|1992-1993 Jack in the Box E. coli outbreak|
|Bacteria strain||Escherichia coli O157:H7|
|Source||Contaminated beef products at Jack in the Box restaurants|
|Location||Western United States|
|First outbreak||Seattle, Washington|
|First reported||January 12, 1993|
|Date||December 28, 1992 –|
February 23, 1993
The 1993 Jack in the Box E. coli outbreak occurred when the Escherichia coli O157:H7 bacterium (originating from contaminated beef patties) killed four children and infected 732 people across four states. The outbreak involved 73 Jack in the Box restaurants in California, Idaho, Washington, and Nevada, and has been described as "far and away the most infamous food poison outbreak in contemporary history." The majority of the victims were under 10 years old. Four children died and 178 other victims were left with permanent injury including kidney and brain damage.
On February 10, 1993, newly inaugurated President Bill Clinton participated in a televised town meeting program from the studios of WXYZ-TV in Detroit, Michigan. He fielded questions from the studio audience as well as studio audiences in Miami, Florida, and Seattle, Washington and responded to questions from the parents of Riley Detwiler – the fourth and final child to die in the E. coli outbreak. The wide media coverage and scale of the outbreak were responsible for "bringing the exotic-sounding bacterium out of the lab and into the public consciousness" but it was not the first E. coli O157:H7 outbreak resulting from undercooked patties. The bacterium had previously been identified in an outbreak of food poisoning in 1982 (traced to undercooked burgers sold by McDonald's restaurants in Oregon and Michigan), and before the Jack in the Box incident there had been 22 documented outbreaks in the United States resulting in 35 deaths.
On January 12, 1993, Dr. Phil Tarr, then a pediatric gastroenterologist at the University of Washington and Seattle's Children's Hospital, filed a report with the Washington State Department of Health (DOH) about a perceived cluster of children with bloody diarrhea and Hemolytic Uremic Syndrome (HUS) likely caused by E.coli O157:H7. Dr. Tarr contacted Dr. John Kobayashi, the Washington State Epidemiologist, who started the epidemiological trace-back, linking these cases to undercooked hamburger patties. Dr. Kobayashi recalled the conversation in an interview: “I knew that, when Phil called me,...for him to say, "this is something that I've never seen before," that was a big red flag.” 
Health inspectors traced the contamination to Jack in the Box fast food restaurants' "Monster Burger" which had been on a special promotion (using the slogan "So good it's scary!") and sold at a discounted price. The ensuing high demand "overwhelmed" the restaurants, and the product was not cooked for long enough or at a high enough temperature to kill the bacteria.
On Monday, January 18, 1993, DOH officials went public with an announcement about the source of the O157 outbreak. This news conference took place during the Martin Luther King holiday weekend at the state lab. After that press conference, Jack in the Box agreed to stop serving hamburgers and quarantine the meat. Only two days later, on the same day of President Bill Clinton’s inauguration, a powerful storm swept through the Puget Sound area (Seattle and King County) The storm ravaged the area, knocking out the power for hundreds of thousands of residents across three counties, some living in the dark for five days. The power outage would impact proper cooking temperatures, proper refrigeration temperatures, and even proper hand-washing – all critical factors in preventing foodborne illnesses.
At a 1993 press conference the president of Foodmaker (the parent company of Jack in the Box) blamed Vons Companies (supplier of their hamburger meat) for the E. coli epidemic. However, the Jack in the Box fast-food chain knew about but disregarded Washington state laws which required burgers to be cooked to 155 °F (68 °C), the temperature necessary to completely kill E. coli. Instead, it adhered to the federal standard of 140 °F (60 °C). Had Jack in the Box followed the state cooking standard, the outbreak would have been prevented, according to court documents and experts from the Washington State Health Department. Subsequent investigation by the Centers for Disease Control and Prevention (CDC) identified five slaughterhouses in the United States and one in Canada as "the likely sources of ... the contaminated lots of meat." In February 1998, Foodmaker agreed to accept $58.5 million from Vons and eight other beef suppliers to settle the lawsuit started in 1993.
A total of 171 people required hospitalization. The majority of the victims who presented symptoms and were clinically diagnosed (but not hospitalized) were children under 10 years old.
Of the infected children 45 required hospitalization – 38 suffered serious kidney problems and 21 required dialysis.
Four children died:
|"Chasing Outbreaks: How Safe is our Food?". Retro Report short film dated May 10, 2015, discussing the Jack in the Box outbreak and how it led to major changes in industry practices and government oversight of the food supply. (Duration: 11 mins 8 secs)|
Sen. Richard Durbin (D-IL), addressing a congressional hearing on food safety in 2006, described the outbreak as "a pivotal moment in the history of the beef industry." James Reagan, vice president of Research and Knowledge Management at the National Cattlemen's Beef Association (NCBA), said that the outbreak was "significant to the industry" and "the initiative that moved us further down the road [of food safety] and still drives us today." David Acheson, a former U.S. Food and Drug Administration Associate Commissioner for Foods, recently told Retro Report that "Jack in the Box was a wakeup call to many, including the regulators. You go in for a hamburger with the kids and you could die. It changed consumers' perceptions and it absolutely changed the behaviors of the industry."
As a direct result of the outbreak: