Editor’s note: This is the first of a two-part series. Part 2 of the series, will be published in the February issue of MEAT+POULTRY, focusing on the possible increase of more consumers eating undercooked hamburgers at home and what the beef industry can do to further warn consumers that eating undercooked ground beef can cause foodborne illness.

undercooked hamburger patty
States and localities have their own food safety regulations, but it is not law, and restaurants can still serve undercooked burgers to customers upon request.

Upon ordering the medium-rare hamburger at Bar 145?, a gastro pub in Kent, Ohio, the customer asked the waitress how the burger would appear inside.

“It will be pretty pink,” she described.

Then the customer asked the waitress what temperature the medium-rare burger would be cooked internally.

“I don’t know,” she said. “Let me check.”

The waitress summoned another employee of the restaurant for the answer and returned to inform the customer.

“145 degrees,” she said.

That’s 10 degrees below the minimum temperature that the US Food and Drug Administration’s (FDA) Food Code recommends licensed foodservice establishments to cook ground beef to kill foodborne pathogens, such as E. coli O157:H7. According to the Food Code, a burger cooked at 145 degrees Fahrenheit is undercooked.

The scene above occurred last month, but similar scenarios are playing out at foodservice outlets all over the US. Incidentally, in May 2014, the Bar 145? in Kent and another Bar 145? location in Toledo, Ohio, were implicated in an E. coli O157:H7 outbreak that sickened four people. Those illnesses were part of 12 total illnesses reported in the spring of 2014 in four states – all attributed to people who ate undercooked burgers made from contaminated ground beef tracked to Detroit-based Wolverine Packing Co. The US Dept. of Agriculture subsequently issued a recall of 1.8 million lbs. of ground beef produced by Wolverine.

But Bar 145?, which operates five locations in Ohio and one in Indiana, continues to sell undercooked hamburgers to patrons who request them. Bar 145? says on its website that the “145?” in its name implies “the temperature of a perfectly cooked, medium-rare burger.”

The FDA says the Food Code, which most state food regulatory agencies adopt, is a model document used by states and localities to establish their own food safety regulations. The FDA recommends that governments put regulations/ordinances into effect requiring that the critical limits established in the Food Code be met as a condition of an establishment’s permit to operate. But the Food Code is not law, and restaurants can still serve undercooked burgers to patrons who request them.

However, many in the food industry wonder why restaurants would risk serving undercooked hamburgers, especially considering the threat of an E. coli outbreak. E. coli, after all, has proven to be a deadly and dangerous pathogen.

“I’m a little astounded by this. It shocks me that consumers should have a choice [of how they want their hamburgers cooked],” says Dave Theno, CEO of Gray Dog Partners, a food safety consultancy firm based in Del Mar, Calif.

Theno, considered one of the top food safety consultants in the nation, is also the former senior vice president and chief food safety officer of Jack in the Box, where he was hired to rebuild the fast-food chain’s quality-assurance program following a 1993 E. coli O157:H7 outbreak from undercooked burgers that sickened hundreds of people and killed four children. Theno, who was dubbed as “the man who saved Jack in the Box” and who introduced the meat-processing industry to Hazard Analysis and Critical Control Point plans, believes restaurants are asking for trouble by serving rare and undercooked burgers.

“If in fact you are serving products like this, it’s really not a question of is [a foodborne illness outbreak] going to happen, it’s a question of when is it going to happen,” Theno says.

‘A growing threat’

E. coli pathogens
Ground beef is a significant source of E. coli outbreaks.

Last October, Worthy Burger, a restaurant in South Royalton, Vt., was implicated in an E. coli O157:H7 outbreak believed to be caused by undercooked burgers. The outbreak sickened at least six people.

Worthy Burger bills itself as a “craft beer and burger bar” and is part of a growing wave of single and small chain restaurants that are capitalizing on the current upscale burger craze. Many of the restaurants are operated by chefs and foodies who seemingly are not concerned about offering undercooked hamburgers. For instance, at B Spot, a chain of burger restaurants in Ohio, Michigan and Indianapolis operated by celebrity chef Michael Symon, customers can order a rare burger that the restaurant’s menu describes as “blood red” and “cold/cool in the center.”

But there may be an audience for “blood red” burgers as more Americans have an affinity for rare and undercooked ground beef than realized. Hannah Gould, Ph.D., an epidemiologist who previously worked in the Centers for Disease Control and Prevention’s Division of Foodborne, Waterborne and Environmental Diseases, says a 2007 study revealed that of the 75 percent of Americans who consumed ground beef patties inside and outside of the home, 18 percent of them reported consuming pink ground beef patties.

“I think it’s clear that many Americans do have a preference for rare ground beef,” Gould says.

Scott Hume, editor of the website BurgerBusiness (burgerbusiness.com), says he would not be surprised if more rare and undercooked hamburgers are being ordered by consumers at restaurants because of their demand for burgers made with more high-quality grinds of meat.

“If that [type of] meat isn’t a bit rare, you really can’t taste it and people want to taste the meat,” he adds.

Jamie Schweid, who with his father and brother owns and operates Carlstadt, NJ-based Schweid & Sons, a large ground beef processor that sells to thousands of restaurants and hundreds of supermarkets, says he has been eating medium-rare hamburgers his entire life and notes that they are popular in the Northeast. Schweid believes the best way to prepare a hamburger is medium-rare at 145° F. A well-done hamburger equals a dryer eating experience, he adds.

Burger patties cooking
The Food Code advises restaurants to cook beef patties to 155°F to kill pathogens.

“There is a demand for having the best flavor and the best quality that you can possibly eat,” Schweid says. “From a flavor and texture profile, medium-rare is the best way to serve it.”

Even Theno says there was a time when he once ate rare and undercooked hamburgers. “I liked them,” he admits. “But with what I know today, I don’t eat them anymore. I know what the consequences are. I know you can become infected with E. coli even if you are healthy.”

Roy Costa, a food consultant based in DeLand, Fla., says some consumers may be frustrated with the “not particularly tasty” hamburgers they are getting at quick-service restaurants, and are reacting by going to restaurants that serve what they deem are better-tasting rare burgers. Costa warns that this trend – and the hazard of foodborne illness it poses – is “a growing threat.”

“It’s introducing more risk into the food supply,” he adds.

Gould agrees. “We know there are certain kinds of bacteria like E. coli that are associated with eating undercooked ground beef,” she says. “I wouldn’t recommend it.”

With more burger bars and joints opening at a rapid pace – “New places open every week, if not every day,” Hume reports – food safety experts including Theno and Costa are getting increasingly concerned about the heightened chances for E. coli outbreaks to occur. Considering the strict protocols that major fast-food burger chains have implemented to cook burgers thoroughly, the chances of a sweeping outbreak the size of the Jack in Box outbreak 23 years ago is small but not impossible, Theno says. But he also stresses that even a small E. coli outbreak would be unacceptable.

Even if it’s a longshot that someone died from an E. coli infection after eating an undercooked hamburger, Theno believes it’s not a chance worth taking.

“Would you ever put your child on an airplane to go someplace if you thought there was a 1 percent chance that the plane would crash? I hope for most people the answer would be no,” Theno says.

False sense of security

meat thermometer
The beef industry’s success at keeping contaminated meat from commerce may give consumers and foodservice operators a false sense of security about the safety of undercooked ground beef.

Bill Marler, a foodborne illness lawyer whose Seattle-based firm represents individuals in claims against food companies whose products caused them foodborne illness, says his case load for E. coli claims have dropped dramatically since 2003.

“The beef industry has done a marvelous job of making the beef supply safer for people. That’s a great thing,” Marler adds.

But Marler believes the beef industry’s success in detecting E. coli and keeping adulterated product from reaching the end of the food chain has given restaurant operators and consumers a false sense of security, causing them to believe that consumption of rare and undercooked burgers is safe. While the industry has improved its food safety systems dramatically, E. coli is still a threat, Marler notes.

“I commend the beef industry for what it has done. But now the fact of its own success could turn around and bite it,” Marler contends.

Gould agrees the beef industry “has done a lot of really good things,” and that the rate of E. coli infections has decreased as a result.

“I don’t know that people would assume their beef is E. coli-free, but I don’t know that they would assume it’s not either,” she says.

There’s another reason that might make restaurants feel safe about serving undercooked ground beef to customers. They are required to list a “consumer advisory” on their menus to alert consumers that eating raw or undercooked meat, poultry, eggs or seafood may increase their risk for foodborne illness. Theno and Marler wonder if restaurant operators believe they are protected legally by listing the consumer advisory on menus if an E. coli outbreak happened and illnesses occurred.

“They [restaurants] probably believe that it’s a get-out-of-jail-free card,” Theno says. “But it’s not.”

“They are absolutely, unequivocally on the hook,” Marler adds.

Theno understands, to a point, why some restaurants don’t turn down consumer requests to be served undercooked hamburgers.

“It’s hard for restaurants to tell their patrons that they aren’t going to give them what they want,” Theno says. “Do I think there is anything smart about this? No. But I’m also fully aware of the fact that these restaurants could lose customers if they do that.”

Editors note: MEAT+POULTRY attempted to reach Jeremy Fitzgerald, founder of Bar 145?, and others from the business to ask them if they thought the chain would lose customers if it stopped serving medium-rare burgers cooked to 145? F, and if they are concerned about the dangers of serving undercooked hamburgers, especially after two of the chain’s restaurants were implicated in the 2014 E. coli outbreak. The company did not respond to requests for interviews.