Editor’s Note: This is the sixth installment in a ten-part series on meaningful foodborne illness outbreaks.
Our reliance on imported fresh foods, and the danger they can sometimes pose, was demonstrated in these green onions from Mexico that brought illness to suburban Pennsylvania. It went down this way:
In late October of 2003, Pennsylvania health officials learned of a potential hepatitis A outbreak from emergency room doctors treating patients in Beaver County. The Beaver County Health Department (BCHD) and Pennsylvania Department of Health (PDOH) began investigating the apparent outbreak, and learned through interviews that all case patients had eaten at the Chi Chi’s restaurant at the Beaver Valley Mall in the weeks before becoming ill.
On November 3, PDOH issued a hepatitis A advisory, encouraging anyone who had eaten at the Beaver Valley Mall Chi-Chi’s restaurant within the past 14 days to receive an Immune globulin (Ig) shot to prevent becoming ill with the hepatitis A virus. Ig is only effective in preventing infection with hepatitis A if it is administered within 14 days of exposure to the virus. PDOH scheduled Ig immunization clinics at several locations over the following days.
By November 7, PDOH had identified 130 people who had contracted hepatitis A as part of the outbreak. The number had grown to 240 cases by November 11, and kept climbing. By November 14, three people had died due to liver failure caused by hepatitis A, and the number of ill people had risen to 500.
PDOH, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), conducted an epidemiological study of the outbreak, and determined that green onions imported from Mexico were the source of the outbreak. The FDA issued a statement dated December 9, 2003, affirming that this outbreak was associated with eating raw or undercooked green onions.
Ultimately, over 650 confirmed cases of hepatitis A, both primary and secondary, were linked to consumption of green onions at the Beaver Valley Mall Chi-Chi’s. The victims included at least 13 employees of the restaurant, and numerous residents of six other states. Four people died as a consequence of their hepatitis A illness. In addition, more than 9,000 people who had eaten at the restaurant during the period of potential exposure, or who had been exposed to ill Chi-Chi’s customers, obtained immune globulin shots to prevent hepatitis A infection.
Chi-Chi’s had filed for Chapter 11 bankruptcy in U.S. Bankruptcy Court in Delaware prior to the outbreak of illnesses; however, an Order issued by the Bankruptcy Court on February 17, 2004, allowed claimants to attempt to mediate and settle their claims against Chi-Chi’s despite the company’s bankruptcy status.