Mary Kleinbauer remembers that late November day two years ago when the first cow got sick. A flurry of Canadian geese had turned the sky and the fields blizzard white. When her husband Dave came in from the morning milking with a troubled look on his face and called Doc Jones, she knew instantly which cow he was worried about.
The big gentle Holstein had been off her feed and not giving milk for several days. Now she was running a fever, 106 degrees, and she had severe diarrhea. From the sounds she made as she stared helplessly at the farmer with big, watery eyes, you could tell she was in terrible pain. Both Kleinbauers were concerned.
For a farmer with 112 cows, calls to the vet are routine; but this was different. ”At first Doc Jones figured she`d gotten into some moldy feed or something, and he tried to treat her,” Dave says. ”But nothing would control it.
”Then there was another cow–and another.” He shudders at the memory.
”As the calves were weaned, we put them on milk replacement with antibiotics, and a couple of days later they had it.”
Dairy farming is hard enough without sickness in the herd. It`s ceaseless work. The cows must be milked at dawn and dusk, seven days a week. Farming hasn`t been paying lately, and it hurts when a cow–worth about $1,000–takes sick and dies. ”The calves didn`t bother us so much. They`re only $50, $60,” says Mary Kleinbauer. ”Some of them were stillborn, the cows were so sick.” ”It got so bad,” her husband continues, ”I had a calf die one morning and I put her on the truck and told my wife, `I`m taking her to Brookings.`
” There, at the South Dakota State College School of Agriculture, Dave turned the calf over to the animal science lab.
”I didn`t know what else I could do,” he said. ”It got to the point we didn`t even call the vet anymore. The cows were too far along to help.”
By Christmas, 1982, when the big Kleinbauer clan had its annual party, it seemed the sickness had passed. There was the usual family talk of new babies and beef prices. The wife and baby daughter of Dave`s cousin were both in the Sioux Falls hospital with some terrible sort of flu. Uncle Roy Kleinbauer had a feeder beef herd ready to go to market. Mary Kleinbauer remembers thinking what a nice quiet way this was to end what had been such a difficult year.
It`s always quiet here in South Dakota when winter settles onto the gleaned fields. The land rolls out before your eyes like a fresh sheet being shaken into place across a bed. It seems to go on forever, as does the gray-blue sky. Die stille in die Land, these sturdy Mennonite farmers call the soundless peace.
It is the last place one would imagine as the center of a storm. Yet something happened here that killed a man and made 17 others so ill they wished sometimes that they could die. What happened touched off a controversy that rages now in the halls of Congress and the Department of Health and Human Services. It threatens a $270-million industry and may change the very foods on America`s tables.
”South Dakota is a very decent state,” says Ken Senger. ”The people who live here are small-town America. Everybody knows everybody else.” Senger is a farmer`s kid from a little town near Aberdeen–but at 35, he`s also state epidemiologist and a 12-year veteran of the public health department. He cautions against using the Kleinbauers` real names. They didn`t do anything wrong, he says, but many are looking for someone to blame. ”I knew this investigation would cause controversy. There`s a lot of bucks involved. I just didn`t expect people to get so rabid. There`s some that will do anything that serves their financial and political greed.”
Kleinbauer is not the family name of these farmers–Kleinbauer is German for ”small farmer.” Suffice it to say they too are concerned that someone from outside their small community will ”harass us,” says Dave Kleinbauer. ”All I`m trying to do is be safe,” he explains.
It was a late Friday afternoon, Feb. 18, 1983, in the offices of the Minnesota Department of Health. Mike Osterholm, state epidemiologist and chief of the infectious disease section, was planning some skiing over President`s Day weekend. But he wasn`t counting on it. He knows better than that. ”I haven`t gone skiing since 1978. Something crazy`s always
happening,” he says.
The last time something big happened on a Friday afternoon, it was toxic shock syndrome. Late in the day a lab report crossed Osterholm`s desk indicating a second case of what appeared to be a mysterious new disease;
within weeks toxic shock had become a national panic and a new chapter in medical history. Osterholm shrugs off praise of his vigilance. ”Toxic shock existed before,” he says. ”We just put two and two together in a new way.” That is unnecessarily modest. Osterholm, 32, is by all accounts a brilliant and aggressive medical detective. A small-town kid from Waukon, Ia., he worked as an assistant for a country veterinarian in high school–huddling with farmers on 30-below nights when their cows couldn`t deliver, learning to turn and pull the calves from their mothers` wombs, and seeing first hand the hard economic realities of farming in the upper Midwest.
It was nearly 5 p.m. when, predictably, the phone rang. Even before he picked it up and recognized the voice of his lab technician, Osterholm knew his ski trip was a goner.
”Epidemiology requires a sixth sense,” he explains. ”There are just some outbreaks of disease, that as soon as you hear about them–even with no scientific evidence yet to say there`s something special here, you know its something important. This time I knew something special was up.”
During the week the laboratory had seen one, then two, now a half-dozen samples of an unusual form of Salmonella–Salmonella newport. Just six cases of S. newport (a form of food poisoning) suggested a ”cluster” with a common source–this particular bug is rare in cold northern states such as Minnesota.
A cluster wouldn`t ordinarily cause major concern–food poisoning is too common. But this time there were other disturbing factors.
”These people were unusually ill. There was every indication the bacteria were in their bloodstream–very high fevers, very bad chills. It`s like putting a drop of food dye into a batch of cookie dough; it changes color almost instantly,” Osterholm explains. ”A patient can go into shock and die suddenly. One woman thought she was dying. That was the spectrum of illness in every patient. I`ve had Salmonella and I never thought I was going to die. These patients were almost in shock.”
Salmonella usually is little more than a discomforting nuisance. In its various forms, the bacteria abound on uncooked chicken, in raw eggs, cheeses and meats. It lurks in the entrails, and is spread to the surface meat when an animal or bird is butchered. Adequate cooking will destroy Salmonella, but people still come in contact with it continually–on the shells of eggs, in ground meat, on knives or cutting boards used to cut chicken. A major outbreak in Ohio was traced to watermelon sliced in a supermarket`s meat department.
Usually the only cases the public hears about are those in which all the kids in a school start throwing up. Or half a church congregation comes down with diarrhea after a pot-luck supper. Or someone dies. Epidemiologists for the Centers for Disease Control (CDC) in Atlanta estimate that barely 1 percent of the cases in any given outbreak are reported. If Osterholm was getting reports on six cases, then there might be 600.
In most disease clusters, researchers quickly find a common denominator. But on this Friday night, an hour or two into their investigation, Osterholm`s team still had nothing to link the victims. They came from all over the Twin Cities. With the exception of one married couple, they did not know one another. They hadn`t eaten at any of the same places, nor had they bought food at the same supermarkets.
Finally, one common factor emerged:
Each of the patients had been sick with something else–a cold, bronchitis, sore throat. Some 36 to 48 hours before the Salmonella hit, each had begun to take different brands of an antibiotic called amoxicillin, a broad-spectrum penicillin derivative.
