When the news broke last month that a settlement was reached involving 66 victims of the 2011 Listeria outbreak linked to contaminated cantaloupe, I remember thinking that I needed to go back and make sure that the official Food Safety News list of the 10 most deadly outbreaks of foodborne and waterborne illnesses in the U.S. was up to date. The list is a project that grew out of the cantaloupe outbreak when it turned unusually deadly. It’s not unusual for foodborne pathogens to make hundreds and even thousands sick, and send people to the hospital in droves. Thankfully, however, medical care in the U.S. usually saves the foodborne disease victim. As deaths were still occurring from Listeria-contaminated cantaloupe, we turned historian and went looking for original reports, books out of print, and old newspapers to try and nail down a top 10 list. I’ve come to accept that nothing that becomes the subject of historical inquiry is ever really over. The end of this civil litigation seems like an appropriate moment to go back over our work from three years ago. The fact is that the number of deaths attributed to this outbreak has changed a bit and is also subject to some explanation by the Centers for Disease Control and Prevention (CDC). We’ve accepted CDC’s numbers for the historic records. Here’s how CDC explains their work in the final report on the deadly outbreak:

• The number of outbreak-associated deaths has increased by three since December 8, 2011. In total, 33 deaths from outbreak-associated cases of listeriosis have been reported to CDC. In addition, one woman pregnant at the time of illness had a miscarriage.
• Ten other deaths not attributed to listeriosis occurred among persons who had been infected with an outbreak-associated subtype. State and local public health officials reviewed causes of death listed on death certificates to determine whether to attribute these deaths to listeriosis. Deaths included in this review occurred as recently as February 29, 2012.

Thus, the Listeria outbreak is the fourth-deadliest in U.S. history, the same ranking we gave it four years ago. In addition to just nailing down the top 10 deadliest outbreaks of foodborne illnesses, this project also discovered that the U.S. appears to have enjoyed a golden era of food safety during the 60-year period from 1925 to 1985 when there were no foodborne illness outbreaks with enough fatalities to be included among the very worst events. The 10 deadliest foodborne and waterborne outbreaks are: 1. Typhoid fever, 1924-25 Oysters from Long Island, NY, held in polluted waters, sickened more than 1,500 people in New York, Chicago, and Washington, D.C.; 150 died. 2. Typhoid fever, 1903 A public water source in Ithaca, NY, was polluted from a dam construction site, resulting in a typhoid outbreak involving 1,350 people; 82 died, including 29 Cornell University students. 3. Streptococcus, 1911 Raw milk delivered door-to-door in the Boston area was responsible for a strep outbreak; 48 people died. 4. Listeria, 2011 “Rocky Ford” cantaloupe from Colorado became contaminated, probably in the packing facility, sickening at least 146 people in 28 states; 33 deaths and one miscarriage. Ten additional deaths were possibly related to the outbreak. 5. Listeria, 1985 Mexican cheese made by a Los Angeles company sickened mostly Hispanic women, many who were pregnant; 28 died. 6. Streptococcus, 1922 Raw milk delivered door-to-door in Portland, OR, was contaminated; 22 died. 7. Listeria, 1998 Ball Park hot dogs and Sara Lee deli meats were recalled after Listeria was found in the Michigan processing plant; 21 died. 8. Botulism, 1919 Canned ripe olives from California sold to inland states were contaminated and caused outbreaks in three states; 19 died. 9. Salmonella Typhimurium, 2008-09 Peanut butter and paste contaminated with S. Typhimurium caused at least 714 illnesses in 46 states; 9 died. 10. Listeria, 2002 Sliced turkey meats from Pilgrim’s Pride were responsible for a multiple state outbreak; 8 died.