Not quite a month ago, Vermont health officials announced they were dealing with an E. coli outbreak, which would eventually grow to an estimated 11 cases in three states. It was likely caused by restaurant hamburgers made from local grass-fed beef and prepared to satisfy the tastes of its customers, no matter how rare. Inside a walk-in cooler at the popular Worthy Burger restaurant, housed in a historic depot at South Royalton, VT, state officials found Shiga toxin-producing bacteria in an unopened package of beef. Such a finding is enough for recall whether the contaminated package was associated with an outbreak or not. However, the recall that might ordinarily have followed such a discovery has not happened. Illnesses associated with Worthy Burger began in late August, prompting an investigation by the Vermont Department of Health that led to the restaurant’s five-day closure that began Sept. 17. Worthy Burger remained closed until Sept. 22, the day Vermont health officials went public with a health alert about the outbreak. The beer and burger joint thanked customers in a Sept. 26 Facebook post: “We have been working closely with the Vermont Dept. of Health during this ongoing investigation. Although the commonality of all those that fell ill ate at the Burger, there is no other evidence to suggest the contamination originated at the restaurant. We agreed to a voluntary closing, which allowed us time for maintenance and cosmetic upgrades which we had already had planned, while the Dept. of Health gathered more data. We have since reopened our doors, taking preventative measures by sourcing several new vendors, as advised, while the Dept. of Health continues its investigation elsewhere. Our customers’ and this community’s health and well-being are a priority for us and we hope all those that fell ill a healthy recovery.” In return, the restaurant got more than 300 “Likes”  from fans, several of whom responded by praising Worthy Burger and its food and thanking the managers for their openness and honesty. This is the first takeaway — it never hurts to be popular. Worthy Burger counts Vermont Gov. Peter Shumlin among its occasional customers. It’s not known how the state’s chief executive prefers his Worthy Burgers. Worthy Burger got a 95-percent score in its most recent restaurant inspection. The state standard is for restaurants to cook hamburgers to at least 155 degrees F for 15 seconds to kill pathogens, but apparently there was no objection to Worthy Burger responding to customer requests for rare and medium-rare offerings. The second takeaway is about division, meaning the split between the Vermont Department of Health and USDA’s Food Safety and Inspection Service (FSIS), which has left the investigation unsettled without any recall. While Vermont health officials turned up the DNA for Shiga toxin in ground beef from an unopened package in the Worthy Burger walk-in, when the pathogen was grown at a state lab, it turned out to be a bit different than the outbreak strain. Still, contaminated product — even in small amounts — is often recalled without ever being involved in an illness outbreak. But FSIS has not recalled so much as an ounce of beef from Worthy Burger or any of its suppliers, nor has it named a farm or the slaughterhouse involved in the investigation. Jason Merrill, Worthy Burger’s executive chef, suggested that the package of beef collected from his walk-in cooler was contaminated at a “USDA-inspected” slaughterhouse and not at the farm where the grass-fed beef cattle were raised. The restaurant reportedly sources all of its food ingredients locally. Bradley Tompkins, Vermont health surveillance epidemiologist, has said that the state believes undercooked contaminated beef caused the outbreak. A spokesman for FSIS claimed the link to beef remained debatable and said the agency wanted “to get to the bottom of this.” A spokeswoman for FSIS responded to Food Safety News via email on Tuesday that the agency did not request a recall because the ground beef sample which tested positive for E. coli O157 did not contain the illness-causing H7 antigen, nor did it contain Shiga toxin-producing bacteria. Therefore, the product “is not adulterated and subject to recall,” said Gabrielle Johnston, FSIS public affairs specialist, adding, “FSIS continues to work closely with our public health partners on finding the source of this outbreak.”

The Vermont outbreak did focus attention back to the fact that there are still burger joints selling pink, rare, or even raw burgers more than 20 years after the deadly Jack in the Box E. coli outbreak brought the danger to the public’s attention. The third takeaway is that government did not participate in this “teachable moment.” While Vermont and USDA both pump out one message after another on their various social media sites, there’s been no mention of the dangers of eating undercooked beef on those government sites in the past month. The estimated 11 victims of Vermont’s E. coli outbreak openly acknowledged dining on undercooked burgers at Worthy Burger, including 22-year-old law student Elizabeth Doherty. She was the last to become ill from eating at Worthy Burger, which was on Sept. 22, after the restaurant’s five-day closure and when the restaurant was still filling customer’s orders for rare and medium-rare burgers. It has since eliminated “pink in the middle” from its menu options. The fourth takeaway is that, whether an individual illness was the first or last, opting into a E. coli O157:H7 outbreak is never going to be a pleasant experience. Doherty’s mother said that she found her daughter hunched over in pain and crying before taking her into the Dartmouth-Hitchcock Medical Center, which helped the law student to fully recover.

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