For those in the food industry, the Jack in the Box E. coli outbreak of 1993 is known as the single event that convinced burger joints across the country to raise their internal cooking temperature by 15 degrees. In that outbreak, hamburgers sold at Jack in the Box franchises predominantly in Washington state sickened more than 600 people and led to the deaths of four children. The chain’s beef supplier had been delivering E. coli-contaminated patties, which the restaurants were only cooking to an internal temperature of 140 degrees F, the federal requirement at the time. Prior to the outbreak, the state of Washington had updated its minimum internal temperature requirements to 155 degrees based on new evidence that 140 degrees was not hot enough to kill some pathogens, including a little-known danger called E. coli O157:H7. However, many restaurants in the state failed to update their cooking procedures. As the Jack in the Box outbreak unfortunately highlighted, cooking burgers to just 140 degrees F didn’t kill E. coli. If Jack in the Box had just cooked their burgers 15 degrees hotter, the outbreak wouldn’t have happened. In the aftermath, restaurants across the country updated their cooking protocols. Many acknowledged that, with the wrong supplier, it could have been their brand making headlines and paying out millions of dollars from personal injury lawsuits. But with the exploding popularity of gourmet burger restaurants and gastropubs in recent years, the lessons learned from Jack in the Box in 1993 appear to be fading from collective memory. Thanks in part to safety improvements in the beef supply, restaurants are warming up to rarer burgers in larger numbers, despite the warnings from food safety experts. Food code requirements In May 2014, Detroit-based beef supplier Wolverine Packing Co. recalled 1.8 million pounds of ground beef after the product was linked to 12 E. coli infections in Michigan, Ohio, Missouri and Massachusetts. Seven people were hospitalized. The illnesses in that outbreak were traced back to restaurants where the ground beef was served, although health officials have refused to reveal any of the restaurants involved. They have said they believe undercooked burgers played a role in at least some of those cases, and they issued a number of warnings about the risks of consuming undercooked hamburger meat following the outbreak. Serving and advertising medium-rare burgers has been a growing trend in the restaurant and “gastropub” industry, said Roy Costa, owner of Environ Health Associates, a food safety consulting firm for restaurants. One of Costa’s clients is a gourmet burger chain with a handful of locations in California and a few other states. They recommend ordering their burgers medium-rare, which means the center remains pink, and, if there are any potential pathogens in the center of the meat, they would likely remain alive. Costa would only work with the chain if they found a beef supplier that tested for E. coli O157:H7, which they did. But that’s still no guarantee that the meat won’t come with Salmonella or Campylobacter, he noted. “It’s not a perfect situation, and there’s still a danger there,” Costa said. But by finding a supplier who tests for E. coli, the chain is still going above and beyond the legal requirements in order to serve undercooked burgers. The federal food code allows restaurants to serve undercooked burgers as long as they have a clear written warning, such as a statement on the menu, regarding the dangers of eating raw or undercooked meat. Servers also need to verbally inform the customer that a pink burger is potentially risky. It’s treated the same as other raw or rare meats such as sushi or raw oysters. What counts as ‘undercooked’? According to the food code, ground beef should be cooked at 155 degrees F internally and held there for 15 seconds, or 158 degrees for even a moment, in order to kill pathogens at the center of the meat. Unlike a rare steak, a rare burger is risky because the germs from the outside of the meat have been ground inside. Lower temperatures require longer hold times. Lowering the burger’s temperature to 150 degrees F requires a full minute of holding at that temperature. At 145 degrees F, it should be three minutes. Any way you slice it, those temperatures and holding times probably won’t result in a pink center to your burger. Numerous independent restaurants have sprouted up in recent years with a promise of delivering a true medium-rare burger. Even in Canada, where medium-rare burgers are illegal, a few daring restaurants — such as Vancouver’s now-closed ReFuel — staked their reputation on juicier, pinker patties. North Carolina recently amended its state food code to allow for medium-rare burgers, much to the rejoicing of aficionados. In Ohio, the gastropub chain Bar145˚ takes its name from the internal temperature of 145 degrees F for a medium-rare burger, which its website claims makes for a perfectly cooked burger. That sort of business angle “flies in the face of prudent food safety practices,” said Dave Theno, food safety consultant and former vice president of technical services at Jack in the Box, where he was hired on in 1993 to rewrite the company’s food safety protocols after the big outbreak. “The basic reality is that, if you’re cooking products below 150 degrees and not carefully timing it, pathogens could survive,” Theno said. Informed consumer choice One factor that further complicates the medium-rare burger issue is the fact that serving undercooked meat contaminated with E. coli is technically illegal under federal law. Even if a consumer orders their burger medium-rare, the restaurant is breaking the law if that burger happens to have E. coli in it. But assuming no one is breaking the law, consumers should be given a choice regarding how their burgers are cooked, said Benjamin Chapman, assistant professor and food safety extension specialist at North Carolina State University. The problem is that many consumers might not be given the information necessary to make that informed choice, he noted. NC State is currently conducting a nationwide study in which secret shoppers patronize restaurants and order medium-rare burgers to see if the server informs them of the risks associated with undercooked beef, as stipulated in the food code. The study is still underway, and Chapman’s team is not yet releasing any data, but he did say he is not convinced the food code stipulation is very effective. “Risk communication from a server-to-patron standpoint in certain cases is not well done,” he said, adding, “No pun intended.” Another problem is that terms such as “medium-rare” and “well-done” have no temperature correlation. “As a consumer, the only thing I can do to guarantee a fully cooked burger is to order it cooked to 155 degrees for 15 seconds,” Chapman said. “I like the fact that people get to make their own decision,” he added, “but I’m not convinced that there are a lot of really good, informed choices happening.”