September 25, 2006

The spinach scare has gripped the US since the link between the sickness of several people and bacteria on the spinach was established. Currently it is being investigated by the government authorities. However people, in general, still have a lot of questions about it. We are attempting to answer the frequently asked questions regarding the spinach scare.

Q: What germ was found on the spinach?

A : Escherichia coli commonly called E. coli (Strain 0157:H7) is the germ which commonly causes travelers diarrhea, urine infections etc. is also known to cause serious infections occasionally.

Q: Does everybody who ingests the infected spinach get the disease?

A : No. Some people ingesting infected spinach may have no symptoms at all if their immune system is able to defend the body from the germs. Others may have range of mild, moderate to severe intensity symptoms.

Q: What are the symptoms?

A : Infection with E.coli causes acute bloody diarrhea usually lasting about a week with little or no fever.

Q: Why it can be dangerous?

A : Severe diarrhea can cause dehydration and shock. Children less than five year old or elderly folks are at higher risk.

A rare complication of E.coli infection called Hemolytic Uremic Syndrome (HUS) can lead to kidney failure and can be fatal. Many patients with HUS will need dialysis or transfusions.

Q: Has anybody been sick in the Carolinas from eating the spinach?

A : No confirmed cases have been reported from North or South Carolina as of 1 pm on September 22, 2005. Remember, 90% of the confirmed cases around the US fell sick between August 19, 2006 and September 5, 2006. So chances that we will have a case in the Carolinas are bleak at the best.

Q: Should I stop eating spinach?

A : FDA has advised consumers NOT to eat any fresh spinach or salad blends containing spinach grown in three counties in California implicated in the current E. coli O157:H7 outbreak: Monterey County, San Benito County and Santa Clara County. Fresh spinach grown outside these counties can be safely eaten. Frozen and canned spinach have not been identified as part of the outbreak and can be safely eaten even if grown in Monterey, San Benito and Santa Clara Counties in California.

But we do recommend our patients and all other consumers to do the following:

• Cook all spinach in boiling water for at least 20-30 seconds to kill the bacteria.

• Any utensil or surface used to handle raw spinach should also be cleaned with soap and hot water.

• Avoid contaminating any other food with raw spinach prior to cooking.

• Wash your hands with soap and lukewarm water after handling raw spinach.

Q: What should I do if I have suspicious symptoms?

A : Call your doctor for medical advise as soon as possible. Your doctor may order stool testing for E. coli 0157:H7 strain to find out if it is the case or not.

Sandeep Grewal, MD

Myo Nwe, MD