In 1993, 623 people in the western U.S. fell ill with a little-known bacteria called E. coli O157:H7. Ultimately, four children would die from their infections; many others suffered long-term medical complications. The bug was later traced to undercooked hamburger served at Jack in the Box restaurants. This outbreak thrust foodborne illness onto the national stage as a real and present threat, sparking a sea change in the way Americans and the government treat this issue. To commemorate the 20th anniversary of the 1993 Jack in the Box outbreak, Food Safety News has produced a series of retrospective stories chronicling the outbreak itself and how food safety in America has changed since that time. Food scientists and microbiologists knew about the risk of E. coli O157:H7 in our food supply before 1993. But that year, after it became the bug that sickened over 600 people and killed four, delivered on a Jack in the Box hamburger patty, it popped up on everyone’s radar. Following months of national media coverage of the outbreak, federal policymakers were motivated to review food safety laws, and newly elected President Bill Clinton and his Secretary of Agriculture Mike Espy were under pressure to act. At the time of the outbreak, the accepted meat inspection procedure was the “poke and sniff” method, wherein USDA Food Safety Inspection Service (FSIS) inspectors would approve or reject meat at the slaughterhouses by looking over each carcass as it went by. That policy had been in place since the Federal Meat Inspection Act passed in 1907. In the interim, the cattle industry grew, as did the presence of the concentrated animal feeding operation. The systems had changed drastically since 1907, and new policies were needed to adapt to these differences. But it wasn’t until the Jack in the Box outbreak that real change occurred. “[The outbreak] made people in the industry realize that poor handling or undercooking could sicken hundreds,” said Dr. Richard Raymond, former FSIS undersecretary in an interview with Food Safety News. “Every fast food chain out there realized they could be the next Jack in the Box.” The first thing FSIS did after the outbreak was to declare E. coli O157:H7 an adulterant when found in ground beef, thus requiring additional testing by meat packers. FSIS would also begin a new sampling program by testing raw ground beef in grocery stores for E. coli contamination. Was that the proper government response? “It totally makes sense, in my humble opinion,” Raymond said. “It behooves the industry to reduce risk in every way they possibly can. The changes the industry has made have just been phenomenal in increasing the safety of our beef.” “It had a huge impact,” said Dr. John Marcy, an extension food scientist at the University of Arkansas who has more than 35 years of education and meat industry experience. “That was the first time, legally, that you had that determination. There were things in place since the mid-’80s to address O157:H7, but politically it changed with Jack in the Box. They seized the opportunity to make dramatic strides.” The FSIS announcement that O157:H7 was an adulterant in ground beef was not met with open arms by many in the beef industry. On the contrary, the industry reaction was to sue the Department of Agriculture. Beef producers argued that USDA didn’t have the authority to make the determination that E. coli O157:H7 was an adulterant and that the new sampling program was an arbitrary use of its power. The issue was decided in favor of the government by a Federal District Court in Texas in Texas Food Industry Association v. Espy. From the opinion:

Plaintiffs in this case claim that USDA’s action is arbitrary and capricious because it will not achieve its intended purpose. Among other reasons, they allege that testing is prohibitively expensive and that the industry is already doing all it can to control the problem….

In response, Defendants argue that their program has already begun to achieve its intended purpose of spurring industry to use preventative measures….

After reviewing the evidence and arguments presented by the Parties, the Court finds that the Defendants E. coli sampling program was not arbitrary and capricious. There is certainly a rational basis for the USDA to conduct some sort of testing in order to educate itself about this problem. Furthermore, the evidence indicates that the program has been at least partially successful in spurring industry to take greater preventative measures. Moreover, in light of the common cooking practices of most Americans, there is at least a rational basis for treating E. coli differently than other pathogens. Finally, the Court finds that the Defendants’ changing policy is a rational response to an emerging problem.

The Texas Food Industry Association case affirmed the new FSIS policy, making official the idea that the slaughterhouse was where the agency’s focus should be. “Inspection was changing,” Marcy said. “There was a need to both cook [the ground beef] and to look at ways to reduce O157:H7 in the supply going to the [meat] grinders.” “[The Jack in the Box] incident brought increased focus on reducing [E. coli] at the slaughter facilities, because that’s the only place you can reduce it under FSIS inspection,” Marcy added. More changes since Jack in the Box In 1994, the E. coli-as-an-adulterant determination only applied to ground beef. Since then, FSIS has added “trim” and non-intact beef to the list of E. coli-inspected meat products. Beef trimmings are used in ground beef, while non-intact beef is blade or needle-tenderized beef. “Just having it as an adulterant in ground beef wasn’t enough,” Marcy said. “Having it declared as an adulterant in trim was probably a bigger step.” In October 2012, an FSIS official stated the department may expand its testing for E. coli to include other beef products. As an example of how the system works, on January 15, FSIS announced a recall of ground beef due to possible E. coli contamination. A Wisconsin firm recalled more than 2,500 pounds of raw ground beef from Glenn’s Markets and Catering in Watertown, WI. That recall occurred five days after the Wisconsin Division of Public Health reported three illnesses from E. coli O157:H7. Another major shift in food handling has been the mandatory implementation of the HACCP (Hazard Analysis and Critical Control Points) system, a science-based risk-management system developed by NASA and Pillsbury to keep astronauts safe from illness in space. The principle of HACCP is to identify steps in food processing where contamination is likely to occur and take measures to address those risks. Beginning in the late 1990s, USDA-inspected plants were mandated to submit their HACCP plans to FSIS for approval. In 2012, FSIS added six other strains of E. coli to the list of those that are now considered adulterants in ground beef, beef trimmings and non-intact beef. Those strands include O26, O45, O103, O111, O121, and O145. “It was a good move,” Raymond said of the additional required testing. “We will see more outbreaks and more recalls and that’s a burden to the industry, but it is something that will have to happen one way or the other.”