Federal officials have announced that an outbreak of E. coli O157:H7 infections traced to organic spinach is over.

The implicated Josie’s Organics prepackaged baby spinach had a best-by date of Oct. 23, 2021.

As of Jan. 6, a total of 15 people had been confirmed sick from the outbreak strain of E. coli, according to the Centers for Disease Control and Prevention. The sick people were spread across 10 states.

No deaths were reported, but four patients required hospitalization, and three developed a life-threatening kidney failure complication called hemolytic uremic syndrome (HUS). No deaths were reported. 

“The true number of sick people in this outbreak was likely much higher than the number reported, and this outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for E. coli,” the CDC reported.

Illnesses started on dates ranging from Oct. 13, 2021, to Nov. 8, 2021. Sick people ranged in age from 1 to 76 years, with a median age of 26, and 80 percent were female. 

State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 13 people interviewed, a total of 11 reported remembering eating spinach.

Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses. DNA fingerprinting is performed on bacteria using a method called whole-genome sequencing (WGS).

WGS showed that bacteria from sick people’s samples were closely related genetically. This suggests that people in this outbreak got sick from the same food.

Officials in Minnesota found the outbreak strain of E. coli O157:H7 in a package of leftover Josie’s Organics baby spinach collected from a sick person’s home.

FDA conducted a traceback investigation for the positive product sample and traced it back to a small number of farms in two different geographic regions. However, investigators did not identify a potential point of contamination.

Whole-genome sequencing of bacteria from 15 people’s samples predicted resistance to chloramphenicol, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. These findings do not affect treatment guidance since antibiotics are not recommended for patients with E. coli O157:H7 infections.

About E. coli infections

Anyone who has developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC).

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor.

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients.

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

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