Surviving a Salmonella Outbreak: How One Patient Beat Foodborne Illness

“I thought normal food poisoning is, you get a stomachache and get some diarrhea and get over it in 24 hours,” Koehler said. “I didn’t know it could be as severe.”

More than a week before he fell ill, Koehler recalled, he’d cooked hamburgers to medium on a grill and shared them with his girlfriend’s daughter. He said he believes that because he handled the raw meat, he was the only one who got sick.

The U.S. Department of Agriculture recommends cooking ground beef to 160 degrees F, a temperature associated with medium to well-done. The USDA cautions people not to judge a burger’s doneness by color alone.

Policy and action

Soon after he recovered from his condition, Koehler went to two grocery stores to ask where the meat came from, but employees couldn’t give him an answer. Although most people affected by the same outbreak lived in the Northeast, one case was documented as far away as Hawaii. 

From Hannaford’s “limited records,” the USDA’s Food Safety and Inspection Service was unable to determine the suppliers responsible for the salmonella contamination, an FSIS spokesperson told AARP. The agency pursued a rule to require retailers of ground beef to maintain records of their suppliers, which became effective in June 2016.

“Our stores keep thorough records tracking information related to ground beef, including the suppliers associated with the product placed on our shelves,” Hannaford told AARP. “These efforts provide greater transparency and accountability within the supply chain, as well as the ability for the USDA to trace all product to its processing facility. We take this work very seriously and are fully committed to delivering safe and wholesome food to our customers.”

Koehler around the time he became sick with a salmonella infection.

Ken Koehler

An FSIS spokesperson highlighted two other changes “of note” to federal regulations around processing ground beef since the 2011 Hannaford outbreak. First, the FSIS expanded its testing for Shiga toxin–producing E. coli (STEC) to include more types of raw beef products. Second, a new sampling method is used to detect adulterants STEC and salmonella in domestic beef trimmings. These changes were implemented as of February 2023.

FSIS said it regularly tests raw beef products for salmonella and STEC. The number of samples it takes can vary based on the type of product manufactured and the quantity produced. The agency may conduct additional testing in response to past performance concerns. It also tests imported beef and ground beef sold in stores. You can find the results of these tests on the FSIS website.

Since the 2011 contamination of ground beef sold at Hannaford stores, there have been nine multistate outbreaks of foodborne illness linked to ground beef. The worst was in 2018, resulting in 403 cases and 117 hospitalizations.

Although there are performance standards for the presence of salmonella in other meat and poultry products, they aren’t strictly enforced because legal cases made it difficult to do so, said Barb Kowalcyk, an associate professor at George Washington University’s Department of Exercise and Nutrition Sciences. Kevin’s Law (or the Meat and Poultry Pathogen Reduction and Enforcement Act), named after Kowalcyk’s son who died of complications from an E. coli infection, attempted to address these inconsistencies, but it never passed. Salmonella causes illness in approximately 1.35 million people in the U.S. annually, according to the Centers for Disease Control and Prevention (CDC). This results in a cost to consumers of more than $4 billion, based on a 2020 estimate from the USDA using data from 2018.

Adults 65 and older, as well as people with weakened immune systems, are more susceptible to severe illness from foodborne infections, according to the CDC.​

Antibiotics and food safety

Even though the Food and Drug Administration (FDA) has regulations banning the use of antibiotics as feed supplements to promote faster growth in livestock and poultry, nearly two-thirds of antibiotics sold in the United States are still given to livestock, according to the Natural Resources Defense Council.

These practices, along with the overuse of antibiotics in conventional medicine, contribute to the spread of antibiotic-resistant pathogens, the CDC said. Like the strain of salmonella that infected Koehler, these pathogens complicate the treatment of common bacterial infections such as food poisoning.

“[Antibiotic] resistant infections can be difficult, and sometimes impossible, to treat,” according to a CDC information page. “In recent years, CDC has investigated many multistate outbreaks caused by antimicrobial-resistant bacteria. These outbreaks have been linked to contaminated food and contact with farm animals, pets and pet food.”

Life after salmonella

Koehler said it took about two months to fully recover, and he lives with esophagitis due to the severity of his vomiting.

“Now my stomach acids have come up and deteriorated the lining of my throat, which makes me more susceptible to throat cancer,” he said.

Koehler’s shopping and eating habits have changed. He no longer buys ground beef unless it’s from a local farm or high-end butcher shop that can tell him exactly where the meat comes from.

At the age of 65, Koehler is an advocate for food safety and works with the non-profit Stop Foodborne Illness. He also co-owns K’sone’s Thai Dining & Lounge in Nashua, New Hampshire, where he says the restaurant consistently receives top marks on food safety inspections.

“I’m the place where the health inspectors come to eat,” he said. “It’s all about creating a good environment to make sure that you have good food and happy people. This experience of mine enabled me to make sure to keep people safe.”