Fresh from celebrating her roommate's birthday at a cozy Baltimore restaurant, the 20-year-old Loyola College student retired contentedly for the night. The piquant flavor of Caesar salad lingered as a pleasant memory. She drifted into sleep.
With a start, she awoke a few hours later with knife-like stomach pains. Then came a cascading series of symptoms: intense vomiting, diarrhea, muscle pains, and alternating fevers and chills that left her too weak to climb stairs without help.
After three days of escalating misery, she checked into the hospital, where doctors found her blood pressure dangerously low and her kidneys verging on failure. They kept her for one week before she was well enough to go home.
The diagnosis: salmonella poisoning.
The source: raw eggs used in the salad dressing.
"I didn't even know that Caesar salad was made with a raw egg," said the woman, who asked not to be identified. "I thought I was orderingthe safest thing."
Three years after state health authorities sounded their first warnings about raw eggs, the practice of using the ingredient in Caesar salads, nogs, cake icings and countless other dishes remains commonplace in restaurant, hotel and household kitchens. Sometimes, it occurs with wrenching results. In mid-October, the Loyola College student was one of at least 20 customers and employees diagnosed with salmonella poisoning after eating Caesar salad at Louie's Book Store Cafe on North Charles Street.
But the problem at Louie's was far from unusual. Since 1988, raweggs caused 17 outbreaks of salmonella -- and 463 illnesses that were traced to those outbreaks, according to state health department records. Forty-seven of the people were admitted to hospitals.
And raw eggs aren't the only culprit: Although the vast majority of eggs are not infected with salmonella, health experts agree that any eggs carrying the microorganism must be cooked until they are firm to be considered safe. People eating their eggs sunny-side up or lightly poached run the same risk as those indulging in Caesar salads made the traditional way.
Poorly cooked poultry and stuffings are other sources of salmonella, but the U.S. Department of Agriculture traces three-quarters of all food-associated outbreaks to the raw egg.
Although the state health department issued a public statement in 1988 advising restaurants and consumers to avoid raw eggs, Maryland has no regulations forbidding the practice in retail establishments. A health department official said yesterday that the agency may propose regulations clamping down on the practice.
Meanwhile, the owner of Louie's said he hadn't heard anything about the danger until two weeks before Halloween this year.
That's when some of his cooks, waiters and kitchen help -- and then some customers -- suddenly got sick. Reports of salmonella poisoning started flooding the state and city health departments, sparking an investigation into the source.
When investigators interviewed the victims, the pieces started falling into place: All of the victims had eaten at Louie's; all had eaten Caesar salad.
"Epidemiologists are never 100 percent certain" about the source," said Dr. John Lewis, chief of preventive medicine at the Baltimore Department of Health. "But the Caesar salad stood out so strongly. There just weren't any other possibilities."
Jimmy Rouse, who owns Louie's, said two shipments of eggs from the same distributor contained contaminated eggs. "We know our shipper, and they've traced it to a farm," he said. "From what I heard yesterday, the farmer destroyed the chickens before [health inspectors] got there."
An official with the U.S. Department of Agriculture said owners of contaminated flocks must destroy their birds or divert all their eggs for pasteurization, a process in which eggs are heated and cooled to destroy bacteria. He would not comment on this case.
Louie's, in the meantime, took precautions to protect future customers: "Immediately upon finding out that eggs were making customers sick, we eliminated the use of raw eggs," Mr. Rouse said. Emphatically, he added: "We will never use raw eggs."
Now, chefs at Louie's make their hollandaise sauce with pasteurized eggs, and are searching for a safe recipe for other dishes such as the Caesar salad. For the time being, the salad is unavailable at Louie's.
Mr. Rouse said 16 employees tested positive for salmonella. Twelve of them had symptoms, ranging from mild queasiness to the wretched intestinal symptoms that are hallmarks of severe poisoning. In addition, he said six customers called in to say they had gotten sick, too.
RF Sick or not, all of the infected employees were taken off the job.
Here is a list of foods containing eggs that were implicated in salmonella outbreaks in 1990 and 1991:
Egg fu yung
Homemade ice cream
Coconut cream pie
Macaroni & cheese casserole