Boy's infection linked to spinach

Harford case part of nationwide outbreak

September 26, 2006|By Frank D. Roylance and Justin Fenton | Frank D. Roylance and Justin Fenton,Sun reporters

Harford County health authorities have identified a 5-year-old Harford County boy whose mother fed him a spinach salad as one of Maryland's three confirmed cases of infection by a virulent and potentially deadly strain of E. coli bacteria.

The other two cases were said to be private school children in Cecil County. All three survived, and only the Cecil children were sick enough to be hospitalized.

"The subtyping of those samples is consistent with what's being seen around the country," said Dr. Andrew Bernstein, Harford County's health officer.

DNA fingerprinting identified the bacterium in all three cases as the 0157:H7 strain implicated in a nationwide outbreak traced to farm fields in California's Salinas Valley.

Except to say they were children, state health authorities have declined to describe the three cases they had linked to the nationwide outbreak. They are among 10 E. coli infections reported in Maryland since Aug. 1.

Bernstein did not name the child, but he said the Harford boy ate a salad containing spinach and later suffered from symptoms associated with E. coli infections. They can include bloody diarrhea, cramping and fever. The child was never hospitalized.

Bernstein did not provide a description of the Cecil children, except to note they attend private school. He added that the risk to other county residents was "minimal."

Meanwhile, state health authorities said yesterday they have now ruled out a spinach link in six other Maryland cases of E. coli infection reported since Aug. 1.

They say Maryland routinely sees 20 to 30 E. coli cases each year from a variety of other, less toxic strains.

"That leaves one case pending," said John Hammond, spokesman for the Department of Health and Mental Hygiene.

The Centers for Disease Control and Prevention has identified that case as an "elderly woman" who ate bagged spinach, fell ill and died. Although E. coli bacteria were cultured from her stool samples, the CDC said DNA fingerprinting of the bacterium to determine whether it is the 0157:H7 strain "has not been possible."

Citing privacy laws, Maryland Department of Health and Mental Hygiene officials have not identified the victim. But she is widely presumed to be June E. Dunning, an 86-year-old Hagerstown woman who died Sept. 13, two weeks after eating bagged spinach and falling ill. Family members say she was a victim of the outbreak, and note that her death certificate cited an E. coli infection as contributing to her death.

Nationwide, the CDC said, 175 cases of spinach-related infection with the E. coli 0157:H7 bacterium have been reported to public health authorities in 25 states.

Most E. coli strains are harmless. But 0157:H7 produces a toxin that can cause severe kidney damage, especially in the very young and the elderly.

Twenty-eight victims of the tainted spinach have developed a potentially fatal kidney failure called hemolytic-uremic syndrome (HUS). One woman, in Wisconsin, has died.

Many other suspected cases remain unresolved pending further DNA tests, including two deaths: the Maryland woman and a 2-year-old boy in Idaho.

After a nationwide alert on Sept. 14, grocers pulled potentially tainted bagged spinach from store shelves, and consumers were told to discard any bagged spinach they had purchased.

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