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If it's marked “Washed and Ready to Eat” on the bag of prepackaged salad mix, you're probably better off not washing it again, food experts say.
The mix made the news Tuesday when Iowa and Nebraska public health officials implicated it as the source of an outbreak of an intestinal illness in the two states. Exposure to the tainted prepackaged mix, they said, was identified in about 80 percent of the cases. They're still trying to determine how the remaining 20 percent became ill.
As of Wednesday, testing had confirmed that 81 Nebraskans and 145 Iowans had been sickened by the Cyclospora cayetanensis parasite. The resulting infections left many people with multiple bouts of diarrhea per day, plus fatigue, lack of appetite and a low-grade fever, among other symptoms. People can be ill for weeks if the illness is undiagnosed and they're not treated with a common antibiotic.
About 150 people in 13 other states also have tested positive for the parasite. The Food and Drug Administration is working with other federal, state and local agencies to determine whether the conclusions that Nebraska and Iowa officials have made apply to the illnesses reported in other states.
The salad mix, which contained romaine lettuce, iceberg lettuce, carrots and red cabbage, was distributed to grocery stores and restaurants across Iowa and Nebraska sometime in early June.
Officials have not identified the producer, the distributor, the stores or the restaurants. But they say the product long ago left the food distribution system.
That's one reason Cindy Brison, an extension educator with the University of Nebraska-Lincoln Extension in Douglas and Sarpy Counties, said she would eat the bagged salad mix. She said people shouldn't wash the prewashed salad again because they are more likely to get sick from cross-contamination than from the vegetables.
“You set up so many problems with rewashing it,” Brison said. “You have to sanitize your sink and your counters first, you have to make sure your hands are washed, you have to make sure the colander you're using is sanitized.”
“There's a ton of bacteria in your sink,” she said. “Actually, they say on an average day there's more bacteria in your kitchen sink than in your toilet.”
Some bagged lettuces aren't prewashed, Brison said, so you have to read what's written on the bag.
Dr. Anne O'Keefe, senior epidemiologist at the Douglas County Health Department, said Brison has a point.
“Cross-contamination in the kitchen is very, very common,” said O'Keefe, who had said Tuesday that she would wash bagged salad mix before eating it.
“I think that we'll know more if they can actually find where (the contamination) happened and why it happened,” she said. “What was it? Was it irrigating the field with contaminated water? Was it washing the lettuce with contaminated water? Then I think we'll have a better idea of do we really have to wash the prebagged stuff or not.”
For the record, the FDA says that if the salad mix package indicates the contents are prewashed and ready to eat, consumers can use the produce without further washing.
Packaged salads are the big seller in the produce department, according to the Mintel/Nielsen Perishables Group. They made up about 15 percent of the $45 billion in fresh vegetable sales listed in Mintel's February 2012 Fruit and Vegetables report.
Gretna mom Michelle Murray said she heard about the link between the cyclospora outbreak and the salad mix on Tuesday “about five minutes after I had a salad from bagged lettuce.”
“Ever since the outbreak,” she said, “we have been very careful about washing everything, especially with a toddler in the house and me being eight months' pregnant.”
Murray said she washes bagged vegetables, but the news made her wonder whether she should start buying from local farmers markets or buying frozen or canned vegetables. Neither of those was implicated in the Nebraska and Iowa cases.
Iowa public health officials posted a statement on their website Wednesday noting that if the source of the outbreak still was in the food supply or that a business was refusing to take some action necessary to protect the public's health, they would inform Iowans about the exact product or source. That wasn't necessary in this outbreak, they said.
Brison said nothing is guaranteed safe.
“You could even cause problems with your lettuce crop in your backyard if you have a pet that poops in your garden,” she said. “Within two hours of an animal defecating or urinating near your food, it's in the root system.”
Although she wouldn't wash prewashed salad mix, Brison said she does thoroughly wash heads of lettuce, cracking the bottom so the stem breaks free and then turning it upside down and filling the head with water. She then rinses it well and turns the head over to drain it.
People shouldn't go overboard with trying to clean fresh fruits and vegetables, Brison said.
“Don't use Clorox, don't use soap,” she said. “Neither of those are food grade. They will make you sick.
“People soak their melons in a light Clorox solution. Melons and eggs are very porous — they will just soak that in.”
Brison washes melons such as cantaloupe and scrubs them with a brush that she uses to clean potatoes. Then, she said, she throws the brush in the dishwasher to sanitize it.
“At some point,” she said, “you just have to say, 'I'm OK with this and it's fine. I buy from a grocery store. I buy from a licensed person who has been through all the regulations who is licensed, who is approved by the state and local, that's gone through all the hoops, and I just have to assume that my food is safe.'”