested for the rest of their lives.
"People think life goes on," Zientek says. "But you're never really the same."
Do you worry about eating "pre-washed" spinach right out of the bag?