Retired nurse Sarah Allman was sitting in the Boise Co-op gazebo eating a sandwich in the early afternoon of June 26. She had been riding her bike on the Greenbelt when the lunch hour struck, and she crossed downtown Boise to grab a bite. Allman said she rarely eats at the Co-op, and had read local media accounts of a salmonella outbreak at the North End grocery store's popular deli. That didn't stop Allman from peeling back the paper wrapper on her sandwich and taking a bite.
"I really think that they just went through this; they're probably on their toes, now more so than any other time," she said of the Co-op deli staff.
Almost two weeks before, on June 13, the Central District Health Department released a statement saying that it had linked the Co-op to approximately 30 cases of salmonella, a foodborne illness. Since then, the number of confirmed cases has mushroomed to nearly 300. The Co-op deli—which accounts for 18 percent of the store's weekly sales—shut down for four days and four lawsuits have been filed by people who fell ill after eating there. The grocery store now faces insurance claims, legal expenses and lost business—all while it is planning a second location in the Village at Meridian, set to open Thursday, Oct. 15.
This is a time of uncertainty for the Co-op: It's unknown how salmonella was introduced to the deli, how many people fell ill or how the outbreak will financially affect the grocer. For Co-op Marketing Manager Maureen "Mo" Valko, those uncertainties are wounds that will take time to heal.
"It's going to take a while to rebuild trust with some people. It's been a widespread incident and we completely understand that we'll need some time to regain some community members' trust in the Co-op," she said.
One thing that is clear in the wake of the outbreak is that the symptoms of salmonella are unpleasant: People exposed to the bacterium can begin suffering diarrhea, fever, abdominal cramps and vomiting between 12 and 72 hours after consuming contaminated foods. The symptoms can last for days. Left untreated, it can kill. Every year, according to the Centers for Disease Control, it sickens 1 million people, hospitalizes 19,000 and kills 380 in the United States.
CDHD investigators have determined that salmonella was introduced to the Co-op deli on or before June 1, and began receiving reports of an outbreak by June 8. By the time the sources of contamination were identified, hundreds, if not thousands, of Co-op customers had been exposed. Approximately a quarter of the cases were traced to the Co-op's recently opened kiosk at the Boise Airport. As of July 1, CDHD had verified 290 cases, making it one of the largest (if not the largest) foodborne illness outbreaks in Idaho's recorded history.
"We don't typically see outbreaks of this magnitude. Normally it's a couple cases here and there, but this is one of the largest in Idaho history," said CDHD Public Information Officer Christine Myron.
At first, the source of the illness was unknown. When CDHD released its initial public warning about verified salmonella cases, it named the Co-op as one of several locations possibly linked to the disease. As investigators gathered testimony from affected customers and examined food samples, it became clear that the contamination wasn't in the Co-op's supply chain—farms and other vendors from which the grocer sources its foods—but the Co-op deli itself.
"We know that many of those same vendors sell to other restaurants in the community. If they were distributed elsewhere, we would know, and we'd be dealing with more cases if that was the case," Myron said.
After tracing the outbreak to the Co-op, investigators were then able to isolate the contamination to three commonly used items: raw turkey, onions and tomatoes. The DNA of salmonella changes quickly, and CDHD investigators are studying it to learn more about the source of bacteria and how it spread through the deli.
According to attorney William Marler, of Seattle-based law firm Marler Clark, the nature of the science behind epidemiology makes it unlikely that the four civil cases filed against the Co-op will go to trial.
"The reality is that most foodborne illness cases don't go to trial because there's really not a lot to argue about," he said. "Causation really isn't an issue. For those people who are culture-positive to salmonella and genetically linked to strains at the Co-op, the real issue is, what are the damages?"
Marler Clark has recovered approximately $600 million in damages for victims of foodborne illnesses since it was founded in 1998 by attorneys who cut their teeth representing clients following the Jack in the Box E. coli outbreak that sickened 732 and killed four children in 1993. Marler is representing the plaintiffs in their suits against the Boise Co-op, seeking damages relating to the salmonella outbreak. Those include medical bills and out-of-pocket expenses; lost wages and earning capacity; emotional distress including anguish, loss of enjoyment of life, and pain and suffering; and reduced life expectancy.
He said damages are "completely dependent on the severity of someone's illness," from the "low five figures" to "quite expensive."
Marler said the Co-op's situation is unusual both for the high number of reported cases and the number of people affected in other states.
"I'd put the Boise Co-op among the larger outbreaks at a restaurant ever," he said. "You have people whose only common denominator is purchasing sandwiches at a kiosk while leaving Boise."
Valko remains optimistic.
"Our goal coming out of this—our long-term goal, something we'd like to see in a few years—is for the Co-op kitchen to be a model kitchen in the [Treasure] Valley," she said.
In 2012, the Co-op spent approximately $800,000 remodeling its deli as part of a larger reorganization and update of its facilities. When staff learned of the outbreak, the Co-op was in the midst of a $1 million community investment campaign that would help build the new deli at the grocery store's upcoming second location, as well as purchase new equipment in the North End. That campaign has since been put on hold, but the goal of the deli becoming a "model kitchen" remains in place. Since the outbreak, each member of the deli staff has undergone retraining and 11 deli employees have been enrolled in ServSafe food safety training at Life's Kitchen.
"The nice thing about the training is that everybody gets on the same page about why safety is important," said Life's Kitchen Executive Director Jeremy Maxand, who has taught the eight-hour ServSafe course for two years.
The Life's Kitchen ServSafe program gives trainees—from kitchen managers to frontline employees—information about food receiving, storage and preparation, as well as food safety documentation and best practices. Managers then implement those practices as kitchen policy. The program was designed to be more rigorous than the state standard for food handling—a 50-question, open-book test that can be taken as many times as necessary.
"[ServSafe] is more intense. It takes more time. There's more back-and-forth conversation," Maxand said.
Meanwhile, at the Co-op, Valko has been directing those caught in the outbreak to the grocer's insurance policy through Oregon Mutual and managing public outreach on the issue, encouraging sickened customers to contact her. The investment drive has resumed, and some of the checks from investors have referred to the outbreak.
"I had one email in particular that said, 'We really want to support the Co-op through this and we believe in what the Co-op stands for, and this incident is really unfortunate, but we want to continue our support of the store,'" she said. "People have rallied behind us."
Valko said that though sales in the deli remain below average, more people visit there daily, and that has helped boost spirits among Co-op staff.
"We've had such a positive response from our customers and community members that I think it's really helped morale through this," she said.