BJ’s Wholesale Club, Inc. (“BJ’s”) is a membership-only supermarket that offers, according to its website, a “no-frills” environment [that] helps keep prices low. When you walk into a BJ’s, you’ll find cement floors, open-beamed ceilings, simple shelving – and plenty of savings.” What BJ’s members are not supposed to find are ground beef products contaminated with E. coli O157:H7. On May 11, 2002, BJ’s ground, packaged, and sold several packages of 90% lean ground beef. Lora Langan purchased one of these packages, took it home, and divided the ground beef for two meals. That evening, the Langan family enjoyed hamburgers made with the fresh beef, and on May 14, Lora made meatloaf with the remaining ground beef.

On May 28, 2002, the Rockland County Health Department (“RCHD”) became aware of a sudden increase of E. coli O157:H7 infections (11 cases) through physician reports and/or laboratory data. RCHD notified the New York State Department of Agriculture and Markets (“NYSDAM”) of the initial cluster and requested assistance in an epidemiological investigation. This original cluster was centered around an Orthodox Jewish Community in the Monsey area of Rockland County. Three days later, on May 31, two additional cases were reported in the Orangeburg area. These two additional cases were, Christina Graff and Katelyn Koesterer.
The case investigation revealed no apparent connection between the Orangeburg and Monsey area cases. Samples of food (seasoned, home-assembled raw frozen meatballs, and hamburger patties, as well as commercially prepared frozen hamburgers) were collected from Katelyn’s home. The beef products were all purchased at the West Nyack BJ’s store. They were submitted to the New York State Department of Health’s Wadsworth Center (“WC”) for testing.
Later in the investigation, a consumer who was not sick provided an unopened package of ground beef obtained on the same day and at the same West Nyack store that Katelyn’s family purchased from. This specimen was also submitted to WC for testing.
Epidemiological analysis did not reveal any links to the Monsey area outbreak, and Christina and Katelyn had PFGE patterns that differed from the Monsey outbreak. The link between Katelyn and Christina was a common hamburger meal in the week before the onset of their symptoms.
Laboratory analysis of the meat samples obtained from Katelyn’s home revealed the presence of E. coli O157:H7. PFGE studies revealed an exact match between the meat samples and a cultured stool sample obtained from Christina Graff. Although the samples tested positive for E. coli O157: H7, the USDA and NYSDAM considered them compromised due to extensive hand-contact prior to being frozen. Therefore, a recall was considered not justifiable. However, the unopened ground beef package that was provided by the non-ill consumer also tested positive for E. coli O157:H7 and was an exact genetic match to Christina Graff. On July 16, 2002, over two months from the date the meat was originally purchased, BJ’s initiated a recall in the form of a notification letter mailed only to those individuals who purchased the ground beef at the West Nyack store between May 8 and May 13, 2002.
On May 29, an epidemiologist from Rockland County, Amishi Shah, called the Bergen County Health Department regarding an outbreak of E. coli they were currently investigating. Bergen County immediately sent out notices to hospitals, health officers and physicians within the county. Rockland County informed BCHD that there were three confirmed cases, and eight suspect cases. The outbreak appeared to be centered in an orthodox Jewish community in Rockland County. BCHD then checked its logs and came up with three potentially related cases, one of them being Owen Langan.
On May 31, BCHD followed up with Rockland County, and was notified that 16 cases were now confirmed. On June 3, BCHD interviewed Owen’s family. No connections were immediately apparent to the Rockland County outbreak. Rockland County was now up to 18 confirmed cases, and appeared to be related to a preschool with two outlying cases in Orangetown.
On June 26, Owen’s sample tested positive for E. coli O157:H7 and was sent to Wadsworth Center in New York. A ground beef sample had also been provided and tested positive for E. coli. Rockland County then began re-evaluating the outbreak. BCHD then spoke with Mrs. Langan and learned she had purchased ground beef from BJ’s on May 11. BCHD then spoke with Rockland County again and learned the two outliers had also eaten ground beef purchased at BJ’s on May 12.
The Langan isolate matches isolates from the BJ’s outbreak in New York, including Christina Graff (gel image NY02121 lane 2, XbaI digest and gel image NY02162 lane 6, AvrII digest), ground beef from the non-ill person’s freezer (gel image NY02156 lane 3, XbaI digest and lane 11 AvrII digest), and ground beef patty from the Koesterer’s freezer (gel image NY02125 lane 9, XbaI, no ArvII analysis available).