In 2006, bagged fresh spinach contaminated with Escherichia coli O157:H7 caused about 200 cases of confirmed illness across the United States and at least 3 deaths. An investigation tracing the source of the contamination ultimately implicated domesticated animals, wildlife, and environmental factors.
Strategies that integrate human, animal, and environmental health may help prevent outbreaks of zoonotic diseases, such as 2009 influenza A(H1N1), West Nile virus infection, highly pathogenic avian influenza H5N1, and Escherichia coli O157:H7 infection.