How Safe Is Your Fresh Produce?
A Source of Infection
John Spratt's illness was as sudden as it was intense. One day in mid-October 2003, the 46-year-old senior financial service associate for a large payroll company in the Pittsburgh area found himself doubled over in pain from stomach cramps, nausea, chills, and a raging fever. "He looked miserable, but we figured he was just battling the flu," says his wife, Robin, 49. The normally buoyant and hearty Spratt was in bed for more than a week. He seemed to recover, however, and on Saturday, October 25, he felt well enough to drive about 25 miles with his brother, Joseph, to watch his beloved University of Pittsburgh Panthers football team play their arch rivals, the Syracuse University Orangemen.
That evening, however, his symptoms returned with a vengeance. On Tuesday he went to the doctor, who thought it might be the flu and prescribed antibiotics because of his fever. But over the next few days Spratt only felt worse. The following Monday, November 3, after having the dry heaves almost nonstop for days and with a fever of 102, he checked himself into the local hospital and was found to be suffering from severe dehydration.
A blood test revealed that Spratt was infected with the hepatitis A virus, which had attacked and damaged his liver. Doctors told Robin her husband might need a liver transplant. "I was absolutely floored," she recalls. That same day, Pennsylvania public-health officials issued a hepatitis A advisory in the Beaver Valley area, near where the Spratts live. In the following weeks, emergency rooms were flooded with people complaining of flu-like symptoms, and at least 100 were hospitalized. Most tested positive for the hepatitis A virus, which can incubate in the body for two to six weeks before symptoms, which can wax and wane, become evident. After epidemiologists interviewed victims, it became clear that almost all of them had something in common: They had eaten the salsa at a Chi-Chi's restaurant in the Beaver Valley Mall in the past few weeks. Sure enough, Spratt had eaten at Chi-Chi's with his 17-year-old daughter, Jacki, three weeks earlier.
Health experts traced the source of infection to the raw scallions in the salsa. Chi-Chi's parent company moved swiftly to shut down the Beaver Valley Mall outlet and pulled scallions from the menu of the other 100 restaurants in the Chi-Chi's chain. It was ruled out that food handlers had been the source of the infection: If they had been, they would have gotten sick long before the customers, not at the same time. So although the restaurant chain unwittingly spread the virus in its salsa, the contamination actually began much earlier, in the country in which the green onions were grown.
Hepatitis A is spread by contact with fecal matter (not by kissing or sneezing, for instance), which can happen when someone carrying the virus, such as a farm worker or food service employee, does not wash his hands well after going to the bathroom and then touches things that other people touch. It is a hardy virus that can remain infectious outside the body for four weeks or even longer. It can also infect produce when the fruits and vegetables are irrigated with, washed in, or packaged in ice made from water that has come in contact with infected fecal matter. The scallions used to make the large batches of salsa that infected Spratt were imported from Mexico, and experts suspect the virus became embedded in the tight layers of the onions, which means that even washing them with clean water wouldn't have been enough to remove the virus. (Only cooking the scallions would have killed the germs.) In fact, the Beaver Valley Chi-Chi's had consistently gotten top marks for its food-safety standards from the local health department.
But this discovery didn't help John Spratt, who was sinking fast. (Jacki, Spratt's daughter, tested positive for hepatitis A, too, but she may have ingested less of the salsa and had only mild symptoms. She recovered within a day or two.) By Wednesday evening, Spratt was having trouble breathing, and his blood pressure dropped so low his doctor could barely detect a pulse. He was put on a ventilator and airlifted before dawn to the University of Pittsburgh Medical Center, where he was evaluated for a possible liver transplant. "We were in shock," says Robin, who describes the next week as a nightmarish roller-coaster ride.
Spratt was heavily sedated to keep him comfortable and conserve his energy while doctors fought to save his life. Robin, Jacki, the couple's 13-year-old daughter Kristen, and friends stayed at the hospital day and night. But Spratt never regained consciousness, and his liver, kidneys, pancreas, and lungs began to shut down, making him too sick for a transplant. On Friday, November 14, a week and a half after he had first been admitted to the hospital, John Spratt died.
The family was devastated by his unexpected death from a virus the doctors said was usually fairly benign. "It was an extremely painful time, but it was also a blessed one," says Robin, crediting their faith as born-again Christians, "because we were able to share our love for him in those last days."