WASHINGTON—The federal disease detectives now tracking bad spinach heard the first alarms on an otherwise quiet Friday, 13 days ago.
Since then, the food-borne illnesses have spread to at least 23 states. Hot on the heels have been scientists and public health officials, who are deploying the microscope, the Internet and an adrenaline-laced intellect familiar to fans of the "CSI" television franchise.
"Of course, this is a very daunting task," Robert Bracket, director of the Food and Drug Administration's Center for Food Safety and Applied Nutrition, said on CNN. "It's very much a needle in the haystack."
The Atlanta-based Centers for Disease Control and Prevention now has about 80 employees devoted to tracking the outbreak of E. coli-related diseases. Some investigators are members of what's called the Epidemic Intelligence Service, working closely with state health departments. Some of their tools were forged in the wake of past E. coli outbreaks.
On Sept. 7, a 77-year-old retired bank clerk from a small Wisconsin town bordering on Lake Michigan died from kidney failure attributed to E. coli. Several children had also fallen severely ill in early September, and a total of five adults had been stricken. Normally, Wisconsin officials say they expect about 200 such illnesses in a year.
"That was a sentinel event," Wisconsin Department of Health and Family Services spokesman Jason Helgerson said Wednesday. "It really set up the red flag."
So on Sept. 8, Wisconsin officials signed on to a password-protected federal database called PulseNet and filed reports of what they had.
Coordinated by the CDC, PulseNet is a network that was created following a 1993 E. coli outbreak. It includes a database now stocked with some 32,000 images of E. coli samples. An Internet chat room enables officials to share observations.
"A message goes out, alerting others to this uptick, so there is heightened attention," CDC spokeswoman Jennifer Morcone explained Wednesday.
Several thousand miles away, Oregon officials were sifting through their own evidence.
Not yet aware of the Wisconsin cases, Oregon public health officials learned of three E. coli cases shortly after 6 p.m. on Friday, Sept. 8. They'd seen such things before.
But by Tuesday, Sept. 12, two more E. coli cases appeared in Oregon. That, said Dr. William Keene, Oregon's senior epidemiologist, "kicked into high gear" the state's detective efforts. Melissa Plantenga, a special-studies coordinator with the Oregon Department of Human Services, set about calling the five victims with a 400-question survey.
"It's essentially a laundry list of every food we can imagine," Keene noted Wednesday. "The thing that jumped out at us was that four out of the five said they had eaten bagged spinach."
Plantenga, a 30-year-old researcher who had previously tracked contaminated almonds, then punched "spinach and E. coli" into the Google search engine. Bingo. She found a 2003 case in which 13 residents of Sequoias Retirement Village in California's Portola Valley were sickened after eating raw spinach.
On Wednesday, Sept. 13, Keene e-mailed Oregon's information to the CDC. As first reported by the Oregonian newspaper, Keene heard back within about 10 minutes. That was when he learned about Wisconsin, where officials had likewise started to zero in on spinach.
They "called with independent suspicions that spinach was involved," Morcone said.
On Sept. 14, officials hooked up a conference call with the CDC and the Food and Drug Administration. The first federal press release went out that day.
On the campus-like grounds of the Centers for Disease Control, officials on Saturday turned the key on the Director's Emergency Operations Center. Previously used during Hurricane Katrina, among other emergencies, the war room is currently staffed with about a dozen epidemiologists.
"They are coordinating the case reports that are coming in from the different states," Morcone said.
State and private-public health labs handle the hands-on scientific work. They pick through the bloody stools of patients in search for what's formally called Escherichia coli 0157:H7. The numbers help identify the bacteria, which are barely two microns long. That's tiny. The period at the end of this sentence could contain about 615 microns.
Scientists take a "fingerprint" of the bacterial DNA using a technique called "pulsed-field gel electrophoresis." The DNA samples are placed in a gel and then subjected to an electric field. The resulting stripe-like patterns are then uploaded to the national database.
As of Wednesday afternoon, state and federal investigators working in three teams had targeted five farms in California's Santa Clara, San Benito and Monterey counties.
"The information from patients leads us back to the (packing) establishments," Dr. David Acheson, chief medical officer of the FDA's Center for Food Safety and Applied Nutrition, said late Wednesday afternoon. "The information there leads us back to the farms."
———
(c) 2006, McClatchy-Tribune Information Services.
Need to map