Poisoned: Inside the Devastating E. Coli Outbreak That Changed How We Eat

Take Part
Published: July 16, 2011
By: Max Follmer
On Christmas Eve in 1992, six-year old Lauren Rudolph showed up at Children's Hospital in San Diego with severe stomach pains and bloody diarrhea. She died less than a week later. No one knew it at the time, but little Lauren was the first victim of a food-borne illness outbreak that would eventually kill four children, and sicken 700 others. 

The Jack in the Box E. Coli outbreak changed the way Americans thought about food. No longer was a stomach bug considered a mild inconvenience that caused a bit of discomfort. All of a sudden, hamburgers became deadly weapons.

In his new book, Poisoned, journalist Jeff Benedict dissects the Jack in the Box case to show just what went wrong. It's a fast-paced narrative that reads like the best whodunnit and crime novels out there. Benedict obtained access to confidential documents and conducted exclusive interviews with the figures at the heart of the story. 

The result is a jarring, explosive account of a terrifying episode that still resonates with anyone concerned about the safety of the food we eat. TakePart spoke with Benedict about his book, and why, twenty years later, the Jack in the Box story is so powerful:

TakePart: Why did you think this story was still relevant and important for the American public to read about almost 20 years after the fact?

Jeff Benedict: It was the biggest food scare in contemporary American history. It’s the foodborne illness outbreak that really set in motion most of the changes that happened in the food safety world in the last 20 years. I think the Jack in the Box outbreak was the most influential incident with regard to food safety policy since Upton Sinclair published The Jungle. 

TP: For people who might not remember what happened in the Jack in the Box case, can you tell us why it was so significant? What was it about this particular case that hit home for people?

JB: It starts with the simple fact that it was the first. Meaning if you go back to 1993, American consumers did not know the word E. coli. It was a foreign term, now it’s a household word, a dirty word, that we all know because there have been so many E. coli poisonings on a small scale since ‘93. That case just burst on the scene, seemingly out of nowhere. Americans were frightened by the fact that a hamburger could be lethal. It was a totally new concept. We understand that now, but if you go back twenty years, people never thought that way back then. This case woke us up, and it was such a scary thing that it led the nightly news on ABC, CBS, and NBC — These were pre-FOX days. It didn’t just lead it for one night; it led it for weeks. 

The country followed this outbreak. Even though the epicenter was in Seattle, people in New York, Boston, Miami and Dallas were tracking this thing on the nightly news. It was on the front page of The New York Times. It triggered congressional hearings that were widely watched by the media. It was a very big deal. 

TP: The story of Jack in the Box is layered and complex, but in a nutshell what was it that caused these hamburgers to sicken so many people?

JB: In a nutshell, Jack in the Box received a shipment of frozen hamburger patties that were severely contaminated with E. coli. The burgers that went into the chain of distribution through Jack in the Box restaurants were mostly in the Seattle area. There are 66 stores up there, and these were kiddy burgers — adults didn’t get sick in this outbreak, for the most part. 

Kids started showing up in the emergency rooms in the Seattle area with bloody diarrhea and severe abdominal cramping. Fortunately, one of the silver linings of the story was that the number one pediatric expert on E. coli was a physician at Seattle Children’s Hospital, and he knew what this was when he saw the symptoms. It wasn’t a question of figuring out what’s afoot; the question was ‘what is the source?’ 

They were able to figure it out within a few days. They traced it to Jack in the Box meat. If Jack in the Box had cooked its meet to the prescribed temperature, we likely would not have had an outbreak. But the problem was they were using old grills and a lot of their hamburgers were not sufficiently cooked. They were below the mandatory temperature of 155 degrees, which kills E. coli.

TP: So what was the result of this outbreak in terms of public policy and public health in this country? What changes did the public see and did the restaurant industry undertake?

JB: Well the first thing — and this was so critically important — was that the federal government declared E. coli O157:H7 an adulterant, meaning it is illegal for that strain to be found in food, period. 

Prior to this outbreak it was not illegal, and it was not even a reportable disease to the CDC. Food inspectors were not testing for E. coli. Beef manufacturers were not testing for E. coli in their products. And doctors and hospitals were not taking E. coli tests from people who came in with these symptoms. So the information was never reported on to federal public health officials. 

Once the government looked at this outbreak in its scale they declared that strain of E. coli an adulterant, which meant two things changed immediately: that strain had to be tested for because it was now a declared adulterant. The meat industry had to test for it; food testers for FDA and USDA had to test for it. On top of that, anytime someone showed up with these symptoms and an E. coli case was found the hospital had to report to the public health program, which then shared it with the CDC. Those simple things brought about a world of change in terms of starting to scale down E. coli outbreaks. 

But the other thing was the restaurant industry was scared to death about what happened to Jack in the Box. There was an across-the-board change to the protocols of food safety, particularly for meat in the fast food industry. When we go to a grocery store we take for granted that any of the meat or poultry that we buy has warning labels on it and cooking instructions and handling instructions. All of that is a direct byproduct of this outbreak.

TP: As a journalist and a writer what was the most eye-opening thing for you in researching Poisoned?

I made some substantial changes in my own habits and my family’s habits. We are much more careful in what we eat. I think I can sum it up and say, prior to working on this book I never realized that you can be seconds away from putting something lethal in your body if you are not paying attention to where your food comes from and how it’s prepared. Something as simple and seemingly innocent as a hamburger or a piece of lettuce or milk can actually put your children in the ICU. As a parent I am much more thoughtful about what is on my kids’ fork every night and how it got there and where it came from. 

TP: One of the most powerful parts of the book is the personal story of this little girl, Lauren Rudolph, who was in the hospital. You worked with her mother in researching and writing the book. I wonder what retelling the story is like for her 20 years after the fact. Does it still have a large impact on her life?

JB: She hasn’t talked about much since it happened. Obviously it isn’t an easy thing for a parent to discuss and its not easy for a journalist to interview a parent about the death of a child — in this case your only daughter. 

I can tell you some of the most emotional interviews I’ve conducted in my career were the interviews with the mothers of the children in this book. Roni Rudolph is a perfect example. The interview that stood out to me the most was the face-to-face interview we did in San Diego where we actually went through the death scene in the hospital where she agreed to have her daughter disconnected from the life support machine. She was literally holding her against her breast when the last breath of air went out of her daughter. That is an unbelievably powerful, emotional moment. She wept. I wept. We were in a restaurant that had people in it and it was like we were on an island somewhere. I will never forget that. I was exhausted when it was over. 

It was similar when I interviewed Mrs. Kiner, whose daughter Brianne was in a coma also, but survived. It was just as powerful to interview her and talk about the moment when her daughter woke up after 40 days of lifelessness in a coma.