A health alert as four people in Kentucky are believed to be the latest victims in a nationwide E. coli outbreak.

The outbreak has been connected to bagged spinach.

Ten states have now been linked to the outbreak -- including Kentucky and Indiana. Officials in California are investigating a possible case.

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View this story What is E. coli?

The latest numbers we’re getting in from around town show two suspected cases of E. coli in Oldham County and two in Jefferson County, including a 9-year-old.

“All of our restaurants are sending it back and I’ve talked to the people in California that we buy from, River Ranch out of Salinas, California, and they’re going to take care of all that we bring back,” says Clyde Combs, general manager of Passafiume & Sons.

How much are you having to ship back?

“I’d say four or five thousand dollars’s worth.”

At Krogers, bagged spinach was pulled off the shelves Friday morning and thrown into compactors for disposal.

Mention E. coli and most of us think of undercooked ground beef, not vegetables. Investigators are exploring if irrigation lines at spinach farms may have been contaminated.

E. coli causes diarrhea. Most people recover, but it can be fatal in some cases, especially among the very young and the very old.

Area McDonalds are pulling spinach from their premade salads, as well.

Officials say washing the bagged spinach isn’t enough and are urging you not to use it at all. If you have bags of spinach in your home, throw it away.

Web story produced by Jay Ditzer.

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From The Associated Press:

WASHINGTON (AP) -- Even if you wash the spinach, you still could be at risk.

Sober warnings for salad lovers came from federal health officials Friday as they struggled to pinpoint a multistate E. coli outbreak that killed one person and sickened dozens more in several states including Indiana.

Bagged spinach—the triple-washed, cello-packed kind sold by the hundreds of millions of pounds each year—is the suspected source of the bacterial outbreak, Food and Drug Administration officials said.

The FDA warned people nationwide not to eat the spinach. Washing won’t get rid of the tenacious bug, though thorough cooking can kill it. Supermarkets across the country pulled spinach from shelves, and consumers tossed out the leafy green.

Jennifer Dunlap, a spokesperson for the Indiana Department of Health, said four people in the state were infected with E. coli that matched the same strain as the outbreak. But the department could not definitively say they were part of the outbreak without further testing.

“We’re waiting for the all-clear. In the meantime, Popeye the Sailor Man and this family will not be eating bagged spinach,” said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University. The Tennessee university’s medical center was treating a 17-year-old Kentucky girl for E. coli infection.

By Friday, the outbreak had grown to include at least 11 states:

Connecticut, Idaho, Indiana, Kentucky, Michigan, New Mexico, New York, Ohio, Oregon, Utah and Wisconsin. Wisconsin accounted for about half the cases, including the lone death, Gov. Jim Doyle said.

“We are telling everyone to get rid of fresh bagged spinach right now. Don’t assume anything is over,” Doyle said.

Health officials also were investigating possible cases in California, Pennsylvania and Washington. In all, the bug is known to have sickened roughly 60 people, ages 3 to 84, the majority of them women.

FDA officials said they issued the nationwide consumer alert without waiting to identify the still-unknown source of the tainted spinach.

“Early is good,” said Caroline Smith DeWaal, food safety director for the Center for Science in the Public Interest, adding that the alert may have prevented hundreds more cases.

An industry spokeswoman said public health concerns justified the blanket warning: “It needed to happen this way,” said Kathy Means, a spokeswoman for the Produce Marketing Association.  “Public health has to trump economics at this time.”

Initial suspicions focused on California’s Monterey County.  Farmers there grow more than half the nation’s 500 million-pound spinach crop, according to the Agriculture Department.

“We’re trying to get to the bottom of this and figure out what happened. Everybody is terribly concerned,” said Dave Kranz, a spokesman for the California Farm Bureau Federation.

Even before the latest outbreak, a joint state and federal effort has been under way in the California county to find and eliminate any possible sources of E. coli contamination.

“We need to strive to do even better so even one life is not lost,” said Dr. Andrew von Eschenbach, FDA’s acting commissioner.

The FDA’s top food expert stressed the importance of stopping the bacterium at its source, since rinsing spinach won’t eliminate the risk. “If you wash it, it is not going to get rid of it,” said Robert Brackett, director of the agency’s Center for Food Safety and Nutrition.

E. coli lives in the intestines of cattle and other animals and typically is spread through contamination by fecal material.  Brackett said the use of manure as a fertilizer for produce typically consumed raw, such as spinach, is not in keeping with good agricultural practices. “It is something we don’t want to see,” he told a food policy conference.

Meanwhile, Wal-Mart Stores Inc., Safeway Inc., SuperValu Inc.  and other major grocery chains stopped selling spinach, removing it from shelves and salad bars.

“We pulled everything that we have spinach in,” said Dan Brettelle, manager of a Piggly Wiggly store in Columbia, S.C.

Local doctors began seeing the first of the ongoing E. coli poisoning cases in late August. The Centers for Disease Control and Prevention and Wisconsin health officials alerted the FDA about the outbreak at midweek.

Consumer activist Barb Kowalcyk said fixing the nation’s “fractured network” of food safety agencies could save lives. In 2001, her 2-year-old son, Kevin, died of E. coli, possibly after eating tainted ground beef.

“How can we improve communication between agencies? That needs to happen,” the Loveland, Ohio, resident said.

Rep. Rosa DeLauro, D-Conn., and other lawmakers seek a hearing on legislation that would consolidate all federal food safety agencies and establish the Food Safety Administration, her spokeswoman said.

Not all strains of E. coli cause illness: E. coli O157:H7, the strain involved in the current outbreak, was first recognized as a cause of illness in 1982. That strain causes an estimated 73,000 cases of infection, including 61 deaths, each year in the United States, according to the CDC.

When ingested, the bug can cause diarrhea, often with bloody stools. Most healthy adults can recover completely within a week, although some people—including the very young and old—can develop a form of kidney failure that often leads to death.

Sources of the bacterium include uncooked produce, raw milk, unpasteurized juice, contaminated water and meat, especially undercooked or raw hamburger, according to the CDC.

Anyone who has gotten sick after eating raw packaged spinach should contact a doctor, officials said. Other bagged vegetables, including prepackaged salads, apparently are not affected.

“At this point, we are focused on the issue of the spinach. As we learn more, as we go further, we will alter or change that recommendation,” von Eschenbach said.

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Associated Press writers Beth Rucker in Nashville, Tenn., Robin Hindery in Sacramento, Calif., and Emily Fredrix in Wauwatosa, Wis., contributed to this report.

(Copyright 2006 by The Associated Press.  All Rights Reserved.)