It doesn't matter what brand of spinach. It doesn't matter how long it's been sitting in the refrigerator. If it comes in bag, the Food and Drug Administration is strongly encouraging consumers, from coast to coast, to throw it out.
Federal officials blame the bagged, grocery store spinach for what has now turned into a massive E.Coli outbreak, responsible for hospitalizing residents in at least 19 states. (So far, according the U.S. Centers for Disease Control: California, Connecticut, Idaho, Indiana, Kentucky, Maine, Michigan, Minnesota, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington, Wisconsin and Wyoming). One person has died, a 77-year old woman in Wisconsin. Dozens of people have fallen seriously ill. There have been at least 14 cases of kidney failure.
Natural Selection Foods, which produces packaged products under the label "Earthbound Farm Organic" has announced a voluntary recall for spinach products with sell by dates August 17 through October 21. Earthbound Farm is the nation's grower of organic produce. It is in 74 percent of grocery stores nationwide and last reported to have $450 million in revenue.
Dr. David Acheson, with the Center for Food and Safety and Applied Nutrition says, "the cases are increasing by the day."
"We may be at the peak and we may not. I don't know," he says. "It is all preliminary data."
The FDA has identified the strain of E. coli as O151:H7, and a typical infection takes a few days to develop and nearly two weeks to pass. It causes severe abdominal cramping and bloody diarrhea. In some cases, it can be fatal.
Dr. Michael Donnenberg heads the Division of Infectious Diseases at the University of Maryland, and says he wouldn't eat any packaged spinach of any kind, and wouldn't advise anyone else to do so either.
"This is an unusual thing," he says. "By now, investigators would normally be able to tell us what lot the spinach came from or what the packaging looked like. At this point, they've usually been able to take cultures of samples that were still sitting somewhere in the victim's home."
None of that has happened, and Donnenberg says that means the FDA is most likely confused and still trying to figure it out. He believes that in the end it will come down to a cow.
"Most likely," he says, the source is "fertilizer, from cow manure."
"And hopefully," the source is "outside the plant," he added, "because if the exposure took place inside a vegetable processing plant, it's extremely hard to track and contain."
This same strain of E. coli was responsible for an outbreak in Minnesota in September 2005. At least 11 people became ill. No one knows how many consumers failed to report illnesses. The outbreak was immediately linked to prepackaged Dole salads with lettuce, cabbage and carrots.
The vegetables in the Minnesota case came from the Salinas Valley, in central California. Among growers, the valley is often called the "salad bowl of the world," for its millions of pounds of annual produce production.
The region does have its issues. Vegetables grown in the valley have been connected to at least eight E. coli outbreaks since 1995. Federal health authorities are there now, inspecting farms and processing plants.
Experts say what makes these types of investigations difficult is that it only takes a minuscule amount of E. coli contamination to trigger an outbreak. Finding the source for such a small amount of contamination is tricky at best.
What makes it even more difficult for consumers is there's little a person can do to clean lettuce or spinach that has been contaminated with E. coli. The FDA says it's not enough to wash or even cook vegetables if they've been contaminated. The only effective preventive measure is to discard produce that fits the established profile.
Dr. Robert Schooley, a researcher of infectious diseases and a professor at the University of California at San Diego, says this time federal health officials may not ever be able to identify the source of the E. coli contamination.
"The cases of infection are so widespread across the country, and E. coli is so ubiquitous in the environment, I wouldn't be surprised if they don't ever figure it out."