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And he was drenched with sweat and he was clutching his stomach.
His doctors couldn't figure out what was wrong with him, and until they did, they couldn't cure him. For now, all they could do was keep the boy hydrated and hope for a breakthrough. But judging from how miserable her son looked, it didn't seem like the doctors were helping at all. The mother was starting to get worried that her little boy's life was in danger. The mother stood up to call the nurse when all of a sudden she felt dizzy and lightheaded.
She sat back down and realized she was starting to sweat. A lot. This was exactly how her son's illness had started. Whatever he had, now she had it too. What she didn't know though, was that thousands of other people were experiencing the same terrifying symptoms too. This was just the beginning of an outbreak that would spread across the entire United States. And there was no cure in sight.
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From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you liked today's story, please offer to detail the follow button's car, but be sure to hide a slightly open can of tuna under their front seat. This episode is called Common Ground.
On August 8th, 1998, Sharon Anderson's eyes shot open to the sound of her eight-year-old son's wailing. She glanced over at the bedside clock and saw it was only 4 a.m. Toby, her son, was a very deep sleeper, so she knew it had to be something serious to wake him up at this hour. So Sharon jumped out of bed and rushed down the hall to his room. Toby was still in his bed, and he was holding his belly with both hands. He was covered by a film of sweat, and he was moaning in pain.
Sharon laid the back of her hand on Toby's forehead and she found that he was burning hot. In fact, he felt much hotter than when he normally got sick. Sharon knew her son needed medical attention right now. She rushed back to her bedroom, woke up her husband, and told him to go get the car ready so they could drive their son to the emergency room. Then she ran back to Toby's room, she scooped him up in a blanket, and carried him down the hall. It was still dark out as Sharon and her husband loaded Toby into their car.
Fortunately, the streets of Minneapolis were empty at that hour as they raced to the nearest hospital. Attending physician Dr. Jean Miller was just starting her shift when her office intercom buzzed and a voice announced that an 8-year-old boy named Toby had just been wheeled into the ER. His mother, Sharon, said Toby had been feverish for hours and was throwing up. Dr. Miller jumped up from her desk and dashed down the hall to the emergency room.
She found Toby lying in bed, his eyes half open and his skin drained of color, while his pajamas were dark with sweat. The boy's parents hovered beside the bed looking worried and helpless. Dr. Miller called for a nurse to bring an IV saline drip to get some fluids into the boy. Then she measured his heartbeat and listened to his breathing. But the child's intense stomach pains suggested that whatever was going on was an intestinal issue.
That covered a lot of possibilities, from food poisoning to something much more serious like appendicitis. Dr. Miller asked Toby's parents if he'd eaten anything unusual lately. They looked at each other and listed various meals from the past few days, but then said that nothing out of the ordinary came to mind. Dr. Miller nodded, then asked Toby where it hurt most. With very shaky hands, Toby pointed to his stomach. Tears formed in his eyes, and he told Dr. Miller the pain was getting even worse.
Dr. Miller smiled calmly, doing her best to hide her concern that Toby seemed to be sinking. The doctor grabbed a phone off the wall and called the lab to order blood and stool samples. That would likely identify what was happening inside of Toby's body. The doctor was pretty sure it was some kind of food poisoning, but the boy's intense discomfort suggested that it could be more serious than your run-of-the-mill 24-hour stomach bug.
Dr. Miller took the parents aside and told them to make a list of every food and every place that Toby had eaten in the past four days. Dr. Miller promised they would find out what was happening to their son and they would do everything in their power to make him right again. A few hours later, Dr. Miller's phone rang. It was the lab with Toby's results.
They found blood in Toby's stool which indicated intestinal bleeding, most likely from bacteria in his food. So Dr. Miller had apparently been right. It was some kind of food poisoning. Now they needed to figure out what kind of food poisoning it was. The lab technician said they had already isolated the bacteria from Toby's stool for closer analysis.
Dr. Miller thanked the technician and hung up. The good news was that they were now closer to knowing what was making Toby sick, but the bad news was, until then, Dr. Miller could not really aggressively treat Toby's illness. For many bacterial infections, the best treatment is antibiotics, but with certain strains of bacteria, such as highly toxic strains of E. coli, antibiotics can actually make the patient sicker or even kill them.
So for now, all Dr. Miller could do was keep Toby's fever down with medication and his dehydration at bay with an IV drip. Dr. Miller checked in with Toby's parents and told them to get some rest and that she would be back at the hospital first thing in the morning. Then the doctor left the room and went to the night nurse and told her to please contact her at home if anything changed with Toby. The next morning, Dr. Miller had just sat down behind her desk with a mug of coffee when a nurse knocked on the door and poked her head in.
She said there was a new arrival to the ER, a four-year-old girl named Peyton Egger. She had a sweltering 104-degree fever, and her mother said she'd been vomiting on and off for 12 hours with repeated bouts of diarrhea. Dr. Miller's mind raced as she followed the nurse down to the emergency department.
White curtains were drawn all around a gurney that had just been wheeled in. Little Peyton was lying on the gurney, drenched in sweat. Her face was drained of color and she was struggling to keep her eyes open, and her parents stood to the side, clutching each other nervously. Dr. Miller immediately ordered the nurses to hook Peyton up to an IV drip while she checked the girl's vitals. Peyton's pulse was weak and her blood pressure was dropping. Dr. Miller worried she might be going into shock, which could cause her organs to shut down.
Dr. Miller realized that Peyton's symptoms were very similar to Toby's, so much so that she wondered if both kids had caught the same infection. Peyton's parents told Dr. Miller that their home was in a suburb north of Minneapolis, which was nowhere near where Toby's family lived. Still, Dr. Miller thought there must be something these two kids had in common. Dr. Miller called the lab and told them she wanted full blood work run on Peyton, plus stool samples tested as well.
Then, Dr. Miller took Peyton's parents into the hallway and asked them for more details. The mother said that Peyton had been complaining of stomach pains last night, but it really hadn't seemed that serious. But at around midnight, Peyton woke up crying from all the pain and then began vomiting. After that, she kept vomiting nearly every hour and had several episodes of severe diarrhea. Then her temperature started spiking.
By dawn, the parents said it was clear that whatever this was, it was only getting worse. So her parents had rushed her to the hospital. Dr. Miller said they had done the right thing. Peyton would be safe here. For now, the best thing they could do was just stay calm and wait. But that was advice Dr. Miller found easier to give than to practice. As Dr. Miller stepped out of Peyton's room and headed back to her office, a nurse hurried up to her and said the lab had been trying to reach her. Toby's new results were in.
The boy was infected with a bacteria called Shigella. Finally, Dr. Miller knew what she was up against. Shigella attacks the digestive system, causing inflammation and bleeding within 12 to 48 hours after eating food contaminated with the bacteria. Toby had all of the classic symptoms: fever, abdominal pain, nausea, diarrhea. Dr. Miller knew that if untreated, Shigella could send Toby into shock, which often leads to organ failure and occasionally even death.
But at the same time, Dr. Miller was relieved. Although Shigella was obviously serious, it could be defeated with antibiotics, so she could finally start treating Toby. Dr. Miller told the attending nurse to prepare antibiotics for Toby and begin administering them as soon as they were ready. Then Dr. Miller rushed to Toby's room to give his parents the news.
The boy was lying in his hospital bed with his eyes half open. His mother sat in a chair next to the bed holding her son's hand and looking flushed and exhausted. Dr. Miller asked Toby's parents to step outside with her so she could explain what was going on. But when Toby's mother tried to stand up, she wobbled and had to sit back down. She admitted she had not been feeling well since she woke up that morning. She said she even vomited a couple of times.
Dr. Miller told Toby's mother to stay seated while she called for a nurse to prepare a bed for her. The doctor told her it was entirely possible that she was also now infected with Shigella, which was the bacteria that they had just discovered her son was infected with. After all, Shigella is so contagious that it can be passed in a handshake if someone who touched the bacteria didn't wash their hands well enough.
As soon as Dr. Miller had settled Toby's mother into her own hospital bed, a receptionist waved the doctor down. It was the lab calling again. They had the results for Dr. Miller's other young patient, Peyton. She had Shigella too.
Dr. Miller put down the phone. First Toby, then maybe Toby's mother, and now Peyton? Suddenly, Dr. Miller felt like she had an outbreak on her hands. And given how easily Shigella is transmitted, there were likely dozens more people out there suffering symptoms at home. And every one of those cases could make more people sick. Suddenly, Dr. Miller had a lot of calls to make.
Later on that same afternoon in August of 1998, a young epidemiologist at the Minnesota Department of Health named Dr. Julie Wickland was sitting at her desk when her secretary buzzed. She told her there was an urgent call coming in from a local hospital.
Dr. Wicklund was only in her 20s and still trying to prove herself professionally, but one thing she had already learned was that being an epidemiologist meant everything was a potential emergency. People's lives were always on the line. She picked up the phone and called Dr. Miller, who described the potential Shigella outbreak she was facing, three cases in her hospital, and likely a lot more people at home right now who just weren't sick enough to head to the hospital yet. But soon they would be.
Once Dr. Wickland was done hearing from Dr. Miller, she requested to have Toby and Peyton's families fill out food history charts with everything they had eaten in the past four days. Then she met with her team at the Department of Health and assigned some of her best investigators to join her on this case. By the time she got back to her office, Dr. Wickland's secretary came in holding a stack of papers. The families had already filled out and faxed over their kids' food histories.
Dr. Wickland spread them out on her desk and scanned them to look for commonalities. Right away, she noticed a pattern. They had all eaten at a restaurant called Roberta's. The odds were extremely low that both Toby and Peyton's families had eaten at the same place in the same four-day window, especially considering how far apart they lived. And so this was exactly the type of breakthrough Dr. Wickland was hoping for.
An hour later, Dr. Wickland and two other health officials stepped out of a dark sedan in front of the restaurant Roberta's, a modest neighborhood eatery. The manager was waiting for them by the entrance, looking very tense. The restaurant was temporarily closed for the rest of the day so that Dr. Wickland and her team could go and conduct their investigation there.
Dr. Wickland needed to inspect every aspect of the restaurant's food handling for possible sources of contamination, such as spoiled food or dirty water. Dr. Wickland assigned one investigator to record the temperatures inside the refrigerators and freezers, while another investigator took water samples from all the sinks and taps. Then Dr. Wickland studied every step in the food's journey to the table, from the delivery area to the storage room to the food prep stations.
The overall layout at Roberta's met safety standards, but Dr. Wickland knew how elusive Shigella could be. Shigella can show up almost anywhere and then can be spread by the people who are simply preparing the food. Dr. Wickland told the manager she needed to interview the entire staff, and so once the staff was gathered in the dining room, Dr. Wickland circled the room asking each employee questions about their recent health and also their daily kitchen routine.
Several members of the staff admitted to Dr. Wickland that they had not been feeling very good lately. Some had even been feverish and suffering pretty severe abdominal pains. It sounded worryingly similar to what Toby and Toby's mother and Peyton were all experiencing.
Dr. Wickland then made copies of the restaurant's reservation list and credit card receipts from the past four days. Flipping through the pages, she estimated at least 400 people had eaten at Roberta's within a few days of when Dr. Miller's patients had eaten there. All of these diners were now at risk of getting Shigella.
Back at the office, Dr. Wickland wrote up a questionnaire for all of Roberta's 400-plus diners. She needed to determine how many other customers out there were suffering similar symptoms. If any of them had contracted Shigella but didn't realize it, they could be infecting other people. These people needed to be notified right away or else this situation could get much worse.
The next morning, when Dr. Wickland arrived at her office, she learned that one of Roberta's employees had tested positive for Shigella. This confirmed that everyone who had eaten at the restaurant could now potentially be infected with the Shigella bacteria. But at least she now had a pretty good idea where the Shigella was coming from, a sick food prep worker who likely had not washed their hands properly.
Dr. Wickland's first step was to call Roberta's and order the restaurant temporarily closed until the Shigella outbreak was totally contained. Then Dr. Wickland called Dr. Miller to get an update on her patients. Dr. Miller told her that Toby's mom was doing fine, but Toby and Peyton were struggling. Shigella is always harshest on the young and the elderly, and the children's conditions were not getting better. If they didn't start getting better soon, Dr. Miller feared they could go into shock and die.
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Go to shopify.com slash mrballin to take your retail business to the next level today. shopify.com slash mrballin Early the next day, Dr. Wicklund's phone rang with new results from the lab. Several more employees at Roberta's restaurant had tested positive for Shigella. This meant that the disease outbreak was not coming from a single unsanitary worker. It was coming from lots of places.
Dr. Wickland got a fresh cup of coffee and then sat down at her desk to begin studying the first wave of questionnaire results from Roberta's recent customers. And she was disturbed to see that a full half of the 400 diners reported experiencing symptoms that were consistent with Shigella.
But as Dr. Wicklund studied the responses, something about the data just didn't seem right. A large percentage of infected diners had eaten at Roberta's before any of the employees started to get sick. So it was unlikely that the employees were giving the infection to the customers. The workers were actually victims too. Dr. Wicklund leaned back in her chair and took a deep, defeated breath. She now realized that she actually had no idea where all the Shigella cases were coming from.
An hour later, the manager at Roberta's unlocked the restaurant door and let in Dr. Wickland. She told the team to put on gloves and start discarding every piece of food in the building. Nothing could be saved. Roberta's manager was happy to comply, and Dr. Wickland told him the business could reopen once all the food had been thrown away and the entire restaurant professionally cleaned. They couldn't afford to take any chances.
Dr. Wickland pulled a bin of produce off a shelf and dumped it in the trash. The Shigella was somewhere under this roof and Dr. Wickland was not going to let it slip past her. Dr. Wickland returned to her office at the Department of Health to find a report sitting on her desk. Her heart sank. It was the details of another case of Shigella, this time north of Minneapolis. A 33-year-old woman had been rushed to a hospital after hours of vomiting, fever, and diarrhea.
The night before, the woman had eaten at an upscale restaurant in her neighborhood called Marty's. Not only that, but she'd gone to the restaurant with multiple friends, all of whom had been contacted and reported feeling sick. But Marty's restaurant was very far from Roberta's. For this illness to strike two restaurants in entirely different areas, miles apart from one another, was extremely rare.
Dr. Wickland sighed and called the manager at Marty's to tell them the restaurant would have to close until further notice. She said that a health official would be there shortly to collect their reservation list and credit card receipts, and all their recent diners would need to be contacted about the disease outbreak. Dr. Wickland then called a meeting with her investigators to brainstorm. She felt lucky that there had been no fatalities so far, but she also knew that young children were in the greatest danger.
She told her team they had to find the link between Marty's restaurant and Roberta's restaurant that could explain all the Shigella cases. Maybe both restaurants sourced particular food items from the same place, or maybe an employee worked part-time at both restaurants, or maybe they shared a water supplier. Whatever it was, she told her team they had to go find out.
By the next afternoon, Dr. Wickland had more information to go on. She and her team had worked around the clock, contacting people and compiling timelines of symptoms. It was a lot to sift through, but she knew it was always better to have too much information rather than not enough. As Dr. Wickland made her way through all the paper piled on her desk, the differences between the two restaurants really jumped out at her.
Marty's got its water from a different reservoir than Roberta's, so this was not a water issue. There was also almost zero overlap in their menus because Roberta's and Marty's served very different types of food. And a review of the two restaurants' employees showed that no staff members worked in both places either.
The researchers could not even identify a single food that all the sick customers at each restaurant had eaten. Everyone ordered different dishes, yet got sick the same way. And so Dr. Wickland wondered to herself, you know, how could that be? This just doesn't seem possible. Just then the phone rang. It was the lab with an update on the Marty's restaurant customers. Everyone who tested had come back positive for Shigella.
The lab had also done a genetic comparison of the Shigella bacteria from the Marty's diners and the Roberta's diners and they found them to be identical. Clearly, both restaurants had been contaminated by the same source. Dr. Wickland thanked the technician and hung up. She felt stumped, exhausted, and ready to call it quits for the day, but she did have a couple more calls to make. The first one just to check up on Toby and Peyton. On the other end of the line, Dr. Miller sounded equally exhausted.
She said Toby was still bedridden because his body was not responding to the antibiotics. He was now faced with a painful and slow recovery. Little Peyton Egger was even worse. Dr. Miller had nurses monitoring her around the clock, but her family was obviously worried sick. Dr. Wickland thanked her for the update, then she hung up and scrolled through her Rolodex until she found the United States Centers for Disease Control.
This outbreak was clearly not settling down the way Dr. Wicklund hoped it would, and so it was time to call in reinforcements. Dr. Timothy Niemi was in his office packing up to head home when his phone rang. He considered letting it go to voicemail, but his position as an epidemic intelligence officer at the Centers for Disease Control and Prevention had taught him the danger of missing an emergency call.
So he picked up the phone and he listened carefully as Dr. Wickland explained the events of the past week and how the Shigella outbreak showed no signs of slowing down. Dr. Wickland said she needed the CDC's help in finding the outbreak's origin so they could stop it. Every bacterial outbreak has its own genetic fingerprint that makes it unique, and the CDC keeps a massive database of these fingerprints from all over the world.
Dr. Naemi told Dr. Wickland to email him an image of the Shigella bacteria's DNA profile. Then he could use the CDC's database to see if the same Shigella strain had been reported anywhere else. The moment Dr. Naemi uploaded the Shigella bacteria from Minnesota to his database, Shigella outbreaks in other areas popped up all over, from Los Angeles County to Boston to Florida, plus up in Canada and Alberta and Ontario.
Each outbreak had been linked to a specific restaurant and all were genetically identical. This meant that there was a good chance all of these Shigella outbreaks were caused by the same source of contamination. The sheer breadth of locations baffled Dr. Naemi. He stared at the map. How did the same contaminant spread across both coasts, down to the Gulf of Mexico and all the way up into Canada?
He emailed his coworkers the results and asked them to help him contact every restaurant associated with an outbreak and compile a comprehensive list of foods and ingredients on their menus. There had to be something in common to all of them that was carrying this particular strain of Shigella. The next morning, one of Dr. Naemi's fellow investigators strolled into his office and handed him a post-it note with one word written on it. Dr. Naemi read the note and couldn't help but laugh.
The investigators had identified the probable source of the Shigella outbreak, and it was something that no one suspected. Dr. Naomi's department even had a term for this particular ingredient. They called it stealth food because it's used in a wide variety of dishes yet usually goes unnoticed. Dr. Naomi congratulated his team. This was the best lead they had. He picked up a phone and he called a colleague at the Food and Drug Administration named Jeremy Brown.
Dr. Naemi told Jeremy what they had discovered and said he'd need the FDA's help tracing this particular ingredient, the stealth food, to the original supplier. Global supply chains for restaurants are incredibly complex, with food shipping from across the world and constantly being reprocessed and repackaged, and so finding one bad batch of food among all of that would not be easy. Jeremy said he would get to work.
A few days later, Jeremy rode in a Jeep through Ensenada, Mexico. At first, the countryside was dry and dusty, but as they curved over a hillside, suddenly everything turned green. For miles into the distance, Jeremy saw nothing but crops in organized rows.
Finally, they turned onto a dirt road and passed a sign that said the name of the farm, Valle Verde. The farmhand pointed out different fields of produce, including tomatoes, celery, cilantro, green onions, radishes, and lettuces, all watered by massive irrigation machines. But the biggest spread of all was an entire 55-acre parcel devoted to growing nothing but the stealth food Jeremy had come to investigate. And the stealth food was parsley.
At some point between when it was harvested and when it was shipped, this parsley was becoming contaminated with Shigella bacteria. Jeremy was not going to leave the farm until he found out where and how this was happening. The Jeep came to a stop on the banks of an old riverbed. Since tainted water is the most common cause of Shigella, Jeremy had requested to visit the farm's water supply first.
The farmhand hopped out and led them to a series of wells that provided all of the farm's water. Jeremy looked inside one of them. The stone casing was old but uncracked. The shaft was dug very deep so that the water came from far underground, which meant the likelihood of contamination was actually quite small. Jeremy could tell the issue was not the wells. Next, the farmhand drove them past several meadows to a reservoir that served as the farm's backup water supply. It looked like a small fresh lake.
The water seemed clean, but Jeremy still bottled up a couple of samples for testing back in the US. The farmhand asked Jeremy where he wanted to head next. Jeremy said he could use a break from the heat. It had gotten much hotter as the afternoon wore on. A few minutes later, the Jeep rumbled to a stop in front of a huge farm shed with a corrugated steel roof.
It contained long conveyor belts stacked with crates of parsley. At the end of the line, men took those crates and stacked them on a pallet and then hosed them down with chilled water from a machine called a hydrocooler. Jeremy watched as hundreds of boxes quickly piled up and were loaded into the backs of huge trucks and then driven away to be shipped all across North America.
Jeremy asked the farmhand if the water for the hydrocooler came from their wells or the reservoir. But the farmhand shook his head and said neither. The water for the hydrocooler came from Ensenada's municipal water supply. Jeremy put on his sunglasses and told the farmhand that that was where he needed to go next.
At the municipal water plant, the facilities director admitted that they had been a bit overwhelmed lately. Due to government funding cutbacks, they had been understaffed for a while. With fewer security guards to watch the place, there had been a few break-ins lately, and some equipment had even been damaged. At one of the water filtration systems, Jeremy noticed that the machine that normally disinfects the water with chlorine was shut down.
Jeremy asked the manager if the chlorinator had just been turned off today or if it really was not working at all. The manager shook his head in frustration and said this had been on their list to get fixed for over a month, but the city hadn't managed to send over the parts yet. Jeremy did his best to hide his shock.
Without chlorine, all sorts of contaminants could flourish in the water, including Shigella. From there, the water was pumped to businesses, homes, and farms all over the area, like the parsley crop at Valle Verde. Jeremy filled several bottles to be tested and told the farmhand it was time to go. Days later, Jeremy got his results. Ensenada's municipal water was loaded with Shigella.
And it was the same strain as the one found at Roberto's, Marty's, and all the other restaurants. The contaminated water had been sprayed directly onto the parsley right before being shipped to restaurants all across North America where people like Toby, Peyton, and their families ate the parsley without giving it a second thought. Jeremy knew they had been lucky in tracking down the source relatively quickly.
He estimated that as many as 1,000 diners had caught Shigella from one harvest of contaminated parsley. But it could have been so much worse. Fortunately, there were no fatalities and both Toby and Peyton eventually made full recoveries. But very few of those who got sick will ever look at their parsley garnish the same way again.
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From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin. A quick note about our stories. We use aliases sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said, but everything is based on a lot of research. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
This episode was written by Britt Brown. Our editor is Heather Dundas. Sound design is by Matthew Cilelli. Coordinating producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda. Fact-checking was done by Sheila Patterson.
For Ballin Studios, our Head of Production is Zach Leavitt. Script Editing is by Scott Allen and Evan Allen. Our Coordinating Producer is Matub Zare. Executive Producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our Head of Sound is Marcelino Villapondo. Senior Producers are Laura Donna Palavoda and Dave Schilling. Senior Managing Producer is Ryan Lohr. Our Executive Producers are Aaron O'Flaherty and Marshall Louis for Wondery.
Hey, I'm Mike Corey, the host of Wondery's podcast, Against the Odds. In each episode, we share thrilling true stories of survival, putting you in the shoes of the people who live to tell the tale. In our next season, it's July 6th, 1988, and workers are settling into the night shift aboard Piper Alpha, the world's largest offshore oil rig.
Home to 226 men, the rig is stationed in the stormy North Sea off the coast of Scotland. At around 10 p.m., workers accidentally trigger a gas leak that leads to an explosion and a fire. As they wait to be rescued, the workers soon realize that Piper Alpha has transformed into a death trap. Follow Against the Odds wherever you get your podcasts. You can listen ad-free on Amazon Music or the Wondery app.
