Remarks on Sprout Safety

Laurie Girand
Mother of E. coli O157:H7 Victim
California Sprout Industry Survey Seminar
Sacramento, CA
August 3, 2025

I'm here this morning for a single reason: this industry has a big problem on its hands. To give you an idea of the difference between the consumer's perspective and reality, before I saw the slides at this presentation, I thought that sprouts were grown by people wearing uniforms and hairnets in white rooms with white floors and white ceilings on stainless steel. I believe that you who are attending this meeting have recognized that there is a problem. However, that leaves a lot of people who are not attending today. None of us had much time to get to or prepare for this meeting; yet, we've managed to be here, and they have not. When you see other members of your industry at your trade conference later this week, I hope you'll be able to pass my remarks onto them .

I'm here wearing three hats today. First, I am a mother of child who nearly died of E. coli O157:H7 poisoning in the fall of 1996. May I ask how many of you are parents? Good. I'd like to invite you on my family's trip to hell courtesy of an organism so small that we cannot see it with the naked eye, so elusive that in 50% of severe cases it causes, it is not identified, so powerful that as few as 10 organisms or perhaps as little as a single organism can result in death. I'd like to clarify a point which is often not clear in the media. You have many beneficial E. coli in your body. This is not one of them. Nor is it the E. coli that cause urinary tract infections. E. coli O157:H7 is an organism that naturally resides in the intestines of healthy ruminants such as cows, deer and sheep. It usually gets into our food through the animal's feces. It is distinctly different from these other E. coli in that its source is animal, not human.

I'd like you to understand my daughter, Anna's personality, before she became ill. She was rarely sick or complained of pains. She was and is a bright, articulate child. She was unusually self confident and out going. If we dropped her off at Grandma's or left her at nursery school, she was immediately engrossed in an activity, not clingy or tearful. So you can imagine my surprise when I called from my vacation on a Sunday three days before we were scheduled to return, and my mother told me Anna was really sick. When she came on the line, she was crying and wanted to know when we would be home. My mother said that she had had a lot of diarrhea over the day and was in a lot of pain.

I thought she would be a lot better when we returned on Tuesday evening; I expected one of those Kodak moments where we would run into each other's arms. Instead, she lay on the couch moaning, "My tummy hurts, my tummy hurts." That night she awakened screaming from the pain several times and rushed to the bathroom, rarely reaching the toilet in time. I slept in her room the rest of that week, awakening every two or three hours to help her to the bathroom. Worse, she would sometimes say things that didn't make sense.

My mother had said the pediatrician wanted to see her again on Wednesday if she hadn't improved, so we took her in the next day. He ordered some stool cultures for foodborne illnesses; it was easy to get a sample because Anna couldn't go anywhere for more than an hour without running to the bathroom. He said to push fluids because she had stopped eating and drinking. Usually, we didn't let my daughter drink any juice other than carrot juice, but I bought more apple juice because my mother had said she liked it. Thursday through Saturday are a blur of trips to the bathroom and trips to the doctor's office. Though she had been toilet trained, I finally put her in back in diapers because she was soiling her panties. I remember that they had to stab her three times to get a blood draw on Thursday and give her an IV. I remember that I called her nurseryschool and begged them to tell me if anyone else had called in sick. They seemed to think I was a little strange. Friday the stool cultures all came back negative. We kept pushing her to drink fluids.

On Saturday, we went to the ER to get more IV fluids because Anna was not drinking at the rate the doctor wanted. She had lost 10% of her body weight. There, Anna threw up all of the fluids she had consumed in the previous four hours. The doctor admitted her for observation because her bloodwork was a little odd, showing that her kidneys weren't working that well.

At last, on Saturday, the diarrhea had stopped, and I had begun to feel safe. Anna was finally resting and getting fluids through the IV site in her arm. At 1:00 a.m., the doctor on call called me and said that she thought she had a diagnosis: HUS, Hemolytic Uremic Syndrome, words I had never heard before. They would be transferring Anna to Stanford in the morning. She closed with, "I'm so sorry to have to tell you this." I didn't understand. After all, they had figured out what Anna had. They were transferring her to one of the best hospitals in the world?

Only in the morning when I had a few minutes to read what my husband had found on this disease was I to understand what we were facing. I went into the bathroom, turned on the shower and began to sob inconsolably. Between 1 and 10 and 1 and 20 children infected with E. coli O157:H7 develop HUS which is a blood disorder, caused by a poison put into the bloodstream by the organism. It results in shredded red blood cells, clots, and a loss of platelets that turns the patient into a hemophiliac. Contrary to what you may have read, the kidneys are merely the first part of the body to fail, clogged with clots and overworked trying to excrete the clots and blood fragments. Indeed, every organ of the body is suffering, including the heart, the pancreas, and the brain. Children can suffer strokes, blindness, coma, death. Even if they survive they suffer the risk of complete kidney loss in adulthood, maybe decades later. They can also develop gallstones, diabetes, colon and intestinal problems, and heart problems. The average hospital stay is two-four weeks with some hospitalized for months. The autopsies of victims who die describe their organs as having been liquefied.

All treatment is merely supportive. It starts with transfusions and moves to dialysis. Sometimes doctors will take all the blood out of the body, save the decent stuff that's left and put that plus a lot of other blood from other people back in, hoping to eliminate the toxin. There is no medical treatment that cures the patient.

At Stanford, we were told that Anna had a moderate case. She was not allowed to leave her bed except to go the bathroom. Later, we learned that this was to prevent an accident that might result in her developing bleeding in her brain. She was taken off all fluid intake. She would beg us for water, but we could only give her a sip. Her body began to swell and they had to cut off the hospital bracelets which had become to constricting. Her lips became cracked and bloodied and her speech slurred.

It came time for the first transfusion and we learned that we could not be blood donors because if Anna's kidney ever failed we would be the most probable donors. We could give her nothing. We could not even get a second opinion because you don't take a child in this condition to another facility. They began a transfusion that night to which she developed an allergic reaction. They were trying to figure out what went wrong, so they put the next transfusion on hold. On the next day, the face of death came to visit my little girl, my only child. She was so anemic that her normally brown skin turned white as a sheet, and her normally red lips and gums turned gray. Her urine turned brown.

You need to understand that if someone you know gets this disease, it is highly probable that he or she will be mistreated or misdiagnosed. On the third day of her illness, our daughter was wrongly prescribed antimotility drugs over the phone. Antibiotics, antimotility drugs and narcotics are all believed to hasten the probability of HUS complications. Yet, these are commonly prescribed for diarrheal illnesses in the US. On that same day, her pediatrician suggested we wait two more days. In the same outbreak, two children were turned away from emergency rooms with obviously bloody diarrhea. On the fifth day of her illness, the doctor ran diarrheal stool cultures. These take at least 48 hours to deliver results. He said he was looking for Salmonella, Shigella or Campylobacter, the top three foodborne illnesses. He also thought he had ordered a test for O157:H7, but the lab looked at my daughter's stools and because the blood wasn't overt, decided not to test for O157:H7. On the 8th day of her illness, when Anna was diagnosed with HUS, we were told she probably got it months before from swimming in water or from hamburger. The time from infection to symptoms is 3 to 10 days. When we arrived at Stanford, we were told that our daughter had tested negative for E. coli, that we were not part of a larger outbreak, that HUS, the condition from which she suffered, was not reportable to the state of California. All of these were untrue. Until the state of Washington determined that there was an outbreak, health officials in California was unaware that it was going on here as well. Yet, our situation is not uncommon.

When we learned that Anna was part of the Odwalla outbreak, we had her stool tested for E. coli O157:H7. The genetic fingerprint of the organism in her stool was identical to that found in the apple juice. Another little girl named Anna died in that outbreak. I'd like to share with you her experience. This is a quote from the Rocky Mountain News (1):

"Anna was admitted to Children's on October 26, two days after her parents took her to a Greeley hospital with bloody diarrhea and severe abdominal pains.

'She apparently spoke a lot when she came in, and everybody said she was so cute,' Berry said. 'Her parents had all of these pictures of her -- in a swing, sitting on a pumpkin in a pumpkin patch. She was obviously adorable.'

But Berry and others at Children's who fought for Anna's life said they never got to know that adorable person because she was critically ill by the time they began treating her.

Dr. Kurt Stenmark, chief of pediatric critical care at Children's, said Anna suffered kidney failure, severe brain damage, seizures, lung failure and, finally, the heard failure that ended her life.

The involvement of her heart in the illness, Stenmark said, 'is unusual in our experience as well as in the experience of people around the country.'

He called Anna's illness and death 'the most severe consequences of this disease that we have seen in the past 10 years at this hospital.'

He said doctors used 'extraordinary techniques to try and save this child's life,' including a heart-lung bypass machine, kidney dialysis and a respirator.

Doctors paralyzed Anna with drugs so they could treat her, and gave her strong doses of painkillers and sedatives.

'I don't think that she really suffered,' Stenmark said.

Still, Anna was sometimes aware.

'When we let her wake up, there were signs that she was conscious,' Stenmark said."

One of the last things I remember saying to our kidney specialist at Stanford was that I was going to make sure that this never happened again. He responded that I couldn't stop it.

And that's why I am here in my second role, as a food safety activist. After Anna's illness, I joined S.T.O.P. -- Safe Tables Our Priority, an organization of victims, families and friends who are committed to ensure that others families do not suffer as they have from pathogenic organisms in food. Many of the people I work with have lost children to E. coli O157:H7 and have devoted their lives since to protecting others. One, whose daughter suffered from the hepatitis A in school lunch outbreak you heard about last year is at the hospital right now with a second child who has developed HUS from a different food. Just over a year after Anna's illness, my husband contracted Campylobacter, commonly associated with poultry. It's long term complications include chronic arthritis. A grower, who is a friend of mine, jokingly calls us Passionately Pissed Off Parents. S.T.O.P. is behind the warning labels that will be placed on unpasteurized juices in 1999. S.T.O.P. is also working to get HACCP implemented in all juicing processes, both large and small. We have expanded our programs from meat and juice to address produce. Here is a preview of our plans for 1999.

At the end of July, S.T.O.P. told FDA that we wanted to see warning labels on sprouts. A copy of those comments on the priorities for FDA's Center for Food Safety and Applied Nutrition are also at our website. In response to the Produce Guidelines, we have also told FDA that we want HACCP and traceback implemented for all produce. In 1999, because of the repeated association of sprouts with outbreaks, we will push FDA to institute HACCP and traceback for sprouts in particular. When the press calls and asks what the next foodborne illness angle is that they should write about, we are now telling them sprouts. Under consideration for 1999 are a media campaign directed at middle aged women through their trade magazines to warn them that sprouts are a leading cause of foodborne illness in produce, and the development of an official S.T.O.P. recommendation about sprouts. Unless there is a scientific breakthrough this year that shows that pathogens can be eliminated, not reduced but actually eliminated, from seeds, I will push that we should recommend that no one eat raw sprouts until sprout seeds can be guaranteed to be pathogen free.

In my third role, I am here as a businessperson, because like you, I run a business, too, a consulting practice in marketing. As a businessperson, I believe that everyone involved in the sprout industry has some really hard choices to make. Here are the choices I see:

1) try to stay in business and do nothing

2) try to improve your safety and ignore the rest of the industry

3) demand regulation that forces the worst producers to comply

I don't think anyone here is opting for option one, but as long as competitors continue to have poor safety records, your business can suffer from outbreaks caused by others. When the lawyers understand the risks involved with sprout growing and that everyone understands those risks, they will be after big settlements. Until science enables you to grow raw sprouts completely free of E. coli O157:H7, this is going to be a tough business.

But there's one another option. When you look at yourself in the mirror in the morning, ask yourself how much you like being in any industry that can leave people maimed or injured through no fault of their own, in an industry which cannot guarantee safe products.

I would have liked to have brought a warm, friendly message to you today, but there's nothing friendly about E. coli O157:H7 or antibiotic resistant Salmonella. Given the number of outbreaks traced to sprouts, and there are undoubtedly more that have not been traced, it's not clear to me that there is a lot of time left to be spent on sugar coating the facts.

When I get up in the morning tomorrow, I'll be asking myself if Anna is peeing frequently enough. I'll be asking myself if the stomach pains she complains about off and on are just constipation or whether we need to do a full colonoscopy on a five year old to determine whether scar tissue in her intestines is the source of the problem. I'll question whether anyone can ever get a reasonable prognosis in this country when most of the physicians involved with this disease are paid expert witnesses on behalf of the food industry. I'll wonder whether her 1 year old brother is a good kidney match for her, how many transplants she could need over the course of her lifetime, whether she will be covered financially in a future of uncertain medical coverage for preexisting conditions. I'll wonder if she will get over her fear of needles and splinters. I cannot afford to take her health for granted anymore.

But when I look in the mirror, you need to know that I also hope: can I keep this nightmare from happening to other people; can I save a life today? If I can save one life, can I save two? I pray that you can share that hope, too. Thank you for your time.

(1) Karen Abbott, "Death of baby apparently tied to tainted juice," Rocky Mountain News, Online Edition, November 9, 1996.