As George Bush left the White House in January 1993, a mass food poisoning was unfolding in the states of Washington, California, Nevada and Utah. More than 700 people were sickened, dozens required dialysis and four died. The cause was E. coli O157:H7, a pathogen so little known outside specialist circles that few of the doctors treating victims had heard of it. The source: "Monster Burgers" sold from overwhelmed grills in a Jack in the Box promotion.
As Bush's son returns to the White House, E. coli O157:H7 contamination is now so pervasive that health authorities are warning against drinking well water, swallowing pool water, swimming in freshwater lakes, drinking fresh apple juice, eating fresh sprouts and taking children to petting zoos, farm visits and even camp-outs.
Not only is America's former national dish--a juicy rare hamburger--now off-limits, the National Advisory Committee on Microbiological Criteria for Foods is asking whether we dare serve steaks rare.
As the notion that beef should be a succulent luxury rather than a fast-food filler slips into obscurity, the political struggle over how to respond to \o7 E. coli \f7 O157:H7 resembles nothing so much as mud wrestling. "You can't tell the good guys from the bad guys without a score card, and they shift all the time," says David Murray of the Washington, D.C., accuracy watchdog agency, the Statistical Assessment Service.
What was in fact a scientific challenge became a political football. Roughly summed up, for Democrats, the emergence of \o7 E. coli\f7 O157:H7 represents Republican collusion with the meat industry. To Republicans, it is one of many bacteria--part and parcel of the natural world.
Whichever party is right, now hanging in the balance is not just the right to eat rare meat, but the environment itself, and America's keenest pleasures of summer.
Bad News by Any Name
"To me, the \o7 'E'\f7 in \o7 E. coli\f7 stands for 'evil'," says Nancy Donley. In 1993 in Chicago, her 6-year-old son, Alex, was so ravaged by O157:H7 poisoning from contaminated hamburger meat that when he died, only his corneas were fit for organ donation.
To biologists, the \o7 E. \f7 stands for \o7 Escherichia. E. coli \f7 is a species of intestinal bacilli named after German physician Theodor Escherich. The \o7 "coli"\f7 signals that it's "of the colon." It's not clear what most \o7 E. coli\f7 bacteria do, just that warm-blooded animals have them. They might serve in vitamin synthesis.
It is \o7 E. coli's\f7 ability to gene-swap that might have given rise to a rogue subclass including O157:H7. Members of this group are able to emit a toxin typical not of \o7 E. coli\f7 but of shigella, the agent that causes dysentery.
In their quick evolution, \o7 E. coli \f7 bacteria appear to be getting tougher. At Cornell University, U.S. Department of Agriculture microbiologist James Russell has shown that many \o7 E. coli\f7 , including O157:H7, are gaining the ability to survive the acid of the gastric juices in our stomachs. This resilience appears to be caused by the way we have fattened cattle since World War II.
"Grain feeding has created a variety of problems for the animal and for the environment," says Russell, who finds that a shift back to a traditional hay diet causes the amount of acid-resistant \o7 E. coli\f7 in cattle manure to drop dramatically.
Once \o7 E. coli \f7 O157:H7 is out in the environment, children and the elderly are the most vulnerable. Donley thinks that she may have had, but shaken off, the same bug that killed her son. The first symptom is bloody diarrhea. The second, potentially fatal complication is when the toxin begins to attack the kidneys and induces a condition called hemolytic uremic syndrome. Victims, usually children or the elderly, require dialysis and can suffer strokes, brain damage and death.
The first recorded outbreak of O157:H7 poisoning among 26 customers of an Oregon branch of McDonald's in 1982 was caught precisely because of the violent symptoms. "The doctor who recognized it saw that these people all had this common syndrome of frank blood in their stools," says Mike Doyle, director of the Center for Food Safety at the University of Georgia.
Doyle studied the outbreak. "No one died," he says. "There were no cases of hemolytic uremic syndrome. It was almost viewed as a freak event." However, within months, a second McDonald's outbreak in the Midwest had the Centers for Disease Control and Prevention, or CDC, in Atlanta convinced it was meat-borne.
By 1984, it was cropping up around the country and had thrown three children into kidney failure in a North Carolina daycare center and killed four in a Nebraska nursing home. By 1987, it had killed two in Walla Walla, Wash., and physicians there were required by law to report suspected poisoning cases. By the time of the Jack in the Box outbreak in January 1993, there had been 22 documented outbreaks across the country and in Canada. At least 35 people had died.