SARAH GONZALEZ, HOST:
There are two kinds of people in this world - people who think about germs...
DAN CHARLES, HOST:
And people who do not. Lisa Rasimowicz - her life is germs.
LISA RASIMOWICZ: I am the director of infection prevention here at Hunterdon Healthcare.
CHARLES: Think of Lisa as the handwashing police at this county hospital in New Jersey.
RASIMOWICZ: I have been called worse but, yes, yes, that is a nickname.
CHARLES: Oh, what's worse?
RASIMOWICZ: Well, we won't go into it. But - (laughter).
GONZALEZ: Lisa is a germ investigator.
RASIMOWICZ: So I'm potentially exposed to a lot of different types of bacteria, viruses, different pathogens that make people sick.
CHARLES: Lisa's job is to prevent germs from spreading. If anybody at this hospital has a bad bug, they have to alert Lisa.
RASIMOWICZ: Any time there's a positive lab, they automatically fax over the result. It's an instant report.
GONZALEZ: Nothing good comes from this fax machine. And one morning last spring, it comes to life, spits out a sheet of paper.
CHARLES: She walks over, picks up the paper, turns it over, and she sees E. coli O157:H7.
GONZALEZ: This is the worst combination of numbers and letters. This kind of E. coli is the really bad kind. They release something called the Shiga toxin. It can shut down your kidneys. It can kill you.
CHARLES: And Lisa, bad bug investigator, her job is to run straight toward the danger.
GONZALEZ: Straight to a 66-year-old grandma, Louise Fraser - normally pretty feisty.
LOUISE FRASER: My norm is to either walk 6 miles, or I run 3 miles - so very energetic, yeah.
CHARLES: But today everyone in the hospital is poking and probing her. They are not going to let her kidneys fail.
FRASER: Blood tests every day. And I think they stuck me, like, 20 times in the one arm.
GONZALEZ: Doctors are forcing liquids into her kidneys to keep them from shutting down. She's weak, bloated from all the fluids, and she just wants to lay there with her eyes closed.
CHARLES: Louise doesn't remember a lot about this time. It's all a blur. But she remembers some woman coming in, sitting down next to her. This was Lisa of course.
FRASER: She said, I'm going to sit with you for, like, an hour. We need to go through and talk about everything you ate in the last week to 10 days.
GONZALEZ: This is where Lisa's detective work starts. Lisa needed to know everything that Louise ate - every sauce, every nut, every fruit - because if you're sick with E. coli, you probably picked it up from something you ate. And Lisa, she needed a list of potential culprits.
CHARLES: So she pulls out a calendar to help Louise remember.
RASIMOWICZ: And we just went back date by date. And then as she told me what she ate, you then have to ask, what was in it? What was on the pizza? Where do you buy the food from? What ShopRite? What Costco? What supermarket?
GONZALEZ: What supermarket? Dan, think about what you had for lunch last Wednesday.
CHARLES: I was working at home. I got something out of the fridge. I don't remember what. What did you have for dinner, let's say, last Thursday?
GONZALEZ: I can pretty much guarantee I had cheese 'cause I eat a lot of cheese. But I don't know where I got it from.
CHARLES: Ask me breakfast. I know breakfast. I had toast.
GONZALEZ: (Laughs) OK. The point is this stuff is really difficult. I honestly have no idea how Louise remembered every single thing that she ate. But Lisa, she's right there with her going through the calendar - Monday's breakfast. What about lunch? Any snacks?
CHARLES: And Louise is like, no, no, Lisa. I can save you the trouble. I know what the problem was. I had this huge meal the day before I started feeling sick. It was a fish fry for the local fire department.
FRASER: I was eating fried clams. I was eating perogies. I was eating French fries. And then I topped it off by going to our local ice cream store and having ice cream. I'm thinking that's what made me sick.
CHARLES: It was not the fish fry. The fire department did not accidentally poison Louise.
GONZALEZ: Do not blame the firefighters.
CHARLES: But something did poison her, and it poisoned a bunch of other people, too.
GONZALEZ: Hello, and welcome to PLANET MONEY. I'm Sarah Gonzalez.
CHARLES: And I'm Dan Charles. Louise is not the only one who's sick. At the same time, all across the country, hundreds of people are getting poisoned.
GONZALEZ: And there's an army of investigators trying to figure out why.
CHARLES: Today on the show, we join the investigation, go on the trail of a nasty microbe all the way to a valley in the desert.
GONZALEZ: Heads will roll.
(SOUNDBITE OF LOUIS EDWARDS' "MYSTERY INC")
CHARLES: There is a step-by-step method to solving a true food crime.
GONZALEZ: And the very first piece of the puzzle is, which food? This is why Lisa Rasimowicz sat there with Louise Fraser in her hospital room going through those food memories - deliciously shameful food memories.
FRASER: Monday, I took my grandson to the show. And I had a great meal that day. I had ice - I had a hot dog - no, pizza with him, ice cream on my way home. That was my meals those days. I mean, talk about bad habits.
GONZALEZ: My kind of girl.
CHARLES: There were some healthy things, too, though - a meal at a Panera restaurant.
FRASER: A Fuji apple chicken salad - my favorite there.
GONZALEZ: And Lisa, our infection fighter, she's back in her office typing Fuji apple chicken salad into this national early warning system. If microbes are launching a sneak attack, this is how the whole country finds out about it. So she's right there typing all this information in, and then the fax machine comes to life again - another case of E. coli in her hospital. Lisa does the same thing - runs to the patient, calendar, survey and, whoa, this patient also ate a salad at Panera.
CHARLES: And Lisa thinks, I got to let the big bosses at the county health department know about this. So she calls Kathy Jaeger, whose job is to stay calm in times like this.
KATHY JAEGER: So she called me saying there's something suspicious going on. I have two cases of E. coli at the same time.
CHARLES: And Kathy's thinking, oh, interesting. I'll keep an eye on that. And then she gets another call, this time from the state. And they tell her two more people in the next county over have also just tested positive for E. coli.
JAEGER: I was shocked, surprised, and my adrenaline was flowing.
CHARLES: And now Kathy has to find out what they ate because if they ate at a Panera, that's more than a coincidence. That's a pattern. So she calls, and she gets through to one of the patients.
JAEGER: Her husband was at the bedside. And the wife would answer the questions through him. And he wouldn't answer my questionnaire.
CHARLES: They go through all her meals, and, yep, this patient also ate a salad from Panera.
GONZALEZ: But they all ate at different Paneras. And this is important because if it was the same restaurant, chances are the problem is at the restaurant. Maybe someone wasn't washing their hands right.
CHARLES: But the fact that people were getting sick from food at different Paneras means this is bigger. This goes up the food chain.
GONZALEZ: All these sick people had different salads. So investigators start looking at the ingredients in these salads. Is it the tomatoes? Is it the carrots? Is it the hearts of palm?
CHARLES: They all had one thing in common - lettuce.
GONZALEZ: Well, sure, 'cause it's a salad.
CHARLES: But specifically, it was romaine lettuce.
GONZALEZ: But then people all over the country start getting sick. Dozens are hospitalized, people who never ate at a Panera. One guy picked up a caesar salad at a Costco in Idaho. So at this point, it becomes clear - Panera is not the problem. It's the romaine.
CHARLES: Five people died. And now the feds are involved. The nation's top cop on the food infection beat - he is on the case.
STEVE OSTROFF: Every moment is of the essence.
CHARLES: This is Steve Ostroff from the Food and Drug Administration. Before he was in the FDA, he was an assistant surgeon general, a rear admiral. People saluted him.
GONZALEZ: And he's like, OK, so we know it's the romaine. But which romaine - from what farm exactly? Who is growing this contaminated lettuce? And the more we can narrow in on this thing, the better. If we can find the store that's selling it, the farm it came from, the exact field, we can shut it down, order a recall, save lives.
CHARLES: Steve sends his investigators to restaurants and grocery stores where sick people bought their lettuce.
OSTROFF: We say, show us your records as to the romaine lettuce that you were serving or that you had sitting on the grocery store shelf on that day.
GONZALEZ: And it is so hard to track a leaf of lettuce back to where it came from. Restaurants are telling Steve's little army, we got this romaine from a bunch of different processors. And processors were like, we got it from a bunch of different farms and chopped it all up together. The investigators are getting nowhere.
OSTROFF: And it gets very frustrating.
CHARLES: The only thing they know is the most basic fact of lettuce geography. Pretty much all the lettuce in the U.S. comes from just two places. There's Yuma, Ariz., and the Salinas Valley in California. They sort of take turns. Yuma grows in the fall and winter. The Salinas Valley takes over in the spring and summer. Given the timing, this contaminated lettuce must have come from Yuma.
GONZALEZ: So the government pulls out their biggest, bluntest tool. They tell the whole country, any romaine lettuce from Yuma could kill you. And I remember this very distinctly. I was texting my mom and my sisters, like, nobody buy romaine. It is killing people.
CHARLES: And, Sarah, you were actually part of a big problem in the country. The government was saying, don't buy romaine from Yuma, Ariz., and what everybody heard was just don't buy romaine.
GONZALEZ: Yeah, that's what I heard.
CHARLES: Even Lisa, the infection fighter who got this whole thing rolling, she had two menacing heads of romaine lettuce in her fridge.
RASIMOWICZ: I'm looking at them, and I thought, well, how do I know if this is packaged in the Yuma region? I didn't go to Arizona and buy it from there. I bought it from a supermarket around here. And at that time, I had been in the supermarket. And they were just directed any romaine lettuce to pull off the shelves.
GONZALEZ: So everyone is just dumping all their romaine in the trash.
CHARLES: But here is the weird thing about this. By the time people reacted to that warning, most of the lettuce wasn't even coming from Arizona anymore. It was coming from California. So it was farmers in California who took the hit.
GONZALEZ: Nobody wanted to buy their romaine lettuce either. So California farmers had no other choice. They had to destroy their beautiful, healthy romaine. They ran over it with these big machines that chopped up all these heads of lettuce and plowed them into the dirt. They had to bury their perfectly healthy lettuce. And, Dan, this sounds so sad to me.
CHARLES: Oh, it's good fertilizer. It'll grow back next year.
GONZALEZ: Oh, Dan, it's so hard to be a farmer.
CHARLES: It is not just public health officials who are looking into this. There's a guy in Seattle, a lawyer. He's watching this very carefully. In fact, he's got his own investigation underway. His name is Bill Marler.
BILL MARLER: You know, I have a morbid curiosity to these things 'cause I've been doing this for so long.
CHARLES: If you get sick from food and you want the food companies to pay, Bill is the guy you call. He sues food companies for a living.
GONZALEZ: And he's serious. The last time salad was making a lot of people sick, Bill Marler got on a plane to California looking for info on how it started.
MARLER: I camped out in Salinas and San Juan Bautista for a week, hanging out in bars, trying to find where the investigators were.
GONZALEZ: Bill is now representing Louise - Louise, who was having fluids pumped into her kidneys. And he's also representing about a hundred other people who got sick during this romaine E. coli outbreak. He's obsessively following every news story related to this thing. And he comes across one that seems like a really big break. It came from a prison.
CHARLES: That's right, a prison break.
CHARLES: Eight men in a prison in Nome, Alaska, of all places, got sick from E. coli. And because they were locked up, investigators knew exactly what they'd eaten. And indeed, romaine lettuce was on the prison menu. But it wasn't chopped-up salad mix this time. It was whole heads of lettuce with the name of the farm printed right on the bag.
MARLER: The plastic bag on the whole-head romaine said Harrison Farms. So it was a pretty good little piece of evidence.
GONZALEZ: And when Bill hears this, he thinks, this is it; we've got the culprit, this one farm.
CHARLES: And in fact, everybody wants the contamination to lead back to just one farm. This is the best-case scenario for consumers, for the FDA, even for the farmers.
GONZALEZ: Except for the farmer whose name is printed on the bag.
MARLER: If ultimately there can be one person to blame and therefore you're blameless, you at least can avoid, you know, direct responsibility.
CHARLES: But here's the problem. Louise did not eat lettuce grown on the same farm as the prisoners.
GONZALEZ: There wasn't one trail of contaminated lettuce. There were lots of trails leading to a bunch of different farms in Yuma miles apart. So something else happened in these fields, something mysterious.
CHARLES: After the break, we catch a flight to Yuma, Ariz.
GONZALEZ: We are on the hunt for E. coli O157:H7.
(SOUNDBITE OF MUSIC)
CHARLES: All winter long, America's salad comes from a narrow valley 5 miles wide and 50 meandering miles long. It follows the Colorado River. When I was there, it was blazing hot, oppressive. When the weather turns cool, though, this place is perfect for growing crops. Most of the farmers in Yuma did not really want to talk to me about E. coli. It is not a pleasant topic obviously. One farmer, though, he said, come on over - Steve Alameda, a big lettuce grower, co-owner of Topflavor Farms.
I found it.
STEVE ALAMEDA: How are you?
CHARLES: I'm good. How are you?
S. ALAMEDA: Come on in. Come on in.
CHARLES: This place is amazing.
Steve's bald, got a plaid shirt and mud in his shoes. He's super friendly and super proud of what he does. I say, can you show me around? He says, sure. He shows me cotton fields, hay fields, some date trees and acres of bare dirt that'll turn into lettuce fields in the fall.
So in another five months, this will all be green?
S. ALAMEDA: It'll all be green, all be green with vegetables.
CHARLES: You can grow anything here, huh?
S. ALAMEDA: Well, it's - for a grower - what would I equate this to? Would this be like being in the Silicon Valley? I equate it to that.
CHARLES: I tell Steve that I am on the trail of E. coli. And he says, yeah, you and the whole FDA.
GONZALEZ: He says there's a team of them poking around this valley, testing the water that farmers use to water their crops. And Steve's son Mike, he knows exactly where they are, like, right now.
CHARLES: So Mike takes my phone, and he pulls up a map.
MIKE ALAMEDA: So I'll drop a pin right here on that road.
CHARLES: And where's the canal?
M. ALAMEDA: Right below it.
CHARLES: If the E. coli is out there, I am going to find it.
Have a good day.
M. ALAMEDA: Thank you. You, too. You, too.
CHARLES: I hop in my rental car. I head east. It takes a while, but eventually I find them. There's a van and a white suburban. Nine people are standing along a concrete-lined ditch with water running along the bottom. Most of them look like grad students. Some are wearing blue latex gloves. They have coolers, high-tech scientific equipment. Every so often, one of them reaches down and fills a bucket with water. A broad-shouldered guy comes over to say hello. He's an FDA employee based in Yuma. He says they can't tell me much about what they're doing out here. It's very sensitive, he says. And a few hundred feet away, there's another canal filled with water. This is a bigger one. A bunch of farmers use that water on their lettuce fields. And right next to this water, cows as far as the eye can see, thousands of them just standing there quietly.
CHARLES: They wouldn't make any noise.
GONZALEZ: They wouldn't move for you?
CHARLES: No. Anyway, they're standing there on this bare dirt, lined up alongside troughs filled with corn and hay, eating, not mooing, pooping.
GONZALEZ: Cattle - the animals that most often carry E. coli O157. This is where E. coli comes from. Humans sometimes, but it's usually animals - deer, wild pigs, cows.
CHARLES: This might be where the long search for the source of the contamination - this might be where that search ends. Actually, here goes a truck carrying cattle manure out into the fields where it's composted driving right past this ditch.
GONZALEZ: The FDA found E. coli in this water canal, the exact genetic strain that got everyone sick. Their theory is that E. coli from the cow manure washed into this irrigation ditch or blew in. And then the contaminated water just flowed into all the vegetable fields across the valley.
CHARLES: I talked to Steve about this ditch. He doesn't get his water from it, but his lettuce-farming friends do. And they've actually been worried about these cows for a long time 'cause they're just so close to the vegetables.
S. ALAMEDA: You've got, like I say, a hundred thousand animals that are all culprits basically. So, you know, you'd be a fool not to have that pop in your head. Anyway - but like I say, we're aware of it, and we're always checking for it and looking and hoping that we can survive, you know, next to each other, which we've done for 60 years. And all of a sudden, there's something changed, something happened, that we need to know. We need to know.
CHARLES: The lettuce growing season in Yuma is supposed to start up again in just a couple of months. And Steve and his friends want to grow lettuce again, but those cattle are still there, and the farmers don't know what to do.
GONZALEZ: The FDA hasn't announced any rules or even recommendations for what the farmers should do differently.
CHARLES: And the thing that really scares the farmers is the possibility that the people who buy their lettuce, the big supermarkets and processors, maybe they will say, we don't trust lettuce from Yuma anymore; we won't buy it. Bill Marler, the food safety lawyer, says they should be worried.
MARLER: If there's another outbreak like this, I mean, a tough question for a Walmart or a tough question for a Costco is, why'd you buy, you know, product from a place that you know is near a feedlot that just had an outbreak last year? That's a very uncomfortable question that a lawyer gets to ask.
GONZALEZ: Steve and his fellow lettuce farmers are trying to figure this out. One way they're talking about is to treat the irrigation canal with chlorine to kill any E. coli.
CHARLES: But they've also been talking about something more drastic. Maybe those cows are now just too much of a threat to the lettuce industry. Maybe the lettuce farmers have to band together and buy the feedlot just to kick the cows out, shut it down. For centuries, farmers have raised their animals and their vegetables side by side. But farming has reached such a scale now maybe they can't anymore.
GONZALEZ: Maybe this valley just ain't big enough for the both of them - poor cows.
(SOUNDBITE OF MUSIC)
CHARLES: You can send us story ideas - email@example.com We're also on Facebook, Twitter and Instagram. I'll put up some pictures from the trip.
GONZALEZ: Today's show was produced by Alissa Escarce and Alexi Horowitz-Ghazi.
CHARLES: Nick Fountain edited.
GONZALEZ: And our big bosses are Alex Goldmark and Bryant Urstadt.
CHARLES: Many thanks to Channa Rock, Christina Tan and Karen DeMarco for their help with this episode. I'm Dan Charles.
GONZALEZ: And I'm Sarah Gonzalez. Thanks for listening.
(SOUNDBITE OF MUSIC) [POST BROADCAST CORRECTION: An earlier version of this story stated that investigators were able to identify a farm that sold contaminated lettuce because the name of the farm was printed on the bags in which the lettuce was delivered. In fact, investigators used purchase orders and invoices, not packaging labels, to identify the farm where those heads of lettuce grew.]
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