Forensic Files - Season 1, Episode 11 - Outbreak - Full Episode | Forensic Files

[BAND MUSIC PLAYING] NARRATOR: In 1985, 121 people in South Dakota and Minnesota
were struck with a mysterious illness. There had been only one outbreak like it.
And the last time it happened, medical detectives couldn't figure out the cause.
[THEME MUSIC PLAYING] Valley Spring, South Dakota-- a tiny farming community of about 800 people, not far from the Minnesota border.
It's a community of farms and suburban professionals, many of whom work in the nearby city of Sioux Falls.
People here are accustomed to hard work and the hard weather and aren't the type to complain.
So when some residents began suffering from irregular heart rhythms, fevers, weight loss, diarrhea, edginess,
and mysterious aches and pains, they wondered if it was more than a coincidence.
RICHARD: I was just fidgety and nervous. And uh-- not all the time. I guess that's what threw you off.
If it'd been a steady you, you couldn't have put up with it. DANIEL: Heart was beating. You know?
You'd feel your pulse. And it was just pounding. You could feel your heart pounding.
And you hate-- your legs and arms hurt real bad. JANE: I started getting chills.
Then I'd get hot flashes. Then I couldn't eat. And I'd be nauseated. Everything was just happening really, really fast.
NARRATOR: At first, doctors were confused about the symptoms. Jane Nettestad's doctor thought she was having
a nervous breakdown and put her in the hospital. JANE: I'd never, you know, had any of this problem
before with the mental problems. So he put me on a mood elevator. And about eight hours later, my heart was 160 beats per minute.
And I just knew I was going to have a heart attack. It felt like it was just flying out of my chest.
NARRATOR: 10 miles down the road, in Luverne, Minnesota, the stories were the same.
Tony Dispanet suffered heart symptoms, too, and immediately went to the emergency room
certain he was having a heart attack. NARRATOR: Well, about 3 o'clock in the morning,
uh, approximately 3:00, I woke up with a, a tightness in my chest. Like some-- it did.
It felt like somebody was sitting on me. NARRATOR: Tests revealed it wasn't a heart attack.
But he spent three days in the hospital as doctors tried to find out the cause. Some of the local physicians thought
it was the flu or a virus. But after weeks of suffering, the residents started to compare notes.
RHONDA: There were folks that were sick and had been sick for a long time. And a couple were-- had gone close to death.
And they couldn't figure out what was wrong with them. And they didn't know if it was contagious,
if it was something in the water. -And they were all feeling these same symptoms.
And then they were hearing of other people that were feeling these same symptoms.
NARRATOR: When Richard Jacobson went to his doctor, he was told that his thyroid was malfunctioning
and was sent to the area's leading thyroid specialist. When Jacobson called the specialist,
he had just one question. -Doc, can you tell me why there's five people in my small town with the same condition?
NARRATOR: Doctor Michael McMillin has been a thyroid specialist in South Dakota for the past 30 years.
At first, he thought Jacobson was exaggerating. But just to make sure, he decided
to do a little of his own investigating. He went to the local hospital and looked through the x-rays
and medical records of some recent patients. He discovered something alarming. There had been an increase in the number of patients
with thyroid type complaints. But there was a problem. Because in every x-ray, the thyroids
we're perfectly normal. The thyroid is a small butterfly-shaped gland at the base of the neck, which produces hormones that
control both metabolism and growth. An overactive thyroid floods the body with hormones,
disrupting the entire nervous system, causing symptoms such as heart fluctuations, weight loss,
diarrhea, nervousness, muscle aches and pains. Doctor McMillin searched the medical journal for clues,
trying to find out what could be causing an outbreak of thyroid problems in the area.
DR. MCMILLIN: And I came across a title that said, first ever epidemic of silent thyroiditis, York, Nebraska.
Well, York, Nebraska is about 120 miles south of here. NARRATOR: The outbreak in York, Nebraska
happened just one year earlier. Residents complained of the same symptoms-- heart problems, fevers, fatigue, loss of appetite,
and weight loss. So many people were ill, it threatened the economy of the small farming community.
Doctors from the Centers for Disease Control in Atlanta were called in to investigate.
But just as they arrived, the outbreak of silent thyroiditis ended as mysteriously as it had begun.
The residents recovered. And the cause of the York outbreak was never discovered.
Doctor McMillin immediately called the CDC to let them know it was happening again.
-This is Dr. Michael McMillin I'm trying to get a hold of Dr. Dan Fishbein -I was-- knew that it was going to happen again because I knew.
The one thing we all admitted is-- even the people who thought it was a virus-- we didn't know what virus.
We didn't know what it was caused by. So I knew that was going to happen again. And so I was not quite expecting but certainly was not
surprised. NARRATOR: As the CDC prepared to investigate this outbreak, the number of cases was rising.
-Even if it just spread to Sioux Falls with all the people here, let alone Minneapolis or Detroit or something,
we would have a major medical catastrophe on our hands. [CHEERING] NARRATOR: Investigators needed to find
the cause of the outbreak before thousands were affected. In June of 1985, there were 50 cases of the mysterious thyroid
outbreak concentrated in two nearby towns, Luverne, Minnesota and Valley Springs, South Dakota.
The Centers for Disease Control in Atlanta was called in to investigate. DR. FISHBEIN: Certainly on of the most puzzling things
about the outbreak is we didn't know what it was due to. And this made it incredibly difficult.
Was it in the air? Was in the water? Was in the food? There, there was just no way to know.
NARRATOR: Investigators needed to know as much about the outbreak as possible. It was striking both men and women equally.
All age groups were affected. There appeared to be no occupation association and no worksite or school clusters.
Entire families were affected. Was it possible that the outbreak was being spread person to person?
Everyone suspected of having the disease was given a blood test and interviewed about where or how
they might have contracted it. DR. MCMILLIN: You talk to the patients. And you hope that by doing unstructured interviews,
you'll get some ideas. One of the questions that I thought was kind of cute that the epidemiologist asked everybody
was, what do you think causes this? And the most frequent response-- there had been a lot of tornadoes in this area the year before.
The most frequent response was, I guess those tornadoes stirred up some chemicals and that got, that into our water supply.
NARRATOR: But in order to determine what was causing the outbreak, investigators first
had to figure out what the problem was. Blood tests revealed that all of the victims
had an excess of thyroid hormone in their system. In some cases, the levels were 8 and 10 times above normal.
Tests of the drinking water did not reveal anything which could have caused the outbreak.
Dr. Lewis Braverman is the country's leading expert in thyroid diseases. He was asked to examine some of the sick patients
in South Dakota. DR. BRAVERMAN: We then went out to a small community called Beaver Creek if I recall.
And went into one household where there were four generations in the house who had all of the signs
and symptoms of thyrotoxicosis And none of them, from a four-year-old child to an 85
or 90-year-old great-grandfather had an enlarged thyroid. NARRATOR: Since the thyroid glands of these victims
weren't enlarged, they had no idea what was causing these symptoms. In the past, enlarged thyroid glands
were so common in this part of the country it was known as "the goiter belt." A goiter is the term for an enlarged thyroid.
-This part of the country's called "the goiter belt" because there was iodine deficiency here.
There's no iodine in the soil. There's nobody eating seafood. And so people used to get large, iodine-deficient goiters.
NARRATOR: The condition was so common, that in 1922, the Mayo brothers opened the Mayo Clinic in nearby Rochester,
Minnesota offering safe, affordable surgery to alleviate the huge number of thyroid problems in the region.
Over the years, as diets improved, the thyroid problems went away. But this outbreak was different.
All of the patients had normal thyroids. And for some patients, the condition was serious.
DR. MCMILLIN: One the cases was a patient I had seen in the intensive care unit here in the hospital.
And it was an older lady who, whose heart had suddenly started beating irregularly.
And she'd gone into heart failure. NARRATOR: To find out if this was indeed a virus,
health officials decided to take throat and fecal specimens for analysis. But all of the tests were negative.
Then Dr. McMillin noticed something interesting-- the geographic location of many of the victims.
DR. MCMILLIN: Here was a community of Valley Springs. And then three miles across the highway,
was the community of Garretson, which is almost the same size. There were nine people in Valley Springs with the disease.
Nobody in Garretson with the disease. How could those two communities-- what, what was,
what was the difference? NARRATOR: In fact, the epicenter of the outbreak was Luverne, Minnesota.
And there were no cases west of Valley Springs. But that changed. When a resident of Sioux Falls call Doctor McMillin to say
that she was suffering from the thyroid disease. Her name, Rhonda Peskey. Her parents owned a grocery store in Valley Springs
where she occasionally purchased her groceries. Dr. McMillin drove out to visit her parents, Larry and Margaret
Long, and to take a look around their store. The Longs did not have thyrotoxicosis,
but their daughter did. Dr. McMillin wanted to know why. When Dr. McMillin learned that the daughter of a grocery store
owner developed thyrotoxicosis, yet her parents did not, he decided to investigate.
The grocery store owned by Larry and Margaret Long had a specialty item, extra lean ground beef.
Dr. McMillin asked the Longs how often they ate the ground beef themselves. They laughed and said, never.
It was such a popular item, they were always sold out. -It was a great meat. It was, it was running about 90% lean.
NARRATOR: But the Longs said their daughter might have taken some with her on her last visit.
On a hunch, McMillin took a sample for analysis. By now, there were more than 100 cases
of the mysterious thyroid outbreak. And for some, the symptoms were troubling. -When I had that thyroid scan, a couple
gals that work in the hospital, they thought I had cancer is what they told me. They told me this personally that we thought you were dying
of cancer because I'd looked so bad when I went in for this thyroid scan. -Then of course the world's greatest
endocrinologist were called in. And, and we had-- I remember the meeting with them.
And we'd laid out all the data, told everything, and they sat there and shrugged their shoulders and said,
we don't know what this is. NARRATOR: The only thing they knew was that patients had 8 or 10 times the normal amount
of thyroid hormone in their bloodstream causing heart problems, fatigue, muscle aches and pain.
Investigators finally got a break when they heard of an entire family with thyrotoxicosis.
It was a large extended family, all of whom had confirmed cases of the thyroid condition, all except one.
DR. FISHBEIN: It must have been 8 or 10 people. We bled everybody in the family.
Did their blood test. And everybody had elevated thyroid function tests except one person.
And that was a teenager. NARRATOR: But how was the teenager different from the other family members who got sick?
The father told investigators he worked at the local meat packing plant and regularly brought
ground beef home for his family. It was the same plant which supplied the Long's grocery
store with their specialty hamburger, the extra lean ground beef. Samples of the hamburger were collected for analysis
and taken to a local pathologist. Using a cryostat, a portion of the hamburger was frozen in a matter of seconds.
DR. FISHBEIN: We convert the tissue, really, into a block of ice. It makes the tissue firm enough that we can cut thin sections,
stain them, look at them under the microscope, and make a diagnosis. NARRATOR: Under a microscope, the pathologist
noticed something unusual, something not normally seen in ground beef-- bits of animal thyroid
mixed into the ground meat. Animal thyroid contains extremely high levels of thyroid hormones.
Was it possible that this was causing the outbreak of thyrotoxicosis in the two small communities?
To find out, doctors conducted an experiment. DR. BRAVERMAN: One can say, well, just because you find it
in the hamburger, how do you know that when the people eat the hamburger that they're really
absorbing the thyroid hormones? So our next step was to feed the ground beef from Minnesota to rats.
NARRATOR: One group of rats were fed the raw hamburger collected in Minnesota. And for comparison, another group
was fed raw burger purchased near the laboratory in Worcester, Massachusetts. The rats which ate the Minnesota burger
exhibited all the signs of thyroid problems. DR. BRAVERMAN: These rats were wild rats.
I mean, they were very jittery, nervous. And this is compared to the rather tranquil,
normal behavior of the rats fed the Worcester hamburger. So that there's no question that these rats were-- one
could use the expression clinically thyrotoxic. NARRATOR: But residents of Valley Springs and Luverne
weren't eating raw hamburger. And cooking the meat usually kills all bacteria and microorganisms.
DR. BRAVERMAN: Most of us eat cooked hamburger. And as a matter of fact, people in the Midwest
tend to cook their hamburgers much more so than we do in the Northeast. NARRATOR: Investigators' next step,
to do some tests on humans. They also wanted to know how an entire family developed
thyrotoxicosis while their young son did not. When investigators from the CDC found a large extended family
who all suffered from thyroid problems, except their young son, they wanted to know why.
Interviews with the family revealed that the boy didn't eat meat except for an occasional pepperoni pizza.
-I hate meat. I like this. -Oh. And he's my son. NARRATOR: This was an important discovery.
The next step, to confirm that the tainted hamburger create elevated thyroid hormone levels in humans
as it did with the rats even after it was cooked. DR. BRAVERMAN: So that we did obtain for young physicians
to participate in the study. And what we did was essentially bring them in the morning,
fasting, drew their blood, and fed them an extremely well cooked half pound hamburger, which they enjoyed immensely
since the-- it was smothered in onions and on toast. So it was a very tasty breakfast.
NARRATOR: The meat used in the experiment was the same that was sold in the local stores.
It came from this local slaughtering house in Luverne, Minnesota. But how was the local meat being contaminated?
Public health officials inspected the local meatpacking plant and learned something interesting.
The plant had been a kosher killing plant up until a few years earlier. -When animals are killed kosher, they're actually bled to death.
And the thyroid gland, it has a real intense blood supply. And it's really red. Except that if you bled the animal death,
then it would look white. And it would look completely different. NARRATOR: And when the thyroid gland changed color,
it was easier for the butcher to see and remove. The animal thyroid was then sold to drug companies.
-All the meat packing companies would carefully dissect the thyroids out and sell them to the drug
companies, so they could make thyroid extract to treat other people. NARRATOR: But two things happened.
First this meat plant discontinued its kosher killing production. And with the development of synthetic hormones,
drug companies no longer purchased the animal thyroids from slaughter houses. The result-- since the animal thyroid
wasn't sold to the drug companies, it was included along with the rest of the neck
trim from the animals' gullet and inadvertently passed along for human consumption.
-The gullet basically is this part of the cow's neck. And the muscles that are trim, that are low fat,
are these muscles here. They're the sternocleidomastoid muscles in humans. The thyroid gland sits right under those muscles.
And if someone is not paying attention as they're trimming, it's very easy to clip off a bit of thyroid gland
as they take off the muscle. NARRATOR: When the animal's thyroid gland was a mixed in with others ground meat for hamburger,
it caused the highly elevated levels of thyroid hormones in those who ate it. The meat plant was producing the equivalent
of 3,600 hamburger patties each day. But as soon as the problem was discovered, they immediately recalled the beef
and instituted safeguards to prevent the problem from recurring. -Well, it was almost like the eureka type thing.
We were-- we were really quite thrilled. We thought that we had, at that point in time,
discovered the cause of this epidemic. And it was something relatively simple. NARRATOR: A simple solution to a complicated problem.
After seven months of investigation, the cause of the outbreak was finally discovered.
And investigators believe that the tainted meat also was the cause of the outbreak in York, Nebraska the year before.
Shortly after this outbreak, the US Department of Agriculture instituted strict guidelines for the trimming of meat
from neck muscles and declared the thyroid gland was to be considered unfit for human consumption.
But the residents of Valley Springs and Luverne don't care much about their place in medical history.
And they aren't the type to hold a grudge. 121 residents developed thyrotoxicosis.
And all recovered. Fortunately, there were no fatalities. -It's become one CDC's major teaching cases because it
illustrates all sorts of things that are really not usually encountered but are very important
lessons for young epidemiologists. NARRATOR: The outbreak was halted promptly thanks
to skill, intuition, a little bit of luck. All are important ingredients in a successful medical investigation.
[THEME MUSIC PLAYING]

In 1985, 121 people in South Dakota and Minnesota were struck by a mysterious illness. There had been only one outbreak like it, and when it happened again no one could figure out why.

Forensic Files is the longest-running true crime series in television history. Evidence and interviews with experts help solve real crimes, disease outbreaks and accidents around the world.

Brief Summary

In 1985, a mysterious outbreak of thyrotoxicosis in South Dakota and Minnesota was traced to contaminated ground beef.

Key points

Mysterious Illness Strikes. In 1985, 121 people in South Dakota and Minnesota fell ill with unexplained symptoms.
The Search for Answers. Doctors struggled to identify the cause of the outbreak, leading to widespread confusion.
The Tainted Meat Discovery. Investigators found animal thyroid mixed in ground beef, causing the outbreak.

Episode highlights

Episode quotes

I just knew I was going to have a heart attack.

Jane describing her panic during symptoms.

2:25WatchMay 20, 2021

Tension

75/ 100High tension

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