Consumers should avoid all fresh spinach, regardless of whether it is pre-packaged, a chief U.S. food safety official warned on Saturday, saying the number of E. coli illnesses had passed 100.
"We need to get a clear message to consumers," said Dr. David Acheson, the U.S. Food and Drug Administration's director of food safety and security.
"Some consumers may not be aware that spinach that may be available to them may have been pre-packaged," he said referring to loose spinach sold in restaurants and supermarkets.
While the FDA did not expand the warning beyond fresh spinach, Acheson said the investigation into the cause of the illnesses was continuing and other possible sources had not been excluded.
Investigators believe that the spinach was contaminated before it was bagged since more than one bag contained contaminated product, Acheson said on a Saturday evening conference call with reporters.
Since August 2, one person has died and 102 people have fallen ill, including 16 who suffered kidney failure after eating spinach suspected of being contaminated with the E. coli 0157:H7 -- a potentially deadly bacterium that causes bloody diarrhea and dehydration.
Wisconsin health authorities said the E. coli fatality was a 77-year-old woman from Manitowoc who died September 7.
The most recent case in the 19-state outbreak was reported on September 9, Acheson said.
On Friday, Natural Selection Foods LLC/Earthbound Farm, the nation's largest grower of organic produce, voluntarily recalled fresh spinach products sold in the United States, Mexico and Canada after the U.S. government said they could be linked to the worsening outbreak.
Patients infected with the bacterial illness told researchers they had eaten pre-packaged spinach packed by Natural Selection, including some sold under the Dole label, prompting the company to start its recall, Acheson said earlier this week.
Acheson was not able to predict when the warnings would be lifted, saying it would "go on as long as it needs to protect public health."