James H. Weaver

“ The epidemic in The Dalles is one of the largest outbreaks of salmonella poisoning in our history for the size of the population in which it occurred. A proportional outbreak in Los Angeles would have 350,000 people ill! If there had been one source, hot dogs at a high school football game, chicken at a big country barbecue, then it would have been explainable though most unusual. But there was not a single source. All evidence pointed to contamination on the premises of the eight restaurants. ”

“ The interviews of affected persons never traced back to such foods; if food handlers had infected salad bars, why had they not infected the more likely foods? Of course food handlers came down with salmonella in larger numbers than the rest of the population: almost all of them ate in the restaurants they worked in. And they were investigated far more intensely than the general population. ”

“ Is it possible to use salmonella for mass poisoning? It certainly is. Salmonella is quite easy to culture. Under the right conditions it grows quite rapidly. It can be transported easily in liquid. However, culturing salmonella and storing it and determining the proper mix for transporting it would best be done by a medical laboratory with trained lab technicians. ”

“ On August 29, a few weeks before the salmonella outbreak, the three county commissioners of Wasco County drove down to Rajneeshpuram to make an inspection. They drove into Rajneeshpuram where they were stopped and asked to continue their inspection in a Rajneesh vehicle. As they got in, Ma Anand Sheela came to the van and said to them: “Snakes should sit in the back seats.” ”

“ There were 10 restaurants where at least one case of patron illness was confirmed by stool culture. Eight of these restaurants had salad bars. Food-specific attack rates were analyzed for four restaurants where we had enough complete food histories from both ill persons and controls. These four restaurants accounted for 274 patron cases (38 percent of the total number of cases) . Attack rates were highest for salad items in all four restaurants; lettuce was the only item whose consumption was consistently associated with illness. ”

“ Then consider that there are about 50,000 salad bars in restaurants in the United States according to the National Restaurant Association and none of them have been pinpointed as the cause of any salmonella outbreaks. They all have food handlers just as likely or unlikely to contract and pass on salmonella as the food handlers in The Dalles. ”

“ Sixty-six (20 percent) were culture-positive for Salmonella typhimurium; this group includes 26 employees who denied any illness. Of the eight restaurants where culture-positive patrons were documented from the second wave only, seven had at least one employee with early onset of disease (on or before September 20) . In one restaurant, the work history of a salad maker with culture-proven, early onset illness coincided with patron exposure. In another establishment, multiple salad makers became ill early on ”

“ The person who spoke for the Rajneeshees most frequently was a woman called Ma Anand Sheela, the personal secretary of the Bhagwan. On September 18 press reports quoted Ma Anand Sheela saying to a rally: You tell your Governor, your attorney general and all the bigoted pigs outside that if one person on Rancho Rajneesh is harmed I will have 15 of their heads, and I mean it. ”

“ All employees from implicated restaurants were required to submit a stool sample for culture. Those with a positive culture or a history of recent gastrointestinal illness were excluded form work until two consecutive stools were negative. ”

“ There were anecdotal reports of widespread illness among employees in both establishments, as well. CDC was contacted on September 25 and was asked to participate in the investigation of this outbreak. Following subsequent publicity, hundreds of affected patrons telephoned to report illness. Illness was not limited to patrons of the two initially reported restaurants, but involved employees and patrons from 10 independent establishments. A total of 715 persons met a clinical case definition (below) or had a positive stool culture for Salmonella typhimurium. ”

“ No other common exposure was identified among these ill patrons of restaurants. Local residents who became ill were geographically scattered by residence and appeared to be equally likely to live in either region served by the two water sources for The Dalles. Thus, the subsequent investigations focused on food consumption in restaurants. ”

“ We attempted to obtain similar information for comparative basis for estimating relative risks. Standardized questionnaires with comprehensive lists of foods available at each restaurant were administered when possible. ”

“ The food items implicated were uncooked and likely to be handled during their preparation without rewashing prior to serving.
7. There was no epidemiologic evidence to suggest deliberate contamination of foods. ”