20 years after Jack in the Box, foodborne illnesses still an issue

Darin Detwiler, a senior policy coordinator for food safety at STOP Foodborne Illness in Chicago and a graduate lecturer in regulatory affairs of the food industry at Northeastern University in Boston, writes in this op-ed:

rileyDI am deeply saddened to read about the deaths this year of a two young girls (one in Whatcom County and another in Portland,) both caused by E.coli.

My 16-month-old son, Riley Detwiler, died from E.coli during the 1993 “Jack in the Box” outbreak. He became ill just as the Whatcom County Health Department warned of a child with E. coli at his daycare. The other child ate an undercooked, contaminated hamburger at the Bellingham restaurant. After noticing symptoms, I took Riley to St. Joseph’s Hospital where, after two days, doctors decided to airlift him to Children’s Hospital in Seattle.

Doctors removed most of his intestines, destroyed by foodborne pathogens, and collaborated with experts to make him healthy. I stood every day beside Riley’s little toddler body — dwarfed by wires and tubes. He laid in a coma for weeks until I held him one last time after he died. His poisoning and death made national headlines — even gaining the attention of President Clinton.

The 1993 “Jack in the Box” outbreak sickened over 650 people and took the lives of four young children. Today, many experts refer to that event as the “9/11” for the meat industry.

A pivotal moment in history, the attacks on 9/11 killed almost 3,000 people and resulted in sweeping changes in our national concept of homeland safety and our day to day security practices. The 1993 Jack in the Box E.coli outbreak should have been a pivotal moment in food safety. However, foodborne pathogens, according to the CDC, still cause 3,000 to 5,000 Americans to die each year. Even worse is the fact that Americans’ perception of food safety has not changed dramatically since then.

Two decades ago I hoped Riley’s death would lead to important national changes in industry, federal regulations, and in American’s awareness and behaviors. Unfortunately, I was wrong. Rarely has a week gone by when I have not heard or read about a food recall, an illness or a death from foodborne pathogens. Changes may be coming, but they will have come too late for the families of nearly 50,000 Americans who have died from food pathogens since Riley’s passing.

The CDC reports that at least 48 million Americans each year become ill from contaminated food leading to at least 128,000 hospitalizations. The CDC also stresses that for every single case of foodborne illness that gets reported, 38 cases go unreported.

Clearly, only the tip of this crisis is seen and reported. The majority of those made ill or who die from food poisoning are young children with immune systems not yet capable of fighting off the variety of foodborne pathogens found in America’s food supply.

Over the last 21 years, every time I see a news report of food recalls or of new illnesses and deaths from foodborne pathogens, I think about Riley — his smiling face, his few words and his few steps, his life cut short by problems in our food supply that persist to this day. These echoes of a needless loss come with the reminder that more needs to be done to prevent tragedies like this from erasing any sense of security and safety in the foods we eat and serve to our families.

Today, foodborne illnesses and deaths are associated with not only meat, but also with many other foods once considered completely safe. Foodborne pathogens are dangerous for all consumers and especially dangerous for those most susceptible to foodborne pathogens: the very young, elderly, pregnant, and those who are immune-compromised.

We may never understand exactly how the young girls from Lynden and Portland became sick and died from presumably safe food. What we should learn from these tragic deaths is that all foods pose the threat of illness or even death and that young consumers are most at risk. Also, foodborne pathogens are spread not only by consuming contaminated food, but also through physical contact with pathogens. My son died from E. coli without ever having eaten a hamburger in his life. Hand washing and prevention of cross-contamination are important. If we as a country can keep this in mind and stay vigilant, together we can minimize the spread and the threat of foodborne pathogens. 

Father of Washington E. coli victim continues push for food safety

Sometimes, when he was a teacher, Darin Detwiler would look at his students and realize they were the same age as his son Riley, if Riley were still alive.

rileyDRiley was just 17 months old when he lost his life 21 years ago. He was one of four youngsters in the Northwest who died from an E. coli O157 outbreak linked to contaminated, undercooked meat at Jack in the Box restaurants.

Detwiler said seeing his students, alive and healthy, reminded him of the importance of trying to be a good teacher, and of weaving the subject of food safety into his classroom content.

“There’s a reason why I am alive and my son is not,” he said. “If I’m going to justify why I’m alive, maybe it’s to continue to be of service and to make a difference in this world. It helps me to go to bed at night.”

Detwiler and his wife, Vicki, were living in Bellingham when news of the E. coli outbreak went public in mid-January 1993. At the time, they were parents to two boys, Joshua, 9, and Riley.

As a precaution, they stayed away from Jack in the Box, but Riley became sick after being exposed to an infected child in day care.

Riley soon showed signs of illness and was flown to a Seattle hospital in serious condition on Feb. 2. Despite major surgery and intensive care, he died 18 days later.

Nearly 500 people were infected by eating the contaminated hamburger meat in Washington and three other Western states.

USDA National Institute of Food and Agriculture funds University of Nebraska-Lincoln (and Kansas State and NC State) to investigate STECs

In January 1993 I was in 10th grade. I had just discovered the Violent Femmes and punk rock; was worried about figuring out calculus (I eventually did); and spent most of my time being uncool and longing to be cool. Probably pretty similar to every other awkward teenager. I didn’t have a clue that a tragic foodborne illness outbreak was unfolding in the Pacific Northwest and that the event would eventually define a bunch of what I focus on every day.

I had never even heard of Jack-in-the-Box.

The outbreak was linked to four deaths, over to 700 illnesses and almost 200 hospitalizations. E. coli O157:H7 contaminated hamburger was then undercooked and served to thousands from 73 Jack-in-the-Box restaurants. Jack-in-the-Box will forever be linked to this event – and over the past 18 years has become a prominent force in food safety risk reduction.

News of this outbreak hit on President Clinton’s inauguration day and as Doug has written,

Those two events, more than any other, dramatically changed the public discussion of food safety in the U.S. The Jack-in-the-Box outbreak had all the elements of a dramatic story: children were involved; the risk was relatively unknown and unfamiliar; and a sense of outrage developed in response to the inadequacy of the government inspection system. The newly inaugurated President Clinton made microbial food safety a Presidential issue.

And the first focus went to E. coli O157:H7 – the serogroup linked to the Jack-in-the-Box illnesses. Food microbiologists and epidemiologists have seen lots of other equally dangerous shigatoxin-producing serogroups (shigatoxin is what makes E. coli O157:H7, along with its ability to stick to cells so devastating). Here’s a list of the non-O157 STEC outbreaks we’ve been able to find going back to the mid-1990s.

Later this afternoon I will be on my way to Lincoln, NE to meet with a group of academics, researchers, extension folks and regulators to talk about a large 5-year integrated project focused on reducing STECs from farm-to-fork that USDA NIFA has funded. Through the wonders of the Internet, Doug will be Skyping in.

LINCOLN, Neb. — The U.S. Department of Agriculture (USDA) announced today that it has awarded a research grant to the University of Nebraska-Lincoln (UNL) to help reduce the occurrence and public health risks from Shiga toxin-producing E. coli (STEC) along the entire beef production pathway. Dr. Chavonda Jacobs-Young, acting director of USDA’s National Institute of Food and Agriculture (NIFA), is scheduled to award the $25 million grant to the UNL-lead research team today at the university in Lincoln.

"Shiga toxin-producing E. coli are a serious threat to our food supply and public health, causing more than 265,000 infections each year," said Chavonda Jacobs-Young, acting NIFA director. "As non-O157 STEC bacteria have emerged and evolved, so too must our regulatory policies to protect the public health and ensure the safety of our food supply. This research will help us to understand how these pathogens travel throughout the beef production process and how outbreaks occur, enabling us to find ways to prevent illness and improve the safety of our nation’s food supply."

Dr. James Keen at UNL, along with a multi-institutional and multi-disciplinary team of researchers, educators and extension specialists, will use the $25 million grant to improve risk management and assessment of eight strains of STEC in beef. This work will include the O104 strain that caused the recent outbreak in Germany. The project will focus on identifying hazards and assessing exposures that lead to STEC infections in cattle and on developing strategies to detect, characterize and control these pathogens along the beef chain. This knowledge will then be used to find practical and effective STEC risk mitigation strategies. The five main objectives of the project include:

Detection: develop and implement rapid detection technologies for pre-harvest, post-harvest and consumer environments.

Biology: characterize the biological and epidemiological factors that drive outbreaks of STEC in pre-harvest, post-harvest, retail and consumer settings.

Interventions: develop effective and economical interventions to lessen STEC risk from cattle, hides, carcasses, and ground and non-intact beef and compare the feasibility of implementing these interventions for large, small and very small beef producers.

Risk analysis and assessment: develop a risk assessment model for STEC from live cattle to consumption to evaluate mitigation strategies and their expected public health impacts.

Risk management and communication: translate research findings into user-friendly food-safety deliverables for stakeholders, food safety professionals, regulators, educators and consumers.

For more check out the full PR here.