Recent foodborne disease outbreaks associated with nonpasteurized fruit juices and undercooked hamburgers are very memorable and have led to considerable regulatory activity and processing modifications. However, the total number of illnesses and deaths associated with those outbreaks pales in comparison to an incident that occurred in 1989 that led to at least 1,500 cases of serious, debilitating illness and 37 deaths. The latter incident led to no new rules, and remains an unsolved mystery of …