Lucky Peach asked me to give a differing perspective on “Hamburger Month.”  Now you know why I am seldom asked to dinner.

Attorney Bill Marler has won more than $600 million for clients since he and his partners formed Marler Clark in 1998. Marler rose to fame—or notoriety, if you’re a food producer—in 1993, when he successfully litigated a series of suits against Jack in the Box on behalf of children who contracted E. coli from eating the fast food joint’s tainted beef. We asked him to explain the ten worst E. Coli outbreaks that he’s seen.

E. coli O157:H7 did not burst onto the scene in the early 1990s, as many in the big food business like to think. It slowly crept into our food supply, spreading in the enormous feedlots that began to dot the U.S. landscape during the last century. The bacteria is now endemic and can be found in cows, sheep, and wild animals such as boar, elk, and deer. As few as fifty E. coli O157:H7 bacteria are enough to cause human illness—and as many as 100,000 can fit on the head of a pin.

Once this strain of E. coli makes it into our small intestine, it can damage the intestinal wall, causing severe cramping and bloody diarrhea. In some instances, the toxin that the bacteria releases gets into the human bloodstream, damaging red blood cells and causing severe complications like kidney failure, stroke, brain damage, and death.

I wrote an op-ed for the Denver Post in 2002 entitled: “Put me out of business. Please.” In it, I discussed how between 1993 and 2002, at least 95 percent of my law firm Marler Clark’s revenue was from E. coli cases linked to hamburger meat. Now, it is almost zero—which is not to say that there are no cases, but that big beef processors have gotten serious about keeping E. coli O157:H7 out of the food supply. Still, I find that knowing your history is a great motivator to maintain and champion continuing diligence—because one person sickened by careless meat processing is too many. Here, then, is a rundown of the most significant E. coli outbreaks in America.

FEBRURARY 1982: 47 ill

The first time E. coli O157:H7 was linked to an outbreak was in 1982, when contaminated hamburgers were sold at McDonald’s outlets in Oregon and Michigan. The source was suspected to be a meat plant in Michigan, which had distributed the beef patties to the restaurants. At the time, the serotype O157 was thought of as a rare occurrence; the only known previous isolation of E. coli O157:H7 was from a case of hemorrhagic colitis (a disease that causes inflammation and ulcers in the colon and rectum) in 1975. This outbreak got barely a mention in the media.

NOVEMBER 1986: 37 ill

Cases of E. coli O157:H7 were detected throughout Washington state in November 1986, after a physician in eastern Washington hospitalized three patients with hemorrhagic colitis that progressed to thrombotic thrombocytopenic purpura, a condition where small clots form within the body’s small blood vessels. The beef was traced back to the farms, where cattle were shown to be carrying the disease. This was not a big outbreak, but it was an important one: it prompted Washington state to be one of the first states to make E. coli O157:H7 a reportable event, and state health officials changed the food code to increase the internal temperature for hamburger from 140 to 155 degrees—the only state in the country to do so.

NOVEMBER 1992/JANUARY 1993: 501 ill; 151 hospitalized; 4 deaths

In January 1993, a physician from Children’s Hospital and Medical Center in Seattle reported that there had been an increase in emergency room visits for bloody diarrhea and hemolytic uremic syndrome, when red blood cells break down and start blocking the kidneys’ filtering system. A study implicated Jack in the Box’s hamburgers, resulting in a multi-state recall of the remaining product. Only 20 percent of the product was still around by the time of the recall; this amounted to 272,672 hamburger patties. No specific slaughter plant or farm was ever identified as the source of the contaminated meat. This was the first event to illustrate the disastrous potential of outbreaks tied to restaurant chains.

At the time of the outbreak, culturing for E. coli in clinical laboratories was being done incorrectly, and many health departments were not actively tracking and investigating the illness.

NOVEMBER 2000: 46 ill; 24 hospitalized

In November of 2000, Minnesota health officials detected a group of people who were infected with the same strain of E. coli O157:H7—most of whom had consumed ground beef from SuperValu’s Cub Food stores. The American Foods Group (AFG) had supplied beef to the SuperValu/Cub Food stores and to 178 independent retailers, and E. coli O157:H7 was isolated from at least twenty-three different meat samples during the investigation. A total of forty-two cases were reported in Minnesota, one case was discovered in Wisconsin, and three cases in Ohio.

On December 4, the American Foods Group recalled the ground beef. USDA records showed that the company had been cited by federal inspectors for a variety of problems, including nine instances where fecal matter had been spotted on the meat and the presence of Salmonella.

JUNE 2002: 28 ill; 7 hospitalized; 1 death

After the Colorado Department of Health identified an outbreak of E. coli O157:H7 among its residents, the same strain started popping up in cases around the country. The initial investigation pointed to ground beef purchased at Kroger’s grocery stores, which was produced by ConAgra Beef Company. On June 30, independent of the outbreak, the ConAgra Beef Company issued a nationwide recall of 354,200 pounds of ground beef produced on May 31—a recall that had resulted from routine microbiological testing that had been conducted by the USDA. After the outbreak was detected and the plant was inspected, the ground-beef recall was expanded, and an additional 18.6 million pounds of fresh and frozen ground beef and beef trimmings were recalled. Turns out that evidence of E. coli O157:H7 contamination had been ignored since January 2001—more than a year before this outbreak was detected.

I think it was at this point that the industry truly began paying more attention to E. coli O157:H7 through intervention, testing, and safer handling practices—and when I first started to see a drop in the number of recalls and outbreaks.

AUGUST 2007: 47 ill

In early October 2007, Minnesota health department officials noticed a cluster of three E. coli O157:H7 cases with the same genetic pattern. Interviews with the patients—and, later, with patients in Wisconsin, North Carolina, and Tennessee—found a common exposure of Cargill hamburger. Sam’s Club was a major purchaser of the Cargill frozen hamburgers, and eventually recalled 845,000 pounds of Cargill ground beef. The outbreak became the focus of the New York Times story “The Burger That Shattered Her Life,” which won the author a Pulitzer Prize.

OCTOBER 2007: 40 ill; 21 hospitalized

Frozen Topp’s brand ground-beef patties gathered from patients’ homes and from unopened packages around the country yielded E. coli O157:H7 with several different genetic patterns—and forty of those cases were matched with the same genetic fingerprint pattern that was found in the ground beef. Confusingly—and maddeningly—the USDA’s Food Safety and Inspection Service refused to recall hamburger that was linked to an illness unless the package was unopened—somewhat of a difficult feat given that it must be opened before someone can consume it.

MAY 2008: 79 ill; 32 hospitalized

Kroger was put back in the spotlight in May of 2008, when an investigation linked ground beef purchased at one of several Kroger stores in Michigan and Ohio to an outbreak of E. coli O157:H7. The ground beef was traced to Nebraska Beef, Ltd., a beef processor. On June 30, Nebraska Beef Ltd. announced a recall of 531,707 pounds of ground beef—and four days later, they expanded the recall to include all beef manufacturing trimmings and other products intended for use in raw ground beef produced between May 16 and June 26, totaling approximately 5.3 million pounds. Nebraska Beef would later be implicated in July in another, separate outbreak of E. coli O157:H7. This was a company simply more interested in production than safety.

MARCH 2009: 23 ill; 6 hospitalized

In June 2009, a multi-state outbreak was discovered involving ground beef produced by the JBS USA beef company. Samples from unopened packages of ground beef recovered from a patient’s home were tested by the Michigan Public Health Laboratory, which yielded E. coli O157:H7 that matched the DNA fingerprint of the outbreak strain. The beef was sold in the United States and Mexico, and Mexican health officials banned further importation of the meat. (I always find it a bit amusing when other countries ban our food products; U.S. companies tend to be so gleeful when they can point the finger at some food manufacturer from somewhere outside the U.S., with the underlying implication that they must be dirty. The truth is that contamination can happen anywhere.

JUNE 2014: 3 ill; 3 hospitalized; 1 death

The Massachusetts Department of Public Health, the Centers for Disease Control and Prevention, and the USDA FSIS identified three patients diagnosed with E. coli O157:H7 who became ill after consuming ground beef sold at Whole Foods stores in Massachusetts. Although there were few victims, the results were vicious; all three were hospitalized, and one child died. This outbreak was linked to grass-fed, organic beef: a product that many consider to be safe, but clearly is not, or not more so than other beef. The danger comes from improper or careless handling, not from how the cows live.