Ann Marie McNamara

April 2023

Volume 77, No.3

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2023 marks the 30th anniversary of the Jack in the Box E. coli O157:H7 (O157) outbreak, the crisis that changed food safety. No event has revolutionized food safety like this outbreak. It became a catalyst for new science, technology, and policy that advanced food safety for consumers.

To understand the impact of the outbreak, we must revisit the 1980s. At that time, chemical pesticides were the focus of consumer advocacy and Food Safety and Inspection Service (FSIS) regulatory programs. FSIS leadership was primarily veterinarians. Salmonella spp. and Listeria monocytogenes were recognized as human pathogens but were considered natural flora in raw meat and poultry. There were no pathogen testing requirements in raw meat.

In 1982, two small outbreaks of O157 from undercooked hamburgers occurred at McDonald’s restaurants. These were the first occurrences of O157 linked to beef products. FSIS microbiologists developed new methods to detect this new pathogen. The Centers for Disease Control (CDC) was battling AIDS at the time. Industry had none of the food safety interventions familiar today, nor teams of professionals focused on food safety. If any interventions were used, they were for shelf-life extension. Total Quality Management was the focus and teams were called Quality Assurance.

CDC alerted FSIS in January 1993 that an outbreak of O157 was occurring linked to Jack in the Box restaurants. The nation was shocked that a hamburger could kill. Over 700 people were ill, and four children died. Others suffered lifelong complications of hemolytic uremic syndrome. Parents of the children formed Safe Tables Our Priority (STOP) and advocated for regulatory reform.

The outbreak was a crisis that became an opportunity to advance the policy and practice of food safety.

This incident spurred regulatory and industry change that accelerated food safety throughout the 1990s and beyond. The outbreak was a crisis that became an opportunity to advance the policy and practice of food safety. As director of microbiology at FSIS, I was involved in investigating this outbreak. I coauthored the congressionally funded “War on Pathogens” program and initiated 30 pathogen research projects, baseline studies of pathogens and indicator bacteria on meat and poultry products, and gained research grant authority to speed development of pathogen detection methods. FSIS administrator, Mike Taylor, took on the legal challenge of making O157 the first pathogenic adulterant in raw ground beef based on the fact that consumers did not cook ground beef to temperatures that kill O157, and the severity of disease. HACCP (Hazard Analysis Critical Control Points) was studied by the National Advisory Committee for Microbial Criteria in Foods. Ultimately, FSIS published the Pathogen Reduction/HACCP rule in 1996, which changed regulations from reactive inspection of meat/poultry to proactively evaluating and controlling risk and mandating microbial testing.

Food safety advances were made on myriad other fronts. Dave Theno, who became vice president of food safety at Jack in the Box following the outbreak, developed a restaurant food safety program, including microbial testing, cook-time validation, and restaurant HACCP. CDC developed the Sentinel Site, Food Net, and Pulse Net programs to identify disease. The U.S. Food and Drug Administration developed the Food Code, a series of restaurant practices to serve safe food. Declaring O157 an adulterant required industry to develop new interventions. Academia and industry researched and developed antimicrobial interventions, carcass steam/hot water cabinets, and steam vacuums. In the 2000s, food safety departments, food safety professionals, and food safety cultures were born.

Progress in food safety science, technology, and policy must continue. New food safety challenges include antimicrobial resistance of pathogens, global disease transmission threatens food production and animal and human health, and climate change threatens food security, which encourages laboratory-derived foods and vertical farming. New technologies can help address some of these threats. Whole genome sequencing allows faster outbreak detection, and artificial intelligence more rapidly identifies trends for safer food. The Jack in the Box outbreak taught us that microbial surveillance is critical, that food safety threats evolve, and that food safety and public health depend on academia, industry, government, and consumer groups working together to address the food safety challenges of the future.

The opinions expressed in Dialogue are those of the author.

Omnivore Podcast

US Foods’ Dr. Ann Marie McNamara joins us to talk about the 30th anniversary of the Jack in the Box E. coli O157:H7 outbreak and how it revolutionized food safety.

In This Article

  1. Food Safety and Defense

About the Author

Ann Marie McNamara, PhD, is vice-president, food safety and quality for supply chain, manufacturing and commercialization, US Foods.

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