Crab meat, rice and chili. It's hard to think of them as suspects in a whodunit.
But they were in Anne Arundel County this year. Three outbreaks of restaurant food poisoning sickened 54 people, and detective work by health inspectors implicated the crab meat, rice and chili.
They all had human accomplices who were the real culprits. In each outbreak, careless mistakes by food handlers allowed bacteria to contaminate the food, inspectors believe.
Similar violations of basic sanitation triggered most of the 49 reported outbreaks of illness at Baltimore-area food establishments during the past three years.
A total of 568 people got sick, 30 needed hospital treatment, and salmonella was the main agent of illness.
Those still are small numbers in a metropolitan area where about 4,000 sit-down restaurants and carryouts, plus scores of convenience stores, serve millions of meals annually.
"Dining out is safe, because it's in [the industry's] best interest to make it safe," says Marcia Harris, executive vice president of the Restaurant Association of Maryland.
"Restaurants don't want folks to go home and spend the night in the bathroom, because they won't be coming back."
Ms. Harris says the relatively low number of outbreaks shows that most restaurant managers are capable. But she agrees that employee training deserves top priority, because many workers have no job experience or understanding of how bacteria can spread.
"If management sends the message that sanitation isn't valued, then it won't be," Ms. Harris says.
The first of the cases of food-borne illness in Anne Arundel County occurred in January.
A meal of crab meat made six people sick, and the restaurant where they dined was closed later by the health department.
In March, at another restaurant, rice served at a retirement luncheon caused 44 people to become ill.
That same month, four people got sick from chili sold at a convenience store. Three of the victims needed hospital treatment.
Three outbreaks. A total of 54 victims.
They all recovered, but complaints from some of them brought the county health department into action.
Inspectors, playing detective, examined food-handling procedures in each establishment for clues about bacterial contamination.
The retirement-luncheon outbreak probably was caused by a cook who placed his bare hand in a container of rice. Also, the rice was prepared the day before the luncheon and cooled improperly overnight, compounding the bacterial problem.
In the convenience-store outbreak, an inspector found that the chili was prepared by staff lacking basic knowledge of food handling. The chili had been kept warm overnight, but the temperature never was monitored.
As for the restaurant that served the crab meat, the health department found so many sanitation errors that inspectors could take their pick as to what had caused the bacterial contamination.
For example, the restaurant was infested with mice, the cook had been sick, and the staff had tracked sewage from a clogged drain into a walk-in refrigerator, where the crab meat was stored.
Anne Arundel's chief food inspector, Larry Luck, is not surprised by where the finger points in such outbreaks -- human error.
"Seventy-five percent [of restaurants] try to meet regulations, 20 percent lack understanding of regulations, and 5 percent don't want to do the regulations. They want to do things their way," he says.
Hundreds of examples of poor sanitation showed up in a Sun review of restaurant-inspection records in the city and metropolitan counties: Anne Arundel, Baltimore, Carroll, Harford and Howard.
The newspaper also obtained summary reports on many of the 49 restaurant outbreaks of food poisoning. The state health department defines an outbreak as two or more reported cases of illness from the same food.
Sixteen of the 49 were in the city, 15 in Anne Arundel County, eight in Baltimore County, five in Howard, three in Carroll and two in Harford.
The number of reported outbreaks has risen this year: Seven occurred in the metropolitan area during the first three months of 1993, compared to nine for all of 1992.
The largest single outbreak during the past three years came in 1991, when 158 people became ill from food served at a restaurant in the city.
State law prohibits health officials from releasing the names of restaurants where outbreaks of food-borne illness occur.
Reported cases of food poisoning could be the tip of an iceberg many times larger, says Dr. Patrick Murphy, chief of infectious diseases for Francis Scott Key Medical Center in East Baltimore and a professor at the Johns Hopkins School of Medicine.
He estimates that only one in 20 cases are reported, because most victims believe they have stomach flu or some other gastrointestinal ailment and don't require medical treatment.
"A tremendous amount of this never comes to light," Dr. Murphy says.
Salmonella is by far the leading cause of food poisoning, he says.