13 Illnesses Prompt Recall of Apple Juices

Makers of apple juice products linked to the illnesses of 13 young people in the Seattle area scrambled to pull the beverages from grocery shelves in California and elsewhere Thursday, the latest in a string of incidents raising safety concerns about the food supply.

The U.S. Food and Drug Administration announced the voluntary recall of all Odwalla brand apple juice and juice blends containing apple juice after the California-made products were tied to an outbreak of a virulent strain of bacteria that causes severe diarrhea and can be fatal.

Meanwhile, health officials in California and Colorado reported Thursday that they are investigating possible additional cases of E. coli illness. Investigators were evaluating three patients--in Los Angeles, Sacramento and the Bay Area--to determine whether the cases were indeed examples of E. coli illness. Colorado state health officials said four cases of E. coli sickness probably were linked to Odwalla juice products, and four more were being investigated.

In Washington state, 10 of the 13 patients to date had consumed unpasteurized Odwalla apple juice. The incident follows last week’s revelation that at least 10 people had become ill with symptoms of E. coli illness after drinking apple cider from a Connecticut mill.

The E. coli variety identified in Washington--E. coli O157:H7--is closely related to the type that sickened more than 9,500 people in southern Japan this year in that nation’s worst food poisoning outbreak in a decade. And it is similar, though not necessarily identical, to the strain that contaminated undercooked Jack in the Box hamburgers in the Western United States in 1993, killing four people and making 500 others ill.

The E. coli microbe normally lives in cattle but can be transmitted to humans through manure or improper slaughtering and can cause brain damage or death, especially in young children. Symptoms might not appear for several days.

Ten of the 13 Seattle-area victims are children and the rest are young adults. Only one of the victims was reported hospitalized as of late Thursday.

High-profile outbreaks of food-borne infections--from “mad cow” disease in Britain to the cyclospora that afflicted hundreds of individuals in the United States and Canada earlier this year--have exacerbated fears that the world’s food supply is unreliable, if not downright dangerous.

Countless food products--from oysters to pineapples to gourmet ice cream to dry-cured salami--have been implicated recently in a rash of food-related illnesses. Each year, tainted meat, poultry, eggs and produce make millions of people ill in the United States, with estimates ranging widely from 6.5 million to more than 80 million. The illnesses kill as many as 7,000 people in the U.S. each year, according to the U.S. Department of Agriculture.

“Eating can be hazardous to your health,” noted John Leedom, a USC professor of medicine who is also chief of the infectious diseases division. “There’s no guarantee that most of the food you ingest is bacterially sterile at the time you ingest it.”

The push for so-called natural food products--marketed as healthy because they are free of preservatives, colorings, pesticides and growth hormones--has created robust demand for products such as the fresh juices that have made a raging business success of Odwalla, based in the coastal city of Half Moon Bay, south of San Francisco. Its promotional material boasts of its juice: “Drink it and thrive.”

Odwalla shares plunged $6.25 to $12.125 in heavy Nasdaq trading Thursday. The stock had been as high as $28.75 over the last year.

In a news conference Thursday at company headquarters, company co-founder Greg Steltenpohl said: “It is very tough, to be honest, to be focused on health and nutrition all your life and have this incident happen.”

Asked whether they have assessed the potential financial effect of the recall and bad publicity on the company, Steltenpohl and Chief Executive Stephen Williamson said their “deepest concern is for the health and safety of our customers.”

Among the products recalled were apple juice plus a variety of other products that contain apple juice. Those include Mango Tango, Super Protein, Strawberry Banana Smoothie, Raspberry Smoothie, C-Monster, Blackberry Fruitshake, Mo’Beta, Femme Vitale, Strawberry C-Monster, Superfood, Serious Ginseng and Deep in Peach.

Bottled in Dinuba, Calif., the products are distributed in California and Washington state as well as Oregon, Colorado, Nevada, Texas, New Mexico and British Columbia, Canada.

Although the precise origin of the disease has not been established, Odwalla said it has taken the extra precaution of removing from store shelves two other products made on the same production line. They are Carrot Juice, Organic Carrot Juice and Vegetable Cocktail.

Epidemiologists were not surprised to hear that the latest suspected villain in an E. coli outbreak is fresh apple juice. If apples that have fallen to the ground are used, they can spread contamination from animal fecal matter.

“It’s something we could have anticipated,” said Michael Osterholm, Minnesota’s state epidemiologist and a noted expert in the field. “We’ve been talking about apples a long time.”

For consumers, the message is that, by taking to heart all the urgings to consume more fresh fruits and vegetables, they appear to have put themselves at risk.

Odwalla, for example, touts the freshness and naturalness of its products. It markets more than 30 juice blends and natural spring water, without concentrates, preservatives or pasteurization, a heating process that kills bacteria. To avoid spoilage, workers must process, ship and sell the highly perishable products in just two weeks. The company delivers the products directly to retail outlets in colorful trucks.

“We live in a world of high-risk diets today,” Osterholm said. “No one should for a moment dispute the fact that some of the dietary changes have been wonderful from a cardiovascular standpoint, but they’ve been hell on the gastrointestinal tract.”

Reports of E. coli symptoms started coming into the Seattle-King County Department of Public Health last week. Epidemiologists began to investigate after three children with abdominal cramping and bloody diarrhea also developed hemolytic uremic syndrome, a complication of the E. coli infection that can cause kidney failure.

Russell Alexander, the county’s chief epidemiologist, credited “shoe leather epidemiology” and DNA testing with identifying the source as Odwalla apple juice.

Now that the Odwalla juices have been pulled from the shelves, Alexander said consumers should not worry about getting the bacterial infection. However, the county health department still has more cases coming in, he said.

“I hope it will stop soon,” he said.

In California, investigators do not yet have enough information to pinpoint the cause of the three cases being assessed, said Scott Lewis, a spokesman for the state Department of Health Services in Sacramento.

Gerald Celente, director of the Trends Research Institute in Rhinebeck, N.Y., called the latest E. coli outbreak “another building block of fear to be put on top of the ones that already exist.”

To be clean, Celente said, a food “has to be processed, delivered and brought to market in the most sanitary conditions.” Reports of illnesses, he noted, are often a boon to health food stores.

That is an irony given that this latest problem has been traced to Odwalla. The company’s products are fixtures in health food stores as well as big retail chains, and Odwalla markets itself as being committed to “nourishment and sustainability.”

Times researcher Elena Bianco in Seattle contributed to this story.