On Wednesday, Food Safety News editor Dan Flynn broke news of the identity of “Restaurant Chain A” as Taco Bell in the 10-state outbreak of Salmonella enteritidis that sickened at least 68 individuals in October and November 2011.

tacobellchain-350.jpgThe disclosure came from officials at the Oklahoma State Department of Health’s Acute Disease Service, who responded to a records request from Food Safety News by supplying a document implicating Taco Bell as the fast-food chain involved in the outbreak.

Sixteen Oklahomans reportedly became infected with Salmonella during the outbreak. According to the document, eight out of 12 individuals available for interviews ate at Taco Bell during the outbreak exposure window. The remaining four victims refused interviews or could not be reached.

In its January 19 outbreak report, the Centers for Disease Control and Prevention (CDC) said that 60 percent of the victims reported eating at various locations of a single Mexican-style restaurant chain — Restaurant Chain A — in the week before the outbreak’s onset on Oct. 13, 2011. Outbreak investigators determined that the illnesses likely were caused by a contaminated ingredient from one of the fast-food chain’s suppliers.

Of the victims who ate at this chain, 94 percent reported eating ground beef, while 90 percent reported eating lettuce. But ground beef was ruled out as a likely source because the chain’s procedures for handling and thoroughly cooking ground beef were said to be appropriate and safe.

The CDC chose not to name Taco Bell in the case because the outbreak had already ended and the agency wanted to keep cordial relations with the chain as it cooperated with investigators. Oklahoma public health officials said they gave the CDC until Tuesday to direct them on how to respond to document requests. When the CDC did not give directions, Oklahoma released the documents.

Before and after learning the identity of “Restaurant Chain A,” Food Safety News repeatedly reached out to Taco Bell for comment. On Wednesday evening, the company released a statement to the media.

“The CDC indicated that some of the people who were ill ate at Taco Bell, while others did not. They believe that the problem likely occurred at the supplier level before it was delivered to any restaurant or food outlet. We take food quality and safety very seriously,” the statement read.

Following the CDC publication of its January 19 outbreak report, Food Safety News had asked Taco Bell and five other major Mexican-style fast food chains to confirm or deny an association with the outbreak. Taco Bell did not respond.

Taco Bell’s history of outbreaks

This is not the first outbreak in which an unidentified “Restaurant Chain A” later turned out to be Taco Bell.

In 2010, the CDC investigated two separate Salmonella outbreaks linked to a Mexican-style fast food chain, “Restaurant A,” eventually revealed as Taco Bell. Those outbreaks resulted in 155 reported illnesses, including 42 hospitalizations. In that case, the CDC adopted the same approach of nondisclosure, initially choosing not to name Taco Bell.

The CDC estimates that for every confirmed case of Salmonella, 38 more cases go unreported, suggesting that many more people were likely sickened in the 2010 and 2011 outbreaks. Typical Salmonella infections can result in diarrhea, abdominal cramps, fever, nausea, vomiting and fatigue lasting one to seven days.

In 2006, Taco Bell was linked to an outbreak of E. coli O157:H7 that sickened at least 71 individuals, hospitalizing 53 and resulting in eight cases of hemolytic uremic syndrome. That time, the CDC was upfront in identifying Taco Bell.

According to BusinessMart, there are more than 5,800 Taco Bell franchises in the United States serving more than 2 billion meals a year.

Nondisclosure: Public health experts weigh in

In an interview with msnbc.com published Tuesday, Dr. Robert Tauxe, deputy director of foodborne, waterborne and environmental diseases at the CDC, defended the nondisclosure in the latest outbreak, noting that the practice is used on a case-by-case basis but supported by a longstanding precedent of withholding names when the public no longer faces an immediate health threat.

Former U.S. Department of Agriculture (USDA) food safety undersecretary and Food Safety News contributor Dr. Richard Raymond disputed that reasoning, but said Tauxe should not be the focus of blame.

Raymond suggested that food industry lobbyists might put pressure on government agencies to not disclose names.

“Obviously, they don’t like their stores being linked to recalls,” he said. “It takes a lot of political power and clout and intestinal fortitude to fight the lobbyists.”

When asked if government agencies might fear lawsuits from companies named in outbreaks, Raymond said it was likely, but agencies that have conclusive evidence should have nothing to fear.

The problem with nondisclosure, Raymond and other public health experts said, is that government agencies cannot reasonably anticipate the consequences of withholding the information and should instead err on the side of transparency. For one, in some restaurant-related outbreaks, consumers could be storing contaminated leftovers in their freezer for weeks before reheating them, he said.

To illustrate the importance of transparency, Raymond compared food recalls to car recalls: When a car is recalled once for a bad part, most customers appreciate the company’s notification and cooperate to get the problem fixed. But if the manufacturer routinely issues recalls for faults, customers eventually become wary and decide to stop giving the manufacturer their business.

The same logic applies to foodborne illness outbreaks, Raymond said. The public understands that companies cannot prevent every outbreak, but they want to know that those responsible are working to keep the same thing from happening again. If individuals never learn who sickened them, no one gets publicly held accountable.

University of Minnesota environmental health professor Craig Hedberg, Ph.D. said that companies who do not come forward about outbreaks miss their opportunity to publicly correct their mistake. He said that companies who proactively take responsibility often regain public favor, citing the examples of Jack in the Box after the 1993 E. coli O157:H7 outbreak and Schwan’s after the 1994 Salmonella outbreak from contaminated ice cream.

“If my food company was involved in an outbreak, I would certainly want to appear to be ahead of the curve and not trying to run away from anything,” Hedberg said. “If they appear to have something to hide, it feeds public anxiety. It’s much more damaging than confronting the outbreak upfront and highlighting your response.”

During his tenure at the USDA from 2005 to 2008, Raymond worked to establish new standards for informing the public on which grocery stores were selling recalled food. Before Raymond’s changes, the agency only revealed the product name, the identifying code and the region of the country where it was sold.

“The rationale behind naming the stores was that people don’t always remember what brand they bought and don’t keep the package to see the code once they’ve opened it,” Raymond said. “If I have leftover spaghetti in the fridge with contaminated beef and then I hear about a recall, I might not remember who made the beef, but I’ll probably know what store I bought it from.”

Raymond said he hoped the FDA and CDC would amend their policies in light of public reaction to recent outbreaks.

“We tried to set a precedent with the USDA,” he said. “I don’t know why we can’t have rules and regulations for letting people know where they ate that got them sick.”