Two Toronto residents are paralyzed after drinking carrot juice that tested positive for a botulism toxin, according to the city's public health department.

"There are two adults who are severely ill in hospital and they had a history of drinking the exact same juice that's been part of the carrot juice recall," Dr. Elizabeth Rea, an associate medical officer of health, told the Toronto Star on Sunday.

The juice, produced by Bolthouse Farms in Bakersfield, Calif., was ordered off North American store shelves late last month after four cases of botulism in the United States were linked to toxic carrot juice.

A Florida woman has been in hospital, unresponsive, since mid-September. Three people in Georgia suffered respiratory failure and are on ventilators since drinking carrot juice a month ago.

Botulism is rare, but it can be fatal and must be treated quickly. Symptoms can include blurred vision, slurred speech, difficulty swallowing and paralysis, Toronto Public Health said.

In severe cases, the paralysis can restrict breathing, forcing patients on to ventilators. There's no word whether the Toronto patients are on ventilators.

Toronto Public Health has warned the public to avoid drinking three brands of carrot juice. The federal regulator, the Canadian Food Inspection Agency, issued a product recall covering the three brands on Sept. 30.

Bolthouse Farms bottles the three brands. The recalled products, all sold in both one-litre and 450-millilitre containers, are:

* Bolthouse Farms 100% Carrot Juice. * Earthbound Farm Organic Carrot Juice. * President's Choice Organics 100% Pure Carrot Juice.

Products with a "best by" date up to Nov. 11 have been recalled.

Consumers who have any brand should "take it out of the fridge, dump it down the sink," Rea said.

Bolthouse said the cases may have resulted from improper refrigeration. Carrot juice is low in acids, so bacteria can grow unless it's kept below 7 C.

This most recent news of food-poisoning comes after California-grown spinach tainted with a potentially deadly strain of E. coli caused grocers to pull the vegetable from shelves last month. It is suspected in three recent U.S. deaths.

The Canadian Food Inspection Agency issued a warning on Sept. 15, advising consumers not to eat fresh spinach from the U.S., including spinach that is bagged, loose or in salad blends.

Juice recall follows spinach concerns

Last week, the U.S. Food and Drug Administration announced it was safe to eat U.S.-packaged spinach again, but Canadian health officials have not yet followed suit.

And on Sunday, Nunes Company Inc. in California's Salinas Valley initiated a voluntary recall of green leaf lettuce purchased last week under the Foxy brand name. Foxy is one of the largest suppliers of lettuce, celery, broccoli, vegetable platters and stir-fry mixes in the United States.

The company made the move after concerns about E. coli contamination of its popular brand of lettuce.

While Nunes Company investigators have not found E. coli bacteria on the lettuce itself, company president Tom Nunes Jr. said it was a precautionary measure.

"We're just reacting to a water test only. We know there's generic E. coli on it, but we're not sure what that means," he said. "We're being extra careful. This is precautionary."