Despite attempting to hide behind the “Restaurant Chain A” mask, it was really not very difficult to figure out that where Leah Smith was sickened was an Oklahoma Taco Bell. (See, Taco Bell Complaint PDF)
Multistate Taco Bell Restaurant Chain Unknown 2011 – 68 Ill – (CDC continues to call this outbreak “Mexican-style fast food restaurant chain, Restaurant Chain A”) – A multistate outbreak of Salmonella Enteritidis was reported by the Centers for Disease Control on January 19, 2012. The outbreak was associated with eating at an unnamed Mexican style fast food chain beginning in October 2011. No specific food was epidemiologically associated with illness, but data suggested that contamination of the food occurred before it had reached the chain’s outlets. Among ill persons eating at the restaurant chain, 90% reported eating lettuce, 94% reported eating ground beef, 77% reported eating cheese, and 35% reported eating tomatoes. The epidemic curve seen in the outbreak was consistent with those observed in past produce outbreaks with a sharp increase and decline of ill persons that spanned one to two months. Ground beef was thought to be an unlikely source due to the handling and cooking processes used by restaurant chain. The Centers for Disease Control and Prevention declined to name the restaurant chain in the outbreak, however on February 1, Food Safety News and Phyllis Entis, of eFoodAlert, reported that the outbreak involved Taco Bell restaurants. An investigation summary from the Oklahoma State Department of Health linked the state’s 16 cases to the Taco Bell restaurant chain.
And, it is not like Taco Bell is new to outbreaks, or consumers suing it:
Taco Bell Restaurants Unknown 2010 – 155 Ill – (CDC continues to call this outbreak “Mexican-style fast food restaurant chain, Restaurant Chain A”) – Two concurrent, multistate outbreaks of Salmonella, involving Salmonella serotypes Baildon and Hartford, were linked to eating at Taco Bell restaurants. Cases of Salmonella Hartford were first identified in late April; the case numbers reached a peak in early June. As of August 4, 75 cases of Salmonella Hartford (CDC cluster ID 1006KYJHA-1) had been identified. Cases of Salmonella Baildon were first identified beginning in early May; the numbers of new cases declined substantially by late June. As of August 4, 80 cases of Salmonella Baildon had been identified. A complex traceback investigation failed to identify a common food source for both outbreaks. The FDA’s tests of produce items did not find Salmonella Baildon or Hartford. A widely distributed contaminated food product was suspected, but was not identified. Taco Bell Restaurants were the source for many of the illnesses, but not all of the illnesses.
Taco Bell Restaurants Lettuce 2006 – 78 Ill – (CDC named Taco Bell) – An outbreak of E. coli O157:H7 occurred in the Northeastern United States. Ill persons ate at Taco Bell Restaurants. At first green onions were implicated by the Centers for Disease Control; later lettuce was suspected. Ill persons ate a variety of food items at the restaurants. Public health investigators identified a few ingredients that were consumed more often by ill persons than well persons and were statistically linked with illness. These items included: lettuce; cheddar cheese; ground beef. Onions of any type were not linked to this outbreak, however a sample of chopped, yellow onion tested positive for E. coli O157:H7; this was not the outbreak strain. E. coli O157:H7 was not found in the other food items that were tested. The investigators gathered additional information about the location of the restaurants, patterns of food ingredient distribution, and the characteristics and preparation of the food ingredients. Evaluation of this data indicated that shredded lettuce was the most likely source of the outbreak. Because multiple Taco Bell restaurants were involved during the same time period, contamination of lettuce likely occurred before reaching the restaurants. A traceback failed to identify a farm source or risks factors for lettuce contamination.
Taco Bell Restaurants Green Onion 2000 – 30 Ill – In December, South Carolina health department workers began receiving reports of hepatitis A that were associated with eating a meal at a Taco Bell in Fruitland Park, Florida. The Florida health department was notified and investigated the outbreak with assistance from South Carolina’s health department. Twenty three cases of hepatitis A ultimately met the outbreak case definition. The analysis of food histories and the environmental health investigation showed that green onions held the strongest association with illness. The green onions were not cooked. Concurrent with the cluster of cases in Florida and South Carolina, outbreaks of hepatitis A were discovered and were also linked to Taco Bell restaurants in Kentucky (6 cases) and Nevada (1 case). Green onion consumption again showed the strongest link with illness. The same supplier distributed the green onions to the outlets in Florida and Kentucky. Food handlers at the Florida outlet were tested for hepatitis A. One food handler had hepatitis A, but this illness occurred at the same time as the illnesses in the patrons, thus was not the index case that caused the outbreak. Serum samples from case patients from the various states showed that the hepatitis A virus was the same strain.
Taco Bell Restaurant Chain Beef Tacos 1999 – 21 ill – In mid-November, 1999, a cluster of children with infections caused by the same strain of E. coli O157:H7 was investigated. Case-control studies found an association between illness and eating beef tacos at Taco Bell restaurants. A traceback investigation implicated a beef supplier; a farm investigation was not possible because of inadequate recordkeeping by the supplier. This outbreak illustrated the importance of hospital surveillance to identify clusters and molecular surveillance to link related, geographically widespread, cases.