Spinach-associated Escherichia coli O157:H7 Outbreak, Utah and New Mexico, 2006
2008

E. coli Outbreak Linked to Spinach

Sample size: 22 publication 10 minutes Evidence: high

Author Information

Author(s): Grant Juliana, Wendelboe Aaron M., Wendel Arthur, Jepson Barbara, Torres Paul, Smelser Chad, Rolfs Robert T.

Primary Institution: Centers for Disease Control and Prevention

Hypothesis

Is there a link between bagged spinach consumption and E. coli O157:H7 infections?

Conclusion

The study found that consuming bagged spinach was significantly associated with E. coli O157:H7 infections.

Supporting Evidence

  • Consumption of bagged spinach was significantly associated with E. coli O157:H7 infection.
  • 57% of case-patients were hospitalized.
  • 29% of case-patients experienced hemolytic uremic syndrome.
  • Shiga toxin 2 was detected in stool samples from all patients.
  • E. coli O157:H7 was isolated from bags of spinach consumed by case-patients.
  • Matched odds ratios indicated a strong association between spinach consumption and illness.
  • Recall bias may have affected the accuracy of reported spinach consumption.
  • FDA linked contaminated spinach to environmental sources in California.

Takeaway

Eating bagged spinach can make you very sick with E. coli, which is a type of bacteria that can cause serious stomach problems.

Methodology

A case-control study was conducted where case-patients were matched with controls based on age and sex, and data on spinach consumption was collected through interviews.

Potential Biases

Controls had a longer time lag between consumption and interview, which may affect recall accuracy.

Limitations

The study had a small sample size and potential recall bias among participants.

Participant Demographics

The majority of case-patients were female (78%) and aged 19-64 years (52%).

Statistical Information

P-Value

0.0001

Confidence Interval

95% CI = 2.8–797.1

Statistical Significance

p<0.01

Digital Object Identifier (DOI)

10.3201/eid1410.071341

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