On June 30, 2003, an Illinois county health department received a report from a local hospital indicating that a patient was ill with a Salmonella infection. A public health investigator immediately contacted the patient and learned that the patient had recently eaten at a popular local chain restaurant.

About an hour after receiving this first report, a second person contacted the health department to report that a family member had become ill after eating at the same restaurant. This prompted the health department to send investigators to the restaurant to inspect it. They found the restaurant’s dishwashing machine broken and corroded. The tube that fed chlorine into the machine was plugged, preventing proper sanitization of dishes.

Employees told the investigators that the machine had not worked properly for at least a week. In fact, according to the inspection report, “[e]mployees had wrapped plastic bags around the line to stop the chlorine from spraying into the air.” Despite the obvious condition of the dishwasher, the restaurant management had done nothing to repair it -- that is, until caught by the health department. The investigators also found food that was not stored at proper temperatures in the cooler. Following questioning of the on-duty manager, investigators learned that three employees, plus another manager, had called in sick that day with flu-like symptoms.

The investigators collected stool samples from the employees there and interviewed each one regarding gastrointestinal symptoms. As a result, investigators discovered 13 employees who had been allowed to work despite suffering from diarrhea and other symptoms. Because of the large number of infected employees identified, the health department ordered the restaurant to close.

The health department also received a call from a customer who had dined at the implicated restaurant on June 27. She informed the health department that the establishment had no running water while she had been there for lunch and that this had been the case for at least an hour or two. Restaurant management had not thought it necessary to share this information with investigators at the time of their initial interviews.

On July 7, the health department received notice from the lab that the stool samples of 17 employees had cultured positive for Salmonella. Returning to the restaurant, investigators interviewed restaurant managers again and confirmed that there had been no water during the lunch rush on June 27 and no hot water the entire day before. No one could explain why the restaurant stayed open despite blatant violation of food-safety regulations requiring that hot water be available at all times during a restaurant’s operation.