Minnesota food detectives solve peanut butter case
ST. PAUL - Nine dead, three in Minnesota, with 654 sick in 44 states.
It almost sounds like terrorists spreading a deadly disease. Federal, state and local investigative agencies nationwide sprang into action well before numbers rose that high.
There were few clues about why Americans were getting sick and dying.
Then, three days before Christmas last year, more than three months after the first person took ill, the Minnesota Health Department's Stephanie Meyer noticed that victims in her state had one thing in common -- they all ate peanut butter.
But the favorite snack of many a child was an unlikely cause for the national illness outbreak.
"We couldn't rule anything out and couldn't rule anything in," Meyer's fellow epidemiologist, Carlota Medus, said.
By Jan. 9, Meyer, Medus and their colleagues in Minnesota's agriculture and health departments had proof that bad peanut butter was being served, and a few days they traced it to a Georgia peanut butter and peanut paste maker.
No one knows how many lives those Minnesota state workers saved, or how many Americans will remain healthy because of their work, their food detective work.
Food inspectors in the Agriculture Department and disease prevent and control experts in the Health Department - and laboratory technicians in both departments - work hand-in-glove together on a daily basis to trace down food-borne illnesses of all types. It is all in a day's work for them, but in an outbreak that rocked the country's food supply, their efforts rose to another level.
Like last year when workers in those two agencies found jalapeno peppers were to blame for a salmonella outbreak - not tomatoes as others suspected - Minnesota led the way to solving the peanut butter salmonella typhimurium outbreak.
"For the sake of public health, we moved quickly," the Agriculture Department's Ben Miller said.
Minnesotans shared their information with federal health authorities, as well as those in other states, and the outbreak has slowed almost to a stop.
However, the outbreak produced the country's largest food recall, which now stands at more than 2,300 products that contain peanut butter or peanut paste made in a Peanut Corporation of American plant in Blakeley, Ga. Even pet food is affected.
The case was solved just like police detectives solve murders - looking over the details time and time again.
The story began in early September, when a few Americans began getting sick due to salmonella, an intestinal tract bacteria that can cause nausea, vomiting and diarrhea. It can be fatal, especially to children and the elderly.
Minnesotans began getting sick, later blamed on salmonella, in mid-November.
Salmonella typhimurium, the particular strain affecting people, gradually became more common as 2008 entered its last month. Federal health authorities held regular conference calls with health experts from states reporting the still-developing outbreak.
Peanut butter and chicken were suspected, but evidence was sketchy at best.
On Dec. 21, with nine Minnesota cases matching the national outbreak strain, Shirley Mae Almer of Perham died in a Brainerd nursing home. Her son, Jeff, thinks she was the first fatality of the outbreak (government health officials do not discuss specific cases, citing privacy laws, so do not confirm that she was the first).
The next day, three new cases were reported at the nursing home and Meyer began to suspect peanut butter as the outbreak's cause.
From there, it was old-fashioned detective work that allowed Minnesota's agriculture and health departments to solve the case.
Miller and Medus said that work involved finding common thread in the cases.
State officials asked affected nursing homes and schools to tell them where they bought their peanut butter.
The invoices led them to Sysco Food Services in Fargo, N.D., a branch of a nationwide food wholesaler that serves institutions such as schools, nursing homes and restaurants.
Sysco sold King Nut peanut butter to all Minnesota's affected institutions.
With that information in hand by Jan. 5, an Agriculture Department food inspector was dispatched to the Brainerd nursing home to retrieve an opened five-pound tub of the peanut butter.
On Jan. 9, with tests showing salmonella in the peanut butter, Minnesota officials warned institutions to stop using the product. That was Friday. By Monday, Minnesota laboratory tests proved King Nut peanut butter made in Georgia was the culprit.
By then, 30 Minnesotans were sick.
"We had a lot of peanut butter eaters," Medus said.
As soon as authorities pegged the peanut butter, Miller said, Sysco workers began rounding it up so it could not be eaten.
Medus, calling him a hero, said Miller tracked the peanut butter to an Ohio distributor, then back to the Georgia Peanut Corporation of America manufacturing plant.
The company began to recall its product, a recall that since has expanded to more than 2,300 foods, ranging from peanut butter crackers to ice cream to pet food that were made from peanut butter and paste originating in Blakely, Ga.
At last report, 654 people were sick nationwide and nine dead from the outbreak, although Medus said uncounted other Americans undoubtedly were sickened by the salmonella, but not bad enough that their doctors ran tests.
Medus said 14 of the 41 Minnesota victims were nursing home residents and eight were institutional food-service workers. At least a couple of school children became ill and nine ate crackers containing peanut butter. One Minnesotan became ill after eating in a North Dakota restaurant, but the source of several illnesses is not known.
On Friday, the Minnesota Education Department said 58 school districts have destroyed or locked away more than three tons of peanuts that came from the contaminated Georgia plant. There were shipped to Minnesota as part of a federal school lunch program.
Medus said the outbreak appears to be on the downside.
"I would not expect a lot more," she said.
Agriculture and Health departments have different roles in a food-born illness investigation, but officials say they work closely together - more closely than in other states.
The general breakdown is that health officials work with people, agriculture officials work with food.
"Once they (Health Department) are aware of facilities where illnesses may be occurring, they start to work with the Department of Agriculture," Miller said.
Once cases are identified, the Health Department begins to track where possibly contaminated food may originate.
The request Miller's staff than makes a food distributor, he said, is: "Give us a list of all the products you distributed for two or three weeks prior."
In this case, Sysco was identified very quickly, in part because it is a major supplier of everything from napkins to food.
Minnesota authorities said Sysco and institutions that used potentially deadly peanut butter products cooperated with their investigation. Only Peanut Corporation of America is suspected of doing anything wrong; it allegedly did not make changes after earlier tests showed salmonella present in its plant.
Among those who help trace illness sources are students on what the Health Department calls Team Diarrhea, so named because many of the illnesses they investigate involve diarrhea.
The students - seven in this case - called victims and others connected to the illnesses, attempting to find commonalities among those who got sick.
Those calls showed that Almer ate little during her nursing home stay other than peanut butter, Miller said, which helped narrow the list of suspected foods.
"When it came out of the peanut butter ... it was the smoking tub." Miller said of the salmonella discovery.
The salmonella contained a genetic fingerprint that never had been seen before, Medus said. That helped other states and federal agencies track their illnesses back to the Georgia plant.
Something that made the case tougher to solve is that salmonella is not evenly distributed through peanut butter - which the Georgia company packed in everything from five-pound tubs to railroad cars.
"Peanut butter is an interesting commodity," Miller said. "Prior to this, it was thought that the water product of peanut butter would prohibit (salmonella) growth."
Laboratory technicians discovered there were "hot spots" throughout the peanut butter container. There was no salmonella in places, "but the other knifefull that you take out, you might have a whole big shot of that. ... It had not been uniformly contaminated."
Besides testing food, Miller's department was charged with telling store managers about the potentially dangerous products and make sure they did not remain on store shelves. That part of the operation intensified Feb. 2 when inspectors fanned out across the state.
"The challenge has been, as this recall has expanded, that the food industry was made aware," Miller said. "We are still going to stay on top of it, probably for the next several months."
"Any product produced in that plant could not be guaranteed to not to be contaminated by salmonella," he said.