On an early summer evening in 2016, Katie Ruffolo, a 36-year old mother of three, was battling diarrhea. She had no idea this signaled the start of an E. coli poisoning that would eventually attack her kidneys and stop her heart three times. Before it was over, doctors would debate whether she faced a partial recovery or death. Her prognosis was bleak.

The next morning, Katie called her doctor and was told to go to her clinic outside Milwaukee and give a stool sample. The doctor didn’t give her any medication, worried that whatever was causing her diarrhea could be made worse with antibiotics — something doctors later attributed to saving Katie’s life. 

While dealing with this mysterious illness, Katie also was watching her three children while her husband was out of town on a guys’ trip. Luckily, her husband returned by the time Katie’s diarrhea had turned bloody. On June 14, Doctors admitted Katie to West Allis Memorial hospital in Milwaukee.

Hospitalization

Because Katie had already submitted a stool sample to her doctor, the doctors in the emergency room were quickly able to figure out what was wrong. On Wednesday, June 15, results came back from the stool sample and E. coli O157 was identified.

Thursday morning, Katie was transferred to the intensive care unit because her kidneys were beginning to fail. “My keratin levels were going up and they knew I was going to need dialysis at some point,” she said.

 Death’s door

On Friday, July 17, Katie was moved to interventional radiology, where they do small procedures, so she could have a port put in for dialysis. But when she lay down, her heart stopped. She coded for 15 minutes. “What they think happened is that the fluids that built up in my body were not flushing through. They told me it basically had drowned my heart and stopped it.”

 The doctors were able to revive Katie, but there were other major concerns, such as brain damage from oxygen deprivation. She was placed on a ventilator for the next two and a half days.  Doctors also started cooling her body and then slowly warming it up. This technique is called therapeutic hypothermia.  It is used to prevent or lessen brain damage. 

Heart stops again

Sunday the 19th, Katie’s blood pressure fell and she coded again, this time for only a few minutes. Miraculously, later in the day, Katie opened her eyes and responded to questions.

Thanks to her parents being able to watch her children, Katie’s husband was able to be at the hospital constantly. He only left when forced to. But then, over the weekend of July 17-19, her parents found bloody stool in Katie’s 2-year-old’s diaper. The  2-year-old and 7-year-old were tested and found to have  E. coli poisoning. Fortunately, neither case was severe. “Thank God they just weren’t sick. They just needed to get tested until it was gone. So obviously we all ate something. And it obviously affected me way more than it affected them,” Katie said.

For the next few weeks, doctors worked to keep Katie alive.

“I remember one of the doctors telling me that they would start the day with 10 or 12 of them around a table talking about what they were going to do, just to keep me alive.”

Katie’s white blood cells and platelets went up and down, so she continued to get blood and platelets transfusions. Doctors had to drain her stomach fluid and were worried that they might have to remove her colon because it showed enlargement. “They put a gallbladder tube in, which I didn’t know was something they could do, which basically stayed in my body for weeks after that. Just to make sure the fluids coming from there were okay.”  

On June 23rd, Katie’s colon started working again, a good sign that her colon was going to be okay. Meanwhile, however, she was on constant dialysis. 

On June 28th, Katie was able to stop continuous dialysis. They started giving her dialysis as needed. Katie had fevers that would come and go, fevers they would have a hard time controlling.

“I don’t really have much memory of this time; I have little blips here and there of things. But I was also on some pretty serious drugs, rightfully so for pain and sedation. And I had some ICU psychosis happening,” Katie said.

On July 3rd, Katie started making her own urine. She became more responsive and she only needed small amounts of dialysis.

Katie’s heart stops a third time

Saturday July 9, Doctors attempted to remove her ventilator and she coded again, this time for a few minutes. “Things had started to look better, but I guess that was kind of the story, you take one step forward and then it would be two steps back. It was just constant back and forth.”Later that day, Katie was the most responsive she had been since entering the hospital. She even got agitated because she wasn’t allowed to have real food. Katie had been on IV nutrition since being put on a ventilator.On July 11th, Katie had her last dialysis. “It wasn’t quite a full month of dialysis but a good three weeks. And my creatinine numbers, the numbers they use to measure your kidney function, were slowly going down.”

Katie remained on and off the ventilator, but she still had difficulty breathing. Doctors finally decided that doing a tracheotomy might help. “They weren’t sure, and they kind of left the decision up to my husband and my parents. Basically, like we can try this and it’s not going to hurt anything. So, they went ahead and did it.”

 ON July 13, they did the tracheotomy. “That was kind of like the magic key. And I needed minimal vent after that. I would go hours and days without it.” During this time, Katie started having physical therapy and occupational therapy. “After you sit in a hospital bed without moving for a month, you can’t move. They had people come in to just get me to sit, or just try and stand, or sit in a chair, or on the side of the bed.”

Coming out of the fog

On July 16, Katie started to feel more like herself. “I pulled out my feeding tube and wouldn’t let them put it back in.” They let Katie try to eat, starting with soft foods like jello and pudding.

When they took Katie completely off sedation, she still had a trachea and couldn’t talk. “I obviously had a lot of questions, but my fine motor wasn’t working the way I wanted it too. I couldn’t use my phone. To type on a phone on that touch screen is really hard. So there was a lot of frustration on my part because I couldn’t communicate what I wanted.” 

On July 21, with her organs stable, Katie was transferred to another hospital in Milwaukee to start rehab. She began therapy for 3-4 hours a day while medical staff monitored her.

 On July 23, Katie’s tracheotomy was removed and after two weeks, on August 6, Katie was released from the hospital.

“Once I started progressing I just started to take off. But also, I had my age working for me, being 36 at the time. I was sort of in the sweet spot. Not too young, not too old. I was a physically fit person before that and physically healthy, no other underlying health concerns, thankfully,” she said. 

Home at last

At home Katie received outpatient therapy. “From talking to all the doctors and nurses, I still keep in contact with a lot of them, they said it was a once in a career case. It’s not something they are used to seeing all the time.”

They explained to Katie that in their eyes, she shouldn’t have been able to live through it. They told her it was a miracle that she didn’t have lasting physical limitations or brain damage from coding. Although, Katie explained, it did take a while for her brain to feel like it was back to functioning at the same level.

“The therapist would come and ask what day it was, and I would say, I don’t know. At one point they asked me what time it was, and I looked at the clock and couldn’t make sense of it. They would have me do things, like a puzzle or something and I remember saying, like, I can’t do this, but I know I should be able to do this,” Katie said. 

But eventually it all came back. “At one point the speech therapist dismissed me, because we were working on brainteasers, and she was like, you’re fine. She was like you’re good.” 

Reflecting

Katie has now had several years to reflect on the trauma she went through.

“I guess I never understood how people could die from E. coli. What is that? I think a lot of my family and friends had no idea either. So, I think a lot of people have learned a lot from what happened to me.”

Katie explained that if there was a silver lining to the incident, it was that it educated a lot of people on the importance of food safety. “People tell me they have rethought food and really think about food. I’ve had people tell me they just won’t eat romaine. Because there have been so many outbreaks in the last few years.” 

 Unfortunately for Katie, there’s no way to know for sure what she ate that caused her to get ill. “It is very frustrating in some ways. But not as frustrating as some people think it would be.”

“They ask, ‘What did you eat? Doesn’t it drive you crazy? Did you drive through fast-food at some point? Could it have been baggage lettuce or salad?’ Yeah, I guess. But it’s too many options to know,” she said.

“People want to hope that that can’t happen to them. But the reality is that it can happen to anyone. It doesn’t matter. And food safety is a really important thing.”

Fully recovered, Katie is back to teaching full time with no long-term health issues resulting from her fight with E. coli. Katie is now an advocate for food safety, including a close relationship with the nonprofit public health organization STOP Foodborne Illness.

STOP Foodborne Illness is the only national nonprofit public health organization whose mission is to support and engage people directly impacted by foodborne illness and mobilize them to help prevent illness and death by driving change through advocacy, collaboration and innovation.

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Foodborne illness can really wreck a party, so we’re asking dads everywhere to brush up on their food safety knowledge. “It can happen to anyone,” says Mitzi Baum, CEO of Stop Foodborne Illness. “We are all susceptible to the dangerous foodborne pathogens that cause 3,000 people to die each year with another 128,000 hospitalized. Many continue to suffer from on-going consequences including heart disease, diabetes, gastrointestinal and stress disorders long after their illness is over.”

 On our website, Stop Foodborne Illness features an honor wall, where we share the stories behind the statistics. You can read first-hand accounts of both survivors and those that succumbed to foodborne illness, including the following two stories:

Ken
Lives can be forever altered by the sudden and confusing experience of foodborne illness. Thankfully, this father lived to tell the tale. In 2011, Ken was handling raw hamburger meat, making dinner for himself and some friends. After two days of continuous vomiting and diarrhea, Ken noticed blood in his stools. At the urging of his doctor, Ken immediately went to the ER, where he was given three liters of IV fluids, and the doctors ran some tests. Two days later, the hospital had results: Salmonella. Ken was prescribed a week of antibiotics, which began his slow recovery. With help from the Maine Center for Disease Control and the 13 other cases that had arisen in nearby states, Ken determined the origin of the infection. It was a three-pound bag of ground beef, of which he had handled and cooked only one pound.

“I know we’re all here for a limited time, so I was never afraid of dying. My kids have seen me go through a lot. I keep a positive attitude to show them how to keep your balance, even through adversity. I’ve always taught them to live each day the best they can.” Ken’s children have seen him battle a monster. But, “I am still here,” he says, “and I still have the opportunity to live and put a smile on people’s faces.” Ken believes that when we come together to help one another, that’s when life is best. “My children are living happy and successful lives, and I’d like to think I had a hand in that.” Despite the trauma he experienced, he is determined to keep a balanced life and pass on a message of positivity and perseverance. Read Ken’s full story here.

Riley
Riley was 16 months old in 1993, when an E. coli outbreak dominated the news in the Pacific Northwest. Because Riley had never eaten hamburger and wouldn’t anytime soon, his dad was more concerned about his nine-year-old brother. That did not matter, however, as Riley became ill not from directly eating food contaminated with a foodborne pathogen, but because of person-to-person contamination — from another child in his daycare who was sick with E. coli. Only 23 days after he became infected with E.coli and later developed HUS – requiring dialysis, exploratory surgery removing a large part of his intestines, and being placed in a medically induced coma — Riley died from a massive brain hemorrhage and multiple organ failure. “Seeing two men carrying my young son in a white coffin on a cold February morning is an image that is forever burned into my memory. That coffin was far smaller than a coffin should ever be,” says Darin, Riley’s father.

After Riley passed, Darin refused to let his son’s death be in vain.

He became an advocate for food safety, along with parents like himself, helping the government make food safer. Over the next five years, Darin was speaking, writing, and working as a consultant to the USDA’s Pathogen Reduction Program. This experience led him, when he started teaching high school history, math and science, to bring this message with him. During his teaching years, he was certified by the FDA as a Food Science Educator and presented before legislators, industry, national organizations, and consulted with and was featured in numerous print and broadcast media. After 15 years of classroom teaching, Darin left his job and moved to the East Coast to pursue his desire to work in some capacity to prevent others from suffering from foodborne illness.

For two years, he was the senior policy coordinator for Stop Foodborne Illness. Meanwhile, he conducted and defended his doctoral research on states’ ability to implement federal food policies. Today, he is a professor of food policy, lead faculty of a regulatory affairs of a graduate program in food, and an assistant dean at Northeastern University in Boston, MA. And he is the author of two recently published books, “Food Safety: Past, Present, and Predictions” and “Building the Future of Food Safety Technology: Blockchain and Beyond.”

Darin believes that focusing one’s energy solely on the failures in the past is neither healthy nor sustainable. He says, “Supporting and inspiring those who act to prevent future failures can bring about immeasurable rewards. Our world needs these voices and their passion to help inspire the changes we all need. My drive has been to create a future where fewer families live with a chair forever empty at the dinner table.”

“I lost my son, yes.  But my son did not lose his father.”

  By focusing on inspiring the future generations of food safety heroes, Darin finds incredible fulfillment, but, more importantly, he also finds peace in those opportunities to still be a father to his son.

 About the organization: Based in Chicago, Stop Foodborne Illness is a national nonprofit public health organization whose mission is to support and engage people directly impacted by foodborne illness and mobilize them to help prevent illness and death by driving change through advocacy, collaboration, and innovation. https://stopfoodborneillness.org/

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Petra Donnison, a family friend, created the Give a Little page for donations to help Grace Archer, her family and partner Theodore Warrick.

Grace is currently being treated in the intensive care unit of Auckland Hospital in New Zealand. She contracted Listeria meningitis which has led to Encephalitis while working in the Cook Islands. She is in a coma and receiving antibiotics to treat the infection, according to the donation page.

“We would like to raise money to support her ongoing recovery and rehabilitation. And also to support her immediate family as they in turn support her,” the page says. “Most of her immediate family live and work distanced from Auckland.”

The Cook Island News reported she is the country’s first Listeria infection patient in more than 10 years. The Health Ministry and Auckland Regional Public Health Service are investigating the source of illness.

Donations and best wishes flood in
Grace was medically evacuated from Rarotonga, the largest island in the southern group of the Cook Islands, where she and her partner Theo work as teachers.

Nearly 300 people have given money so far since the appeal was launched in mid-May.

“The money will initially be used to cover expenses regarding accommodation and travel to Auckland for Grace’s family. This will be re-evaluated as Grace begins her long term recovery and the ongoing financial needs for that,” according to the donation page.

Grace and Theo taught at Apii Te Uki Ou, a Ministry of Education and privately funded school on the main island of Rarotonga. “We love and miss you guys. Sending you and Miss Archer loads of love, hugs and strength,” said a post on the school’s Facebook page.

Listeriosis is an infectious disease caused by the bacterium Listeria monocytogenes. Symptoms include fever, muscle pain, septicemia (blood poisoning) and meningitis. The incubation period is usually one to two weeks but can vary between a few and 70 days.

High risk foods include pre-packed sandwiches, deli and ready-to-eat meat products such as cooked, cured and/or fermented meats and sausages, soft cheeses and cold smoked fishery products.

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Beulah Rhode (Roberts) started experiencing flu-like symptoms and felt constantly fatigued in mid-May 2018. She was in the hospital from June to August. In July, she went into a coma and was on life support until late August 2018. Tests while she was in the hospital were positive for listeriosis. After waking from the coma, Beulah had lost the ability to speak, read, write, and walk.

The listeriosis outbreak began at the start of 2017 and was declared over in September 2018 with 1,065 confirmed cases and 218 deaths. It was traced in March 2018 to a ready-to-eat processed meat product called polony made at a plant in Polokwane run by Enterprise Foods, which is owned by Tiger Brands.

Visits to three hospitals
Beulah, who lives in Cape Town, saw two doctors who diagnosed her with a slight fever. She took a week of sick leave but her mother, who is a theatre nurse, convinced her to go to the hospital.

“I was feeling tired all the time like I had the flu. I saw the GP before I got sick because I said why do I feel like I have the flu but I’m not really flu-ish? The first hospital said you’re fine you’ve probably got a bit of flu. At the second hospital I went into the emergency room and doctors told me the same thing. They said maybe I have the flu but I was like no it is not, something felt different,” she told Food Safety Website.

“When I went to my house, my mum called and said I want to check on you as you’re not feeling or looking well, then she took me to a different hospital and my journey with listeriosis happened.”

The 35-year-old was in hospital for three months and physical rehab for two months to learn to walk, talk, read, write and how to use a knife and fork again. She was discharged in October 2018.

“That was very frustrating as I have always been motivated and able to do everything for myself. In my life before I could take my three dogs and go and walk with them. I don’t have the physical ability to do this the way I used to before. After rehab I was at home for five or six months and then the company I was working for gave me temporary disability for that period I was not working,” said Beulah.

“During that time I was thinking would I be able to do my job again because the listeriosis affected my brain. I realized it was so difficult because I couldn’t send a text message from my phone because of the spelling of a word. I have a bachelor’s degree in law, I was enrolled to do my Master’s degree and suddenly I couldn’t spell a simple word.”

Going back to work
Beulah said her job as a qualified advocate involves a lot of responsibility and there was no replacement cover in the time she had off. She returned to work in February 2019.

“I was under pressure to pick up where I left off but with the brain having an injury it is impossible to do that. That is the hardest part, my brain wasn’t performing the way I was used to and the same thing for my body,” she said.

“I’ve been blessed in many ways but my biggest challenge is the brain doesn’t recover as quickly as, especially employers, think. Because it is not a physical injury they can see like a broken leg, if it’s a brain, emotions or self-confidence they can’t see that but you feel it.

“For me, every day when I walk into my floor and office it is “oh, here we go” it takes a lot of courage to stand up in a room and speak about things I am struggling to remember. The good thing is it has cleared up a lot of things in terms of what we are lacking, especially in labour law and I could focus on that for a Master’s degree topic when I am ready to commit to it.”

Beulah said the first six months back at work were “terrible” as she was a shadow of her previous self.

“It was very challenging and traumatic because I didn’t know what was happening, I didn’t understand myself because part of your brain is still not processing what’s happened because half of it you don’t know due to the coma. When I did come to I was on life support, so a lot started opening up in terms of what actually happened in that time and that obviously affected me emotionally.”

Beulah’s neurologist and physician recommended she see an expert for a neurocognitive assessment.

“I went to see him in August last year and we did a three hour session with exercises on how the brain responds to questions, lighting, memory and all those things. He provided a report on my capabilities at that stage which were very poor compared to before the incident,” she said.

“He recommended a follow up within six months. The six months after August were very traumatic. I had an epilepsy episode at work in late August as a result of listeriosis which left a scar on the brain and that is causing the connections from the brain to the body to sometimes go crazy.

“Three weeks ago I was in hospital for a week with migraines, my neurologist did another scan and he said it was the scarring that was causing it. A week ago I went to the neuropsychologist for my follow-up assessment and he gave me a very good report. There are a lot of functions that are not at 100 percent yet but I have increased by 80 percent compared to the exercises we did in August.”

From death’s door to marriage
Beulah got married to Envor Rhode this month. Speaking before the big day, she described the occasion as bittersweet.

“It is quite bittersweet because I am thinking this is the most special day ever. But will I have a headache now the whole weekend? If I think about my quality of life, we have expectations, we want to have kids and we want other things and not just a career but what is the quality of that life when you have to lie down if you have a headache, when you have to be careful as your head can’t get hurt again. It’s things that you’ve never considered and you cannot put a value on it,” she said.

“I have good medical aid so got the best care I could get and not everyone has that available. The same with support at work, a lot of people don’t have the support that I had. I had an income for the entire time, businesses close all the time and if you are sick for nine months they are just going to get rid of you but I walked right back into my job.”

While she was in the hospital Beulah’s parents were called by doctors to say farewell to their daughter. However, hopeful she would regain consciousness they kept her on life support.

“I was resuscitated twice in hospital, putting my parents into a tail spin, as Beulah doesn’t get sick but she is in ICU. It is very traumatic, my mum hasn’t got over it. I was at death’s door and now I am getting married. It affects your complete life, your perspective and you either go off on a tangent or you can rise up and I’ve made the decision to rise up. Unfortunately, the listeriosis did not end, it continues every day. My follow-up got cleared, it is out of my body and system but the side effects are still there.”

Emotional journey
Beulah said the third hospital trusted what she said about not feeling well and knowing something was wrong and despite not knowing what the problem was they were determined to find out.

“They did so many tests. My mum was sitting by my side morning and night. My family supported me so much, especially my mum and dad they just believed this is not it for Beulah, she has worked too hard,” she said.

“To myself there were a lot of questions, I was at the top of my game when I got sick so I was confused, why did this happen to me? In hospital and rehab there are a lot of nights lying awake, everyone is sleeping around you, and you are trying to figure out what am I doing here? Look at all these people that can’t walk or talk properly and then I thought oh but Beulah that is who you are right now. In a sense you feel angry, what did I do to have that happen to me and yet it did.”

Initial details about the outbreak were not clear, according to Beulah.

“There was news about it but there was never a name for it, they were saying there is a virus and people must be careful what they are eating but you never heard of someone it happened to, so it didn’t seem like it was here. Even when people heard it happened to me, they couldn’t believe it and didn’t know what it actually was. So we didn’t know enough about it, where we would be at risk and that it was as deadly as it is, it was the last thing on anybody’s mind,” she said.

“I ate polony and a lot of other meats. They wanted to know exactly what I ate and I said I was a single woman living on my own, I would go to the shop and buy things for the month. So when I come home late at night I would throw something in the microwave. It could be a pasta meal or a sandwich. No I don’t eat it now, absolutely not and I don’t buy any brand of polony.”

Beulah said her perspective on life has changed in many different ways and she is looking forward to married life.

“You realize you don’t have as much time as you think and you are here today so make it good. You can have all the cars, titles, degrees and jobs but if you don’t have your health it doesn’t matter what you earn or own or who or what you know,” she said.

“For me it was accepting you are where you are now, so what do you want to do for the next 35 years and I don’t want to spend them running around from 5:30 in the morning and leaving work at 7 or 8 o’clock at night and coming home to feed my dogs, talk to them for a few minutes, have a bath and go to sleep.

“We don’t have kids, we are hoping that is going to come. That is one of the things I shifted aside because of my career. It has to wait until the doctors give me the go ahead when my body has fully recovered. We are working on my health to get it to the optimum level and once the doctor says I am ready then we can try.”

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Petra Bischoff was admitted to the hospital in May 2017 and diagnosed with Listeria meningitis.

She was in the ICU for nearly a month with 20 days on ventilator support. Petra went into a coma and was paralyzed when she woke up. The paralysis extends to Petra’s vocal cords, which makes it difficult for her to speak for any length of time.

‘To be a baby at 69 isn’t easy’
Petra, 71, said listeriosis has ruined her life and that of her daughter.

“I was a very active and happy woman and I cared about my appearance and my health. I ate healthily and exercised regularly. I liked to appear well-groomed and dressed. All of that changed,” she told Food Safety Website.

“I was ill two months beforehand and we didn’t know what was wrong. I was feverish, with muscle pains and headaches, an upset tummy and I ended up in hospital. To be a baby at 69 isn’t easy. When I look in the mirror I look at a strange person. I don’t know this person.”

The listeriosis outbreak began at the start of 2017 and was declared over in September 2018 with 1,065 confirmed cases and 218 deaths. It was traced in March 2018 to a ready-to-eat processed meat product called polony made at a plant in Polokwane run by Enterprise Foods, which is owned by Tiger Brands.

Corne, Petra’s only child, said she noticed something was wrong as her mum was very run down and not like she used to be. The pair live together in Cape Town.

“All of a sudden she started being very tired and lethargic and didn’t want to do anything, just lie down. My mum has more energy than me and she is 30 years older but that did change a month or two before May you could see she was starting to become just despondent with everything and we couldn’t figure out what was wrong.”

Re-learning to walk and talk
Petra was in hospital and rehabilitation for three months including the time on ICU mostly in a coma, one month on a hospital ward and a month in another hospital for rehab.

“In the hospital they rehabilitated her and taught her how to speak, walk and eat again. I visited her every day, I was there more than I was anywhere else. She had to learn everything new because the doctor had explained if your body lies still for so long all the muscle mass goes, so they had to build the muscle mass and retrain the body to do everything. She was very frustrated, angry and stressed. It was very taxing on her, it still is,” said Corne.

“She can’t hear or speak very well due to the damaged vocal cords, her eyesight is very bad so she doesn’t have that quality of life. She doesn’t have good mobility and walks very slowly, her hands sometimes cramp up and we have a full time carer here every day. She’s far better than what she was but it’s still not so that I can leave her alone as sometimes she gets dizzy and bumps into things and she bruises and bleeds easily.”

Petra trained as a color and line consultant in the fashion industry. After working in the real estate industry for 25 years she planned to direct her attention toward her love of interior design and start a business. Petra had bought specialized software to present 3D renderings of designs to clients, and done a course in home staging and property styling.

These plans have been abandoned and Corne lost her job after taking time off to support her mother. She now works in skills development but also used to be in property.

Lifestyle impact
Corne said she has been left mostly alone to deal with her mum’s illness and the heavy financial burden has involved selling property.

“Because she is now a full time responsibility I don’t really go out a lot any more, I was very sociable but now I prefer to stay here to keep an eye on her. I’ve lost quite a few friends as nobody wants to visit someone who is not 100 percent well and fun. This has isolated us in some ways because a lot of her friends don’t know how to cope as she can’t do all the activities she used to with them.

“My mum had a lot of friends and now she has one friend left who is in the medical profession, she is a retired nurse, but the others are few and far in-between to come visit. It is because she gets tired very quickly, her voice goes, she can’t hear them well or walk for long periods of time, so she can’t go out as often and everywhere she used to.”

Corne had not heard of Listeria before being told of the diagnosis by a specialized physician but the pair ate cold cut meats regularly.

“Back then I would buy once a week what we called a mixed packet of the olive loaf and I would take some with the polony and some with the peppers in and curry brawn so there was a variety that she could put on her sandwiches in the day if she was at home. Every week we would buy cold cuts. We will not buy or eat any processed meats now, if we want something like ham I will buy gammon, cook it and cut it up.”

Bearing responsibility: ‘I didn’t get my mum back’

Tiger Brands should bear responsibility after they put the public in danger, according to Corne.

“Apart from the fact so many people have died it is also the quality of life for those who contracted listeriosis is so bad. If I look at my mum, I didn’t get my mum back. So they should take responsibility for this and the Listeria in their plant. They should have pulled those products so people wouldn’t buy it,” she said.

“Tiger Brands bears the biggest responsibility but our government and the health department should also be brought to book for this as well because they obviously didn’t do all the tests that needed to be done to check the health and safety of those plants.”

Corne said the future at the moment is looking pretty dire.

“Her medical costs between the carer and the medication, vitamins and minerals to keep her going are high, as it compromised her immune system. It has affected everything. So financially it has ruined us. I couldn’t finish my degree because I have so many costs to cover that I can’t still pay for my studies so my career path ended as well,” she said.

“It is also a big emotional burden because I don’t ever know in the morning when I go if I am going to be phoned if she is not alright, does she need to go to hospital, she is ill a lot and depressed a lot which makes me depressed a lot, so it has diminished our quality of life and made us withdraw socially.”

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Cheryl Tavakoli paid tribute to her husband ahead of a pre-inquest review hearing.

Niptoon Tavakoli, of Lindholme, Doncaster in England, died in a hospital two months after falling ill complaining of sickness and diarrhoea.

The 65-year-old had eaten duck eggs bought from a stall at the Messingham Show in North Lincolnshire five days before becoming ill.

‘Massive hole in our lives’
Cheryl, 60, said seeing Niptoon so poorly in the last few weeks of his life and being powerless to help was truly horrific.

“Niptoon was the most wonderful, loving and caring husband and stepdad we could have wished for. He was never happier when spending time with his family or visiting antique centres and fairs,” she said.

“Niptoon has left a massive hole in all our lives and we miss him so much. We had so many plans for the future still, but now he is no longer with us, these will only ever remain as plans. It is difficult not to think that he was taken too soon.”

Niptoon, who had worked in the catering industry and retail management, bought six ducks eggs at Messingham Show in June 2019 and cooked and ate four of them.

Five days later an ambulance was called to his home but Niptoon did not go to hospital. On June 10 he was taken to Doncaster Royal Infirmary after paramedics were called again. Doctors found evidence of Salmonella. Niptoon was admitted to intensive care. However, his condition deteriorated and he died of organ failure on Aug. 12.

Provide the family with answers
Public Health England investigated and confirmed a second case of Salmonella in the West Midlands with the same strain but was unable to trace the source of the pathogen.

Cheryl said knowing another person contracted Salmonella after eating duck eggs adds to the concerns about Niptoon’s death.

“We know that nothing can ever make up for what has happened but we need to know if more could have been done to prevent his death. We know that the inquest process is going to be an emotional time but it is something we have to do to honour Niptoon’s memory,” she said.

Cheryl has instructed lawyers at Irwin Mitchell to investigate and support the family through the inquest process.

Tim Annett, from Irwin Mitchell, said Salmonella can cause serious health problems and in the worst cases, can lead to death.

“Understandably Niptoon’s family has a number of concerns about the events that unfolded in the lead up to his death. We are determined to provide the family with the vital answers it deserves and the start of the inquest process is a major milestone in being able to do this,” he said.

“We will continue to support the family throughout the process. If during the course of our investigations any issues are identified it is vital that lessons are learned.”

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Elizabeth Matthee, 73, fell ill in January 2018 and was in and out of hospital until early August of that year. Doctors initially thought the source of illness was her knee, but in March 2018, she was asked to return to hospital because tests confirmed she had listeriosis.

Elizabeth lives in an old age care home. Prior to her illness she enjoyed reading and watching TV and used to sit outside chatting and laughing with others at the home. The pensioner was able to move around with assistance. Her immune system has been severely hampered by listeriosis and she now depends on full-time care.

The listeriosis outbreak began at the start of 2017 and ended in September 2018 with 1,065 confirmed cases and 218 deaths. It was traced in March 2018 to a ready-to-eat processed meat product called polony made at a plant in Polokwane run by Enterprise Foods, which is owned by Tiger Brands.

Emotional impact
One of Elizabeth’s daughters, Christina Tiana Verhave, said she was a very bubbly, cheery type of person.

“We had absolute hell with touch and go situations continuously. This took a toll on my mother’s will to live, her spontaneity and her outlook on life in general. You could hear her laugh when you walk down the hall and everybody that knows her knows she will always have a joke, doesn’t matter if she is in pain or not. This took away her spirit because she was feeling so ill for so long, and she is still not well. At one stage she told me she doesn’t want to live anymore,” she told Food Safety Website.

Having some polony was part of the regular routine for Elizabeth.

“Every single night she wanted Enterprise French or garlic polony, viennas from Spar or Woolworths with bread and coffee, that was her treat and she loved to have it for supper. Needless to say she is not touching polony since she found out what happened. I can’t even dare to ask her if she wants something like that. We eat ham but I don’t like polony so what we buy for my mum is different than what we eat. I thought they cleared everything to say it is safe now but I will never ever buy it again,” said Christina.

In and out of hospital
Elizabeth was first admitted to hospital in February 2018 due to an infection in her knee. The same month she was hospitalized with a urinary tract infection and more knee problems.

In early March, blood tests showed she was positive for Listeria monocytogenes and after three weeks of treatment she was discharged. At the end of the month she was admitted again complaining of constant severe headaches, vomiting, and diarrhea. Her blood culture was negative for Listeria but a stool culture showed Clostridium difficile toxin. She was discharged one week into April.

Elizabeth had to go to hospital several times in April and May complaining of leg pain. She was readmitted in mid-June with complaints of nausea as well as stomach and leg pain but insisted on being discharged.

She was admitted again one week into July for symptoms of pneumonia and herpetic pharyngitis. She had developed sores in her mouth and had not been eating properly. Elizabeth remained in hospital until early August.

Christina said she was in and out of hospital with her mum and it was a never ending story.

“It was a long, long trial for us to get her to be healthy again. Now the knee is acting up again, it is smelling so bad, and I have another appointment at the hospital for a check-up,” she said.

“At first she fell ill with fever, we didn’t know what was going on so we took her to hospital, they couldn’t find what was at fault but they gave her some antibiotics and sent her home. We went again and eventually the second or third time as they were loading her into the ambulance, her knee where she had a previous knee replacement, the scar popped open and started draining. When they took her in hospital they did a swab and tested it. They sent her home again and it took a couple of weeks before they realized that she had listeriosis. The doctor phoned me and said I must bring her back immediately.”

Elizabeth’s treatment was further complicated by the fact she is allergic to penicillin, one of the antibiotics used to treat listeriosis.

“In hospital she was lethargic, she did know who I was but she had stories in her head that weren’t true and she got aggressive at a stage. They said it was the listeriosis treatment she was on,” said Christina.

“There was a fluid build-up in her ear drums because of the infection. So she couldn’t hear when we were talking to her and that made her more anxious and upset. We had to put our mouth by her ear and talk really loud for her to hear a kind of noise. She didn’t know what was going on around her.

“I’m with my mum every day at hospital, I sometimes drive there twice a day because the health care here is not good. I go and check up on her and see she is eating and drinking and I feed her if I need to and brush her teeth. I just look after her, I can’t not do that, I will never sleep if I were to leave her and not see her every day and know she is alright. I can see my mum is going downhill. I can feel when I touch her arms that her bones are brittle.”

A lasting memory
Christina said there is one occasion that she particularly remembers.

“One night I remember, it was a Thursday, the old age home phoned me and said you must come to your mum, so when I got there she was out of it completely and it looked like a dead person lying in the bed. I saw her a week before, I used to fetch her to us at least every second weekend as we are a very close family and she was always game if you say lets do this or that,” she said.

“We phoned the ambulance service and they didn’t come. I was actually praying the Lord would take my mum because it was difficult for me to look at her and see she can’t really breathe.

“The next morning we were sitting by her bed waiting for the ambulance to come. It came Friday evening and then I sat next to her bed at hospital and in the ER until 11 that Saturday morning and a doctor still hadn’t come to see my mum. I had to go home and when I came back nobody knew where my mum was. They put her in a room that was almost like a storage room and left her there. When they read on her chart she had listeriosis they secluded her from everybody else and forgot she was there. She didn’t have her medication that she should have every four to five hours. It was horrifying to find my mother in that condition. We had so many bad experiences in hospital.”

Christina said she had heard of Listeria on the news but didn’t give it much attention.

“It was only when the doctor said your mum has listeriosis I said will you refresh my mind and then it all dawned on me. Since then people have been treating her differently because they are scared to be close to people with Listeria, they think she is contagious. It was an experience, we had to explain to staff working with her and people sharing the room that they are safe and she can’t infect them.”

Christina is a single mother, working long hours in a bookkeeping and accounting job and she sometimes relies on her sister to help with her 11-year-old son.

“You have to be strong and carry on for your family’s sake. It gets to a point where I work in the evening and at weekends and rush from the hospital to work and back to hospital and then I come home and see everything is sorted with my son. Tomorrow morning you get up at 5am and start your day, I go to the hospital before work to see she is fine and then to work, sometimes I will go during lunch if I know I can’t make it after work. I don’t know what the future holds, I am just trying to survive from one day to the other.”

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When doctors told his wife Belva that Munro had died because of massive intravascular hemolysis and a liver abscess caused by a Clostridium perfringens infection, she couldn’t understand how it had happened. She couldn’t understand how he had gotten infected by Clostridium perfringens. Doctors explained that because of his diabetes Munro was the perfect host for the bacteria. They said the infection was from something he ate and they explained that the bacteria multiplied so quickly Munro did not have a chance.

“I think people who are diabetic or have an autoimmune disease or survived cancer should be able to eat in downtown Charlotte without fear of dying,” she told the doctors.

How Belva and Munro met

Belva met Munro 30 years ago at a church Christmas party. Munro introduced himself and told Belva that he thought he knew her. “I found out he’d only been in Charlotte no time, so I thought, oh, he’s shooting me a lie, here, at a church Christmas party.”

Despite Belva’s reservations, the two exchanged names and numbers. Munro would end up dating someone else until March, but after that relationship ended Belva and Munro began talking on the phone.

“He would call me every night. And talk for 30 or 40 minutes. But he never asked me out.”

Finally, Munro did ask her out. He asked her to join him at a Fourth of July picnic party. Belva described Munro on the date, “He was shy and a hunk. An absolute hunk.”

The two won a Fourth of July costume contest at the picnic.

 From there Belva recalls things moving quickly. She said she knew by September that if things kept progressing, they would get married.

“He wanted to marry me and I told him that if he wanted to marry me now, he’d want to marry me in a few months and we could wait. And I told him, not to pray that we got married, pray for God’s will. And I didn’t trust him. So I told God, I said, if he’s over there praying for us to get married, don’t listen to him.”

Belva wanted a sign that she was supposed to marry Munro. Whether it was finding the perfect wedding dress by accident or being able to book the best wedding photographer in Charlotte, Belva got multiple signs. “There were so many things, it was uncanny. I just knew that it was what I was supposed to do.” Munro and Belva were married Oct. 6, 1990. 

Family life

When marrying Belva, Munro became a stepdad to her two teenage daughters.

“They loved Munro as their own father. He loved them like they were his.”

Belva says that Munro was the role model her daughters needed. “They got to see what a good man was like.” “He was a great father. He was very loving to them and if they called, he would want me to put them on speakerphone so he could hear every word.”

Munro always supported Belva’s passions including her love for oil painting. He urged her to pursue art.  Belva explained that their relationship wasn’t always perfect.

“Don’t get me wrong, there were times when he would have paid someone to take me and vice versa, but it was a wonderful marriage. He always seemed to love me more. And all my girlfriends loved him because he was cute as a button. And was obviously in love with me, and that’s attractive to a woman, to see a man in love with his wife the way he was with me. He adored me. He loved me with all of his heart, and I loved him the same.”

Munro’s death

On Monday, March 9, 2015, at the age of 50, Munro went to Subway with a friend where he ordered and ate a meatball sandwich. He began feeling ill that night. Munro and Belva attended a midweek church service and friends told Munro that he wasn’t looking well. The next two days Munro felt ill — abdominal cramps, nausea and vomiting. Belva was gone all day Wednesday. When she returned home, she found Munro laying on the bed. He called his doctor to ask what kind of medication to get from the pharmacy because he felt so ill. 

Belva offered to accompany him to the store but he told her to stay and socialize with his sister and her husband. “The thing that kills me is I didn’t even hug and kiss him.”

Munro threw up at the pharmacy and came home in even worse condition.

“We were going to eat and he didn’t feel like eating, so we were eating and he’s lying on the couch and feeling worse.” Belva told him that he would be able to attend his Bible study in the morning. He told her that he knew he would and began to yell out in pain.

Belva took Munro to the emergency room. But as they exited the car, Munro laid on the parking lot ground. Belva ran and found a police officer. The office instructed medical attendants to get a gurney and followed Belva out to Munro. 

They rushed Munro into the emergency room and started tests. Belva remembers hearing them say, “That can’t be right,” as they rushed about. He was quickly transferred to the intensive care unit. Belva recalls a team of at least 17 devoted to her husband that night — surgeons, internists and nurses.

“I had no idea what was going on, and I told him to hang on. I told him to fight. And then a flash was maybe this is it? And I just pushed that right out of my mind. Because that’s ridiculous. I begged him to hang in there.”

Belva called Munro’s doctor and good friend and told him, “Munro is in the ER and he’s very sick.” He told Belva that he was trying to have some time off, but he listened to Belva and told her, it’s probably gallbladder. Belva said she would tell Munro. “I went in there and I said, Bobby just said it’s probably your gallbladder.” But he didn’t get better and early in the morning he had to be revived.

“I talked to him about holding hands. We would hold hands and watch TV and movies and eat popcorn. And I was begging him to stay, for that.” At 9 in the morning, Munro passed again, and this time was not revived, just 12 hours after entering the hospital.

Munro’s primary doctor and friend called crying. “He had gotten up and checked things, about an hour before Munro died. So he knew when he called that Munro probably wouldn’t live.”

When a stunned Belva asked the doctors what had happened, she was told they needed to perform an autopsy.

Clostridium Perfringens — How doctors traced it back to the meat sub

 The causes of death were noted to be the liver abscess caused by Clostridium perfringens infection, complicated by patchy pulmonary edema, cardiomegaly, bilateral pleural effusions, and diffuse cutaneous erythema.

The incubation period for Clostridium perfringens infections is 6 to 24 hours.

Such manifestations of C. perfringens infection are rare but well-documented in the medical literature. Munro’s C. perfringens infection was most likely the result of the consumption of the Subway meatball sub sandwich.

C. perfringens is the third most common cause of foodborne disease in the United States. It is estimated to cause almost 1 million illnesses per year. Munro’s illness began with gastrointestinal symptoms, which makes a food item the most likely source of the C. perfringens.

The time it takes C. perfringens from ingested until the first illness symptoms begin C. perfringens ranges from 6 to 24 hours. The time from when Munro consumed the meatball sub sandwich to when he first became ill fit within that time frame.

The types of food that most commonly serve as sources for C. perfringens infections for people are meat and poultry, and food items that are made from or incorporate meat and poultry.

“They told me what the germ was. Then they told me that it has a biological, it has a timestamp. And it doubles every seven minutes. So that’s exponential growth.”

Belva was told Munro, as a type 1 diabetic never stood a chance. 

“They said that he was the perfect host because he is diabetic. And they said people that are diabetic, or have an autoimmune disease, or have survived cancer are perfect hosts. And I said I think people who are diabetic or have an autoimmune disease or survive cancer should be able to eat in downtown charlotte without fear of dying.”

Aftermath

“I pretended that he wasn’t dead. That he was at home or at work. I could not accept the fact. It was too devastating. I couldn’t take in the fact that he was really gone. It took me a long time before I could say or really admit that he was gone.”

Munro’s funeral was attended by the greatest number of people in the church’s history — a building that seats 720, had standing room only. Belva recounted a conversation with her and Munro’s young grandson at the service. 

“I said to my little grandson, ‘Your grandfather was very, very handsome. Do you think all these people came because he was handsome?’ 

“And he said, ‘No.’ 

“I said, ‘Like your grandfather, you’re very handsome. Like your grandfather, you’re very intelligent. Do you think they came here because he was intelligent?’

“He said, ‘No.’

“I said, ‘Like your grandfather, you have a wonderful heart. So do you think they came because of his heart?’

“And he said, ‘Yes.’

“And I said, ‘Yes, so go out and make a mark with your heart.’”

Munro will be remembered forever by his wife, daughters and grandkids, as well as those in the Charlotte community.

“I’ll love him forever,” Belva said. “He was a wonderful man. People saw the love he gave me.” 

After his death, art helped Belva get through difficult times. Belva’s work can be seen here.

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If you haven’t heard, a Seattle attorney is petitioning the USDA to make it illegal to sell meat and poultry that is contaminated with Salmonella. 

Yep, as of right now — and who knows how much longer — it is perfectly legal to sell you hamburger, whole hogs, turkey legs, chicken strips, and any other meat or poultry product if it is contaminated with this infectious bacteria. Even if they know a product is contaminated with Salmonella, producers from single-family farms to the world’s largest meat manufacturers are allowed to sell it.

Today I will share some of the petition, a legal document, focusing on the human suffering it represents through the stories of five victims. You can read the full petition and all of the 62-pages of legalese, but if you want to zero in on what Salmonella infections do to people, keep reading through a bit of background here and you will find the faces behind the petition.

To borrow an expression from the previous century: 

If  you’re not outraged, you’re not paying attention. 

The bottom line is that the government hasn’t declared Salmonella to be an “adulterant” in meat and poultry, so it’s considered an OK ingredient. Tongue in cheek use of ingredient there, in case you missed the implied emoticon.

Full disclosure here, the Seattle attorney who is handling the USDA petition for three consumer groups and five victims of Salmonella poisoning is the publisher of Food Safety Website. His name is Bill Marler and you can read about him in this profile the Washington Post published yesterday under the headline “He helped make burgers safer. Now he’s fighting food poisoning again.”

The plaintiffs on the petition are victims Rick Schiller, Steven Romes, and the Porter Family. The consumer advocacy groups petitioning for the change are Food & Water Watch, the Consumer Federation of America, and Consumer Reports. Specifically, the petition asks the USDA’s Food Safety and Inspection Service to declare the following outbreak serotypes of Salmonella as adulterants in meat and poultry products:

Salmonella Agona, Anatum, Berta, Blockely, Braenderup, Derby, Dublin, Enteritidis, Hadar, Heidelberg, I 4,[5],12: I :-, Infantis, Javiana, Litchfield, Mbandaka, Mississippi, Montevideo, Muenchen, Newport, Oranienburg, Panama, Poona, Reading, Saintpaul, Sandiego, Schwarzengrund, Senftenberg, Stanley, Thompson, Typhi, and Typhimurium

The faces behind the petition

Rick Schiller, Salmonella Heidelberg, 2013
Rick Schiller was one of the hundreds of people sickened in March 2013 in a Salmonella Heidelberg outbreak linked to poultry distributed by Foster Farms. The outbreak spanned more than a year and sickened 634 people in 29 states and Puerto Rico. At least 240 victims were hospitalized, according to the Centers for Disease Control and Prevention.

On Sept. 27, 2013, Rick was diagnosed with gastroenteritis, yet did not seek medical treatment as he was convinced that he was suffering from a mild case of food poisoning. Rick could not have been more wrong.

On Saturday night, Sept. 28, 2013, Rick went to bed early, hoping to feel better in the morning. When he woke up the next day, his right knee was painful, reddened, and warm to the touch. 

On Sunday night, Rick went to bed with his right leg propped up and an ice pack on his knee. In the middle of the night, he was awakened by a sharp pain. When he pulled back the covers, he was startled by the sight of his own body— his right leg was dark purple and swollen to about three times its normal size. Rick’s fiancé immediately dialed for an ambulance, but Rick thought it would be faster to have her drive him to the emergency room. However, this was no easy feat. Rick recalls the agonizing experience:

“I couldn’t get my leg into the car because it wouldn’t bend. I leaned over into the driver seat and (my fiancé) had to force my leg into the car. It was excruciating. At the hospital, it took five people to help get me out of the car and into the ER. As soon as I got in there, they pumped me full of morphine for the pain, then they put Novocaine in my leg and attempted to tap the knee.

The first needle they stuck in didn’t work, so they got out a bigger one. They pulled on the syringe and meat- like stuff came out. It was excruciating, even on the morphine.”

Rick was in so much pain that he felt like he might die. After being admitted to the hospital, Rick took out his cell phone, snapped a photograph of himself, and proceeded to draft a Last Will and Testament on his phone.

During his time at the Kaiser San Jose Medical Center, Rick developed a very high fever. He recalls an unpleasant memory of being covered head-to-toe with ice packs. He continued to have pain all over the right side of his body. Both his right leg and right arm were painful. His right eye would crust up and his right ear had intermittently muffled sound.

The following day, doctors ran blood work and performed an arthrocentesis, a duplex Doppler sonography, and an MRCP (magnetic resonance cholangiopancreatography) on Rick. 

On Oct. 2, he was diagnosed with colitis — localized Salmonella infection — and arthritis of the right knee, and he was discharged from the hospital.

On Oct. 15, Rick returned to the Kaiser Medical Center for a follow-up. He was seen by Orod Khaghani, MD, who informed him that his gastroenteritis and Salmonella colitis were resolved; however, Rick was diagnosed with reactive arthritis. 

A few days later, Pradipta Ghosh, MD, performed X-rays on Rick’s lower extremities and diagnosed him with bone spurring and mild joint space loss, consistent with mild osteoarthritis.

Four months after his Salmonella infection, Rick returned to Dr. Khaghani, unfortunately having relapsed with lower left quadrant abdominal pain. He also complained of decreased appetite and loose stools. Dr. Khaghani confirmed his initial diagnosis of reactive arthritis and informed Rick that he was suffering from diverticulitis of the colon. At this point, Rick’s medical bills and estimated wage loss totaled nearly $15,000.

Rick’s reactive arthritis remains symptomatic to this day. He feels as if his “entire right side is now weaker than (his]) left.” He constantly worries about his health and feels as if he never fully recovered from his systemic illness. He notices generalized fatigue and is no longer able to do the handyman work that he once enjoyed.

According to the Centers for Disease Control and Prevention, the multistate outbreak Rick was involved in lasted from March 1, 2013, to July 11, 2014. The USDA’s Food Safety and Inspection Service (FSIS) was first notified of the Salmonella outbreak as early as June 2013. 

By September 2013, FSIS officials had determined that Foster Farms’ chicken was behind the outbreak, yet they were powerless and unable to force a recall of the tainted poultry until July 2014. 

The FSIS did not request a recall because “despite its efforts to identify the product causing the illness, no data were available that enabled its investigators to pinpoint the types of contaminated chicken products — for example, chicken breasts, whole chickens, or ground chicken — or production dates or lots.” 

In September of 2013, during a USDA-FSIS in-facility testing for Salmonella at three Foster Farms production plants in California and Washington, FSIS determined that sanitary conditions at the facilities were so poor that they posed a “serious ongoing threat to public health.”

Steven Romes, Salmonella Newport, 2018
In 2018, Steven Romes, of Gilbert, AZ, was a healthy and athletic husband, father, and insurance underwriter. On Sept. 3 of that year, he consumed medium-to-well done hamburgers as part of a Labor Day family cookout. 

Two days later, Steven fell violently ill with painful diarrhea, fever, and stomach cramps. Over the next few days, Steven’s symptoms worsened. He was unable to consume any solids and was forced to lay on his bathroom floor because he did not have the strength to crawl back into bed after severe bouts of diarrhea and vomiting. 

On Sept. 8, 2018, after his diarrhea progressed to bloody stools, Steven was rushed to the emergency room where urine tests revealed he was suffering from acute kidney injury. He was admitted to the hospital and his illness was determined to be one of many illnesses in a nationwide outbreak of Salmonella Newport linked by public health officials to the various ground and non-intact beef products. The manufacturer was the U.S. unit of JBS, the world’s largest meatpacker. 

The outbreak spurred one of the largest-ever recalls of ground beef — more than 12 million pounds of ground beef, the meat of an estimated 13,000 animals, was recalled. The recall affected nearly 50 different JBS product lines. 

There were 255 cases of Salmonella confirmed across 32 states. Twenty-nine percent of patients for whom information was available were hospitalized; 6 percent were admitted to intensive care units, and two died, according to the CDC.

Fourteen months before the recall the decades-old JBS beef plant in Tolleson, AZ, which was at the center of the outbreak, had received numerous complaints of “egregious” livestock conditions. Despite the conditions, JBS was allowed to continue producing meat for human consumption.

After a colonoscopy and three-day in-patient stay at the Dignity Health Mercy Gilbert Medical Center, Steven was finally discharged from the hospital. Unfortunately, his normal bowel habits and appetite never returned, and he was diagnosed with Irritable Bowel Syndrome. Today, Steven can only tolerate bland foods and he still occasionally suffers from stomach cramps and diarrhea.

The Porter Family, Salmonella I 4,[5],12: I -, 2015
On the afternoon of June 28, 2015, Rose and Roger Porter hosted a going away party at their home in Rainier, WA. The Porters planned on moving to Costa Rica and wanted to celebrate with their family and friends one last time.

On June 27, Rose Porter picked up a whole hog from Stewart’s Meats in McKenna, WA. The next day, Rose cooked the pig just the way she was told to by Stewart’s. Hours later, the Porters’ home was filled with friends and family, many of whom were about to become seriously ill with Salmonella poisoning. It all seemed so easy and matter of fact in retrospect, as Rose recalls:

“When (the whole roasted hog)was done, I served it up. After everyone left, I cleaned everything up and threw out any food that was leftover. We packed everything up and went to bed. The next day, I woke up with explosive diarrhea. I had a very busy day because we were packing up to move to Costa Rica. I had to get out of our house because we had renters coming in. I had to find a hotel and I was dealing with my daughter not feeling well at all. She went with me for the day because she wanted to sleep in a bed at a hotel. I had to stop every half hour to use the bathroom. Diarrhea kept up.”

Once Rose and Mikayla arrived at the hotel, all Mikayla could do was lie down. She fell asleep at 6 p.m. By 2:30 a.m. she was up and vomiting. Mikayla woke her mom up and, at 4:30 a.m. on June 30, they both headed to Providence St. Peter Hospital in Olympia, WA. Joseph Pellicer, MD, was on duty in the emergency hospital and listed Mikayla’s chief complaints as “abdominal pain, emesis, diarrhea, and fever.” 

Rose explained that Mikayla had been sick since the morning before with severe diarrhea. By the evening, Rose stated that Mikayla “felt like she was on fire.” Mikayla also described having shaking chills with fever and Rose told Dr. Pellicer that she was having similar symptoms. Mikayla was miserable, wracked with body aches and pain that radiated up into both of her shoulders.

Dr. Pellicer did an exam and found Mikayla was tachycardic with a heart rate of 125 and a diffusely tender abdomen. The doctor also observed that Mikayla was dehydrated with turbid urine, ketonuria, proteinuria, and dry mucous membranes. 

Despite these clinical symptoms, no cultures were sent to the lab and no stool sample was collected. Dr. Pellicer diagnosed Mikayla with “acute gastroenteritis.” Just after 8 a.m., he discharged Mikayla from the ER with a prescription for an antiemetic drug and clearance to travel to Costa Rica.

On July 2, 2015, the Porters landed in Costa Rica. Mikayla was still suffering from frequent bouts of diarrhea. Upon logging in to a social media website, Rose discovered that a party attendee’s daughter was being hospitalized for Salmonella poisoning. Rose decided to take her daughter to the local ER — Beach Side Emergency Clinic in Santa Cruz Guanacaste. Andrea Messeguer, MD, the medical director of the clinic, evaluated Mikayla and noted that she was lethargic with persistent abdominal pain in the periumbilical area. Because Mikayla was currently afebrile and able to orally hydrate, Dr. Messeguer told Rose she could watch her daughter at home.

Over the next day, Mikayla did little but drink ice water, sleep, and go to the bathroom. Unfortunately, things soon took a turn for the worse. Rose recalls:

“She started crying in the bathroom that she could not bear the stomach pains anymore and needed to go back to the doctor. She told me that she had blood coming out of her butt, that it had been that way for a while, and that she didn’t know what to do. The amount of time between her going to the bathroom went from every 20 to 30 minutes to every five to 10 minutes. She was screaming in pain in the bathroom. She said that she felt like someone was stabbing her over and over again in the stomach.”

On July 3, Rose took Mikayla back to see Dr. Messeguer at the urgent clinic and told the doctor that there was now mucus and blood in her daughter’s stools. Dr. Messeguer examined Mikayla and performed a stool smear and culture. While at the clinic, Mikayla’s diarrhea decreased in frequency and she was still holding down fluids, so the doctor diagnosed her with “bacterial gastroenteritis” until proven otherwise and sent her home.

It was not long before it was clear that Mikayla’s condition was deteriorating. By the morning of July 4, her stools were entirely bloody. Rose, once again, rushed her back to the urgent care clinic. Upon their arrival, Dr. Messeguer asked to speak to Rose privately. She informed her that Mikayla was losing a lot of blood and may need a blood transfusion. However, the clinic did not have the equipment or resources necessary to perform the procedure. 

Dr. Messeguer told Rose that her daughter could die on the four to five-hour drive to Hospital CIMA San Jose, and therefore, Mikayla would need to be airlifted there.

Rose and Mikayla were both transported by helicopter to Hospital CIMA San Jose in Costa Rica. According to a memorandum written by Luis Picado, MD, Mikayla presented with a high-grade fever, bloody stools, general malaise, and moderate dehydration. He wrote: “On admission, she presented with clear signs of bacterial gastroenteritis and required intravenous rehydration and parenteral antibiotics to control the infection. Stool studies were positive for Salmonella.”

Rose does not require a formal medical record to recall how things went for her daughter over the next several days. The memory is still fresh in her mind:

“For the next three days, I sat back and watched as my daughter cried in pain. I changed her bloody sheets when she couldn’t make it to the bathroom. I didn’t sleep for the first couple of nights because I was so scared that she wouldn’t wake up. (She) couldn’t process food or water. The doctor told me that the bacteria had gotten into her system and shut it down completely. When she ate or drank, it would go straight through her. She wasn’t getting any nutrition or hydration.

“The good news is that she is out of the hospital now. We have cut all pork out of our diets and are fearful of chicken and eggs. I have dealt with a husband over in Afghanistan and this was still the scariest thing I have ever been through.

I can’t say that I know what it is like to have a child die, but I do know what it is like to see a child on their deathbed.

“I have spent the last couple of months going over every detail that has happened over those two weeks. I felt totally responsible when this happened. I had to question all of my decisions as a mother. I felt like I poisoned my own child and everyone else that ate at my house. I lost friends from all of this. It was weeks later that I found out that, in the end, it wasn’t my fault.”

During the time of Mikayla’s illness, Rose and Roger had their own Salmonella illnesses to contend with. On the helicopter ride to the hospital in San Jose, Rose’s blood pressure plummeted, and she lost consciousness. Roger had gastroenteritis with uncontrollable diarrhea for several days. Rose and Roger still suffer from periodic bouts of severe diarrhea.

The Porters were three of 152 diagnosed victims of a nationwide outbreak of multidrug-resistant Salmonella I 4,[5],12:i:-. Stewart Meats’ distributor of whole hogs was Kapowsin Meats. 

Laboratory testing of environmental samples at Kapowsin Meats by the Washington State Department of Health confirmed the presence of Salmonella I 4,[5],12:i:- in the facility. As a result of the investigation, Kapowsin Meats voluntarily recalled more than half a million pounds of pork products.

No wonder the petition requests an expedited hearing, calling the situation with Salmonella contamination “an imminent threat to public health necessitating prompt agency action.”

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“In the Marine Corps, I’m seen as the other. Being a recruit is derogatory until you finish training, you’re worthless. They break you down to build you up but it’s not fair if you don’t get built back up,” Browning said recently.

In Oct.  2017 an outbreak of E.coli O157:H7 swept through the Marine Corps Recruit Depot in San Diego and Camp Pendleton. According to the Centers for Disease Control and Prevention, there were 62 confirmed cases, 62 probable and120 suspected cases. Thirty people were hospitalized and 15 were diagnosed with HUS, a type of kidney failure known as hemolytic uremic syndrome. Patients’ ages ranged from 17 to 28 years with a median of 18 years. Consumption of undercooked beef was linked to the outbreak and was traced back to a single ground beef supplier at the Marine Corps Recruit Depot in San Diego.

One of the victims of this outbreak was Hunter Browning, an 18-year-old Marine recruit.

“What 20-year-old do you know with a full hip replacement?” Browning asked. Browning is dealing with the lifelong impact of food poisoning. “I don’t know how to deal with it. It’s not normal. When I tell people, they have a shocked look on their face and they pity me.”

In high school in Aberdeen, SD, Browning participated in drama clubs and skied in the winter. He graduated from high school in the spring of 2016. A call from a Marine recruiter convinced him that he was an ideal Marine recruit: fit, disciplined and bright. Browning was eager to challenge himself and gain the type of experience only the Marines could provide.

Boot camp

Browning took his first trip out west in the fall of 2017 to begin boot camp at the recruit depot in San Diego.

“I settled in pretty quick. I just went with the flow and tried not to screw up.” Browning said he made friends quickly, the group struggle bonding the recruits.

Marine boot camp is 13 weeks long. Browning thrived during the first phase of his training. It was not until his eighth week that he started to feel ill. 

“The first symptom I showed was a fever. And then later, I was getting stomach aches,” he said.

Browning described his symptoms as increasing severe.

“They make us do this exercise at night, where they had staff that was trying to invade our barracks building. Toward the end of the exercise, I started to get this pretty heavy fever. Throughout the night, there had to be a group of four people up, making sure that nothing goes bad, or that none of the trainees leave. I was at the front post and you can’t leave when you’re doing that, and I really needed to go to the bathroom. I could feel diarrhea coming on or something. And I really needed one of the other guys to take the front post. They weren’t willing to do it because they thought I wouldn’t come back. So, it wasn’t until after I got off fire watch that I was able to go to the bathroom, and it was definitely diarrhea. Before we left the barracks I had diarrhea again, this time it had blood.”

Browning said he had never experienced pain like that. He was afraid to tell the instructor, but he was in too much pain to not. The drill inspector sent Browning to the medical center but despite running tests, they could not figure out the cause of his illness.

He explained to medical personnel that he couldn’t eat, was throwing up and had bloody diarrhea. They took his temperature and thought he had the flu. They gave him an anti-diarrheal medicine — Pepto-Bismol — a solution that Browning now realizes was counterproductive if not harmful as his body tried to expel the E. coli.

Browning stayed in bed five days before returning to physical training. Despite the pain and fever, he pushed through his physical training. But when taking off his training clothes at the end of the day, Browing noticed his legs had swollen. He recalls the other trainees’ mouths dropping when they saw how large his legs had become, from his thighs to his feet. Browing was sent to the emergency room by ambulance.

In the emergency room, blood tests were run and Browing was told that he was suffering from hemolytic uremic syndrome (HUS) connected to Shiga toxin-producing E.coli. Browning had heard of E. coli but had no idea what kind of damage it could do to his body. In just a couple of weeks, Browing says he lost more than 15 pounds, going from 165 to 149 pounds.

Contaminated food

Browning recalls in vivid detail the mess hall where he ate the burger contaminated with  E.coli. 

“You get your tray and your silverware, and then there’s a salad bar with a bunch of different salads or toppings for salads, and then after that, they have like a main course line, so between they’ll have like fruit sometimes, and in the morning they’ll have cereal, then the main course line where they’ll have the hot food,” Browning recalled. “And then you go past and you take a left and go past the drink machines to sit down. Then you get back up to get a drink. It’s crowded and there’s always lots of yelling. It’s very stressful.” 

These details are etched in Browning’s memory because of the strong emotions surrounding that day. Browning’s life was altered because of this mess hall, the food and how it was prepared.

“There are bouts of anger, of very extreme feelings toward my situation. Because it could have been different in so many ways. If the food was cooked properly. I would be out doing my job in the Marine Corps,” he said.

The military officials held tight to the investigation process and information about it, so it was not until much later that the Centers for Disease Control and Prevention confirmed the link to the mess hall and its ground beef. Browning still remembers the hamburger and the day he ate it.

“On Saturdays, they have burger day, and that was when I got sick. I didn’t have symptoms until the Thursday after.”

Medical Rehab Platoon

After his trip to the emergency room, Browning was sent to the medical rehab platoon, where he would spend the next eight months.

Browning was in constant pain, especially in his hip joint. X-rays and MRIs revealed a divot in his femur head. He was diagnosed with septic arthritis and osteonecrosis in his hip joint caused by the Shiga toxin-producing E.coli. At first, it was the cartilage that hurt, but as the cartilage wore away, it was the femur head grinding directly against his hip that caused the pain. Standing, sitting, and any movement in between was agonizing. Browning walked with crutches or with a cane.

In late December that year, two months into his stay at the medical platoon, a hip specialist informed him that it was unlikely he’d be able to stay in the military. Browning had a hard time accepting his new reality. He recalls thinking, “I’ll get better and I’ll go back to training.”

Having not finished his training and still a Marine recruit, Browing was given little access to the world outside of the medical rehab platoon.

“You don’t have your phone. You can’t watch TV,” Browning said.

He spent his time reading and doing crafts as he waited in six-week blocks to see the doctor again. Each time the doctor told him that they would check in another six weeks.

“That was awful. You don’t know how long you’re going to be there.”

Surgery

In March 2018 – five months into his stay at the medical platoon — Browning had his first surgery. A left hip decompression was done. Calcium phosphate bone cement was injected into the femoral head cavity to provide structural support. A checkup two-weeks after the surgery showed that Browning’s hip was deteriorating quicker than initially thought. His doctor at the medical rehab platoon recommended a hip replacement. Administrative details and funding questions made Browning wait.

“There was a bit of a feud happening between the doctor and the marine corp, just because nobody in my position had ever got a hip replacement before and that’s a big-ticket item,” Browning said 

Finally, in July 2018, Browning was moved from the medical rehab platoon to the Wounded Warrior Battalion where they would perform a total left hip replacement. In August, Browning had his hip replacement. His father flew out to stay with him during the surgery and help him navigate during his recovery. “It’s not like being completely fixed and mobile. That’s the struggle, knowing that it’s going to be different forever.”

Browning walked with assistance the day after his surgery. He used a walker for the first couple of weeks, progressed to a cane, and then eventually, was able to walk without assistance.

“The thing that really helped me improve was that it wasn’t painful all the time. It wasn’t bone on bone grinding anymore,” he said.

In December  2018 — after months of rehab — Browning’s doctor at the Wounded Warrior Battalion concluded that the recruit was no longer fit for service because of his hip replacement. Seventeen months after leaving home for boot camp, Browning left the Marine Corps and returned home to South Dakota where he was able to spend the holidays with his family. 

Life Now

Long term, Browning will need at least one more hip replacement, and possibly two more in his lifetime. As the plastic liner inside the hip joint wears down he will endure more frequent and severe pain. Back in South Dakota, Browning can no longer enjoy the winter sports. Skiing is too dangerous for his hip. Even walking outside the house in the cold weather and potentially slipping on ice has become a terrifying possibility.

“I could have the anchor bust out of my femur, and it would be really painful. That’s something I have to watch for all the time,” he said.

Browning still has pain when standing for too long or sitting on a hard surface. The limited leg motion has made simple tasks more difficult, and even repositioning his leg while sleeping has been a challenge.

“I would hope that no one would have to go through what I’ve been through. There were a lot of things that could have gone better, and I wouldn’t be in this situation.”

But harder than the physical situation with his hip and the impact E. coli has had on his body is what it prevented him from being able to accomplish.

“I didn’t even get to finish boot camp, so they don’t even consider me a marine,” he said. “It’s very difficult not to have negative feelings. Given a chance, I would have worked for everything.”

Browning said he is thankful for his doctors and all they did to prevent the situation from becoming any worse, and for his family’s continued support. He will turn 22 in March and plans on attending college in the fall to study business. He also hopes to get a pilot license and dreams of teaching flying.

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