Contamination of lettuce and spinach grown in the Salinas area is blamed in three major food-illness outbreaks since 2002, although state investigators have been unable to pinpoint the sources of bacteria that killed one elderly woman and sickened at least 114 other people.
All three incidents, two in California and one in Washington state, involved the most dangerous form of the bacteria E. coli -- type 0157:H7.
This form, which can lead to kidney failure in the worst cases, is more often transmitted in food handling than during cultivation or processing. But in two of the outbreaks, multiple contaminations of lettuce from the same shipments in different places suggest that trouble occurred before the produce reached food preparers.
"The multiple sources of romaine involving two distant states suggest that contamination was not caused by consumers or a food handler," said a Washington State Department of Health report released in March 2003. "It is likely contamination occurred prior to lettuce distribution."
At least 16 victims were hospitalized with symptoms that included severe cramping, vomiting and bloody diarrhea, according to official reports. All survived except for a resident of a Bay Area retirement community, who ate contaminated spinach in October 2003, and a fellow resident, who was hospitalized for bacterial infection and died days later of an unrelated cause, the San Mateo County Health Services Agency said.
Following each of the outbreaks reported between July 2002 and October 2003 -- at a drill-dance camp in Washington state, a restaurant chain in San Diego County and the retirement community in Portola Valley -- California health officials completed extensive investigations around Salinas.
Although research by the state Department of Health Services included scientific analysis and detailed inspection of practices and facilities used in growing, harvesting,
processing and packaging of produce, investigators say they can't determine whether contamination occurred before the lettuce and spinach were shipped to customers.
But Health Services reports obtained by The Salinas Californian through the state Public Records Act point to various stages -- from planting to consumption -- when E. coli 157 could have infected the produce if proper procedures weren't followed.
Without assigning blame, the state has made specific recommendations for improved safety. Salinas-area growers, some of whom didn't learn of those recommendations until seven weeks ago, said they already were largely following them.
The state recommendations include such things as:
· Cleaning and sanitizing harvesting tools and using harvesting knives made of stainless steel and nonporous handles.
· Ensuring that water used in field operations and cooling is of the quality required for its intended use.
· Reviewing methods for testing compost containing animal manure and using this type of compost cautiously.
'Even one is too many'
Neither state health officials nor ag industry members say the three outbreaks represent an ongoing threat to consumers, despite the mystery over the exact source of the E. coli.
"The food is safe ... ," said Jim Bogart, president of the Grower-Shipper Association of Central California. "If there is one incident, what does that say? For us, even one is too many."
Dr. Jeff Farrar, food safety chief at Health Services, said that the threat of E. coli in produce remains very low and that most food-borne illness occurs during preparation -- for example, by putting food on an unwashed cutting board where raw meat has been.
"There are no 100 percent guarantees in life," he said. "Fresh fruits and vegetables are still very safe, and we encourage consumers to keep eating them."
All three outbreaks involved produce that had been cut in advance for convenient use, as opposed to heads or bunches.
Allan Stroh, director of environmental health for the Monterey County Health Department, said ready-to-eat salad mixes typically go through chlorine washes to kill bacteria, but he recommends consumers wash all of their produce, even that labeled as pre-washed.
"The only 100-percent-safe way to be absolutely assured any food is safe to eat is to cook it," Stroh said. "Unfortunately, I think the people are so spoiled in our society sometimes they lose sight of that." Food-borne pathogens, including E. coli 0157:H7, are responsible for approximately 76 million illnesses in the United States each year, according to the federal Centers for Disease Control and Prevention (CDC). Precise figures are not available for what percentage of those total cases involves produce. The Alliance for Food and Farming, a Watsonville-based industry organization, and the Center for Science in the Public Interest, a consumer advocacy group in Washington, D.C., both estimate that about 12 percent of outbreaks involve produce.
According to the Alliance, of those produce-related outbreaks, 2 percent are caused by produce contaminated before the food reaches food preparers or consumers.
Alex Avery, director of research and education for the Hudson Institute's Center for Global Food Issues in Washington, D.C., said that while food-borne illness itself is not rare, the risk of death from E. coli infection is negligible.
"The chance of lightning hitting you with 0157:H7 is not very great," Avery said. "You're more likely to be in a car accident. The vast majority (of food-borne illnesses) pass in a day."
The CDC's Food Net surveillance program -- the most comprehensive database in the nation -- keeps track of food-borne illness outbreaks caused by nine different pathogens, including E. coli 0157:H7. However, FoodNet does not record what kinds of foods are associated with the outbreaks.
Limits on how findings are shared
Because the state essentially just completes its investigations and files away the results, even basic information about the outbreaks has only recently become known within the Salinas-area agriculture industry. However, copies of the reports were available through the California Public Records Act.
Local vegetable growers, packagers and shippers said they've had to seek out findings themselves, even after aiding state Health Services investigators who visited their operations in the past two years.
Health Services, which is part of the California Department of Health and Human Services, regulates all food produced in California and works to trace back contamination involving state products even when it occurs out of state.
Both Monterey County health and agricultural officials and ag company owners said that only since last month have they begun to learn the results of safety probes, even concerning the 2002 outbreak in Washington state.
Health Services has no policy of distributing results of food-borne illness investigations to companies that are directly involved, Farrar said by e-mail. But the department does "attempt to make firms and farm owners aware that we will be writing a summary report and will provide a copy if they would like to receive one," he said.
Because the determination of the precise source of the contamination is often difficult, Farrar said, "Reports of environmental investigations of farms identified as possible suppliers of produce in foodborne outbreaks generally reflect only those observations and findings that the grower is already aware of on their farm."
The state agency also has no policy of distributing results to companies whose operations are similar to those of the firms and farms being investigated -- or to consumers.
Despite limitations on the flow of information, dialogue is now under way between people in Monterey County and state investigators.
In April, state officials notified the county Health Department and county Agricultural Commissioner's Office of the three outbreaks and asked health officials for continued help in pinning down what caused the contamination.
Working together
State health officials, ag industry representatives from the Grower-Shipper Association of Central California, the International Fresh-cut Produce Association and the Monterey County Farm Bureau also met in Sacramento two weeks ago, said county Agricultural Commissioner Eric Lauritzen.
Participants decided the next step will be to survey and focus on what information growers have about bacterial contamination, Lauritzen said, and whether there are ways to further improve "what is already a really good food-safety system."
Although still gathering the details, Salinas-area produce companies and industry leaders say they're already using information from the investigative reports and meeting with state officials to review and strengthen their food-safety practices.
A total of 10 Salinas-area companies are named in state reports as being associated with the lettuce and spinach involved in the outbreaks. They include three grower-shippers who finally sold the produce linked to illness. One of the lettuce fields mentioned in the reports is near Watsonville, but all the others are in the northern Salinas Valley.
Although none of the firms is accused of causing the contaminations, if any had been found responsible, they could have faced product embargos, administrative hearings, licenses revocations and referrals to local prosecutors for civil or criminal prosecution.
"However, these actions are considered to be last resorts and are reserved for those food processors that will not voluntarily resolve violations of the Health and Safety Code," Farrar said by e-mail.
He also stressed that because of the relatively short shelf life of produce, multiple suppliers to food processors and inadequate recordkeeping by some firms, it is extremely difficult to determine the source of pathogens.
Firms say safeguards in place
Companies who discussed the outbreaks with The Californian expressed confidence in their own efforts to grow, package and distribute produce that's safe.
They stressed that it's not at all clear the contamination occurred before the lettuce and spinach reached out-of-area food handlers who prepared it for eating.
Bob Jenkins, chief operating officer for River Ranch Fresh Foods LLC, a grower-shipper named in both the Washington state and San Mateo County reports, said he's certain his company was not the source of E. coli.
"(State officials) appear to be extremely satisfied with everything they saw here," Jenkins said. "We feel strongly that nothing happened in our shop that would contribute to anyone being ill."
While River Ranch contracts with many local growers to produce its bagged salads, fresh-cut vegetables and spinach, it harvests most of the crops itself.
"I don't think it's accurate to portray that in each case (E. coli) came from the (Salinas) Valley," Jenkins said. "It has nothing to do with how (the produce) left here."
Matt Conley, harvest manager for Dobler and Sons, a Watsonville-based grower named in the Washington state outbreak report, concurred.
"What was in this report is nothing more than the 'good-agriculture-practices' manual," Conley said of the state's recommendations, adding that there were not any steps that his company doesn't follow.
"I think we came through looking like they didn't have any more recommendations. It's a lot more minute than the needle-in-the-haystack story."
He said that what gives local companies peace of mind, despite the outbreaks and subsequent investigations, is the many safeguards they employ to ensure their products are safe to eat.
"It's not Earth-shattering," Conley said, "because if you are an active member of Grower-Shipper and you are using third-party audits and you are out constantly seeking to be the best in the industry, you've got these things in place."