QuoteHeadlines from recent years have made the combination of peanut butter and Salmonella a notorious duo, predominantly due to two massive outbreaks in the second half of the 2000s: Peter Pan peanut butter in 2006-07, and products made with Peanut Corporation of America peanut butter in 2008-09.

Together, the two outbreaks resulted in at least 1,139 confirmed cases of Salmonella infection. The CDC estimates that for every one laboratory-confirmed case of Salmonella another 29 cases go unreported, meaning the outbreaks potentially sickened tens of thousands of people.

At least 425 people in 44 states fell ill with strains of Salmonella Tennessee in 2006 and 2007 after eating Peter Pan and Great Value peanut butter manufactured by ConAgra in Georgia. Of those ill, 20 percent required hospitalization.

One of those people was Mora Lou Marshall, an 85-year-old cancer survivor and grandmother from Louisiana.  After her dentist recommended eating a spoonful of peanut butter every day for supplemental vitamins, Marshall continued to eat the Peter Pan brand throughout months of illness before health investigators finally traced the nationwide Salmonella outbreak back to that product.

Clifford Tousignant went through an all-too-similar experience two years later when he was hospitalized just after Christmas 2008 with what became diagnosed as a Salmonella infection. Tousignant, a sociable, 78-year-old Korean War veteran and three-time Purple Heart recipient from Minnesota, had recently moved into an assisted living facility where he was eating a peanut butter sandwich almost every day.

As it turned out, Tousignant was part of a Salmonella outbreak that eventually sickened at least 714 people across 46 states. Just after New Year's 2009, investigators finally began to connect the rampant outbreak to thousands of products all made with peanut butter manufactured by Peanut Corporation of America.

For Tousignant, however, the discovery did not come fast enough. Health complications from his infection led to his passing on January 12. The outbreak also contributed to the deaths of 8 other victims.

Life, mobility cut short



Mora Lou Marshall Salmonella Peanut Butter Outbreak Illness from Marlerclark on Vimeo.

Even at the age of 85, Mora Lou Marshall was still active. She cooked her own meals and enjoyed gardening. She had just moved in with her son David and his family in November 2006, but David really didn't see much sign of her slowing down.

"We thought since she was independent, then the best thing to do was to add on a mother-in-law suite to our home with a small bedroom, den and kitchen," he said after her death.  "I started sketching plans and even went down to the city permit office to see if there were zoning ordinances for this add-on. We considered buying her a small house so she could have her own place and a yard to work in."

But just months after moving in with her family, Mora Lou's life changed forever.

In the week between Christmas 2006 and New Year's 2007, Mora Lou fell badly ill with nausea, vomiting and diarrhea. Her illness progressed through January 2, when David and his wife Terri decided to call her an ambulance.

Now hospitalized, the one thing Mora Lou made sure to eat every day was the Peter Pan peanut butter. Neither her family nor any medical personnel had any idea she was continuing to eat the food that was making her sick in the first place. They didn't even know she had a Salmonella infection.

Growing so physically weak that she could hardly transition from her bed to a wheelchair, Mora Lou was placed under strict quarantine in a long-term care facility. It wasn't until January 30 that she was transferred to a nursing home.

Still unaware that her food was the source of Mora Lou's illness, David and Terri brought her the Peter Pan peanut butter she had grown accustomed to eating by the spoonful. On February 16, nursing staff discovered her slumped in a chair and unresponsive. She was rushed back to the hospital.

Days later, Mora Lou was still on a feeding tube when the Marshall family first heard of the Peter Pan peanut butter recall. They checked her jars of peanut butter and discovered that the product codes matched those affected by the recall.

Not until February 23 did laboratory tests confirm Mora Lou's infection with Salmonella Tennessee, the strain at the center of the Peter Pan outbreak.

Back in long-term care and finally rid of her peanut butter, Mora Lou's weakness and severe malnutrition proved too much of a challenge for doctors and nursing staff to reverse. She now also suffered from dementia, depression, and a host of other ailments.

Mora Lou lived out the remainder of her life under nursing home care. She never regained the mobility and independence she still enjoyed right up until her infection.

A veteran debilitated



PCA Peanut Butter Salmonella Outbreak Victim: Cliff Tousignant from Marlerclark on Vimeo.

Clifford Tousignant moved into his new room at the Good Samaritan Woodland Skilled Nursing Facility in Brainerd, Minnesota, in November 2008 at the age of 78.

The place was a good fit: Cliff was in good spirits and would often be found chatting with his fellow residents and appreciated the attentive care he received there. He was also a fan of the food, and almost every day took to eating a sandwich made with King Nut peanut butter.

Much like Mora Lou two years earlier, Cliff began to fell ill with frequent diarrhea during the week between Christmas 2008 and New Year's 2009. Staff took a stool sample, but Cliff's symptoms only worsened as the days went on, and so the home's attending doctor ordered him to be transferred to the hospital on December 30. His short-term memory seemed to be deteriorating.

The next day, his culture test came back positive for Salmonella infection and he was prescribed a new antibiotic to treat it. At the same time, however, the constant need for cleanings and tests wore down Cliff, a gentle man still accustomed to a certain level of independence.

He was experiencing intense aching over his body as he grew weaker by the day. By January 3 he could not leave bed without assistance. During one of countless times a nurse had to wake him, Cliff finally had an angry outburst.

With little more to do, the hospital discharged Cliff back to his nursing home. The return to familiar settings was a relief, but Cliff's condition failed to improve over the next week.

On January 11, Cliff's son Marshall stopped in to check on his dad as he regularly did. Cliff seemed lethargic and agitated, and then went unresponsive.

An ambulance returned him to the hospital, where he experienced bloody diarrhea and more vomiting throughout the night. A blood sample came back positive for Salmonella, meaning the bacteria had made it from his gastrointestinal tract into his blood stream.

Cliff passed away the next morning, January 12, 2009, two years short of a goal to outlive his father. He left behind six children, 15 grandchildren and 14 great-grandchildren.

Tragedy leads to activism

Following her Salmonella infection, Mora Lou Marshall became essentially bedridden from early January 2007 until her death in the spring of 2011.

In April 2007, Mora Lou's daughter-in-law Terri went to Washington D.C. to testify before the U.S House Committee on Energy and Commerce Subcommittee on Oversight and Investigations about Mora Lou's illness and its life-changing impact on her family.

"It seems Mora Lou has literally lost her life without physically dying," Terri told members of Congress.

"She cannot walk, get out of bed, use the bathroom, shower, read the newspaper, or talk on the telephone," she went on. "All aspects of her former life are gone."

Lou Tousignant, another of Cliff's sons, testified before that same House committee two years later on behalf of his family. The committee was investigating evidence that executives at PCA, namely President and CEO Stewart Parnell, had ordered the shipment of peanut products they knew to be contaminated with Salmonella.

"My father was a good man," Lou told committee members. "He fought for his country. He died because he ate peanut butter."

In January 2011, President Obama signed a law passed by Congress known as the Food Safety Modernization Act, inspired in part by the outbreaks that impacted the Marshalls and the Tousignants. Once fully enacted, the law will grant the U.S. Food and Drug Administration new authority to help prevent or combat foodborne illness outbreaks.

Late last month–on November 27, 2012–the FDA used one of its new powers for the first time to suspend the registration of Sunland Inc., the peanut butter manufacturer tied to this autumn's Salmonella peanut butter outbreak. Until the company proves it can make peanut products without risk of contamination, it will not be allowed to sell those products anywhere in the U.S.

Now four years after the PCA outbreak, the statute of limitations is nearing for filing criminal negligence charges against Stewart Parnell and PCA. The U.S. Department of Justice recently subpoenaed at least one former PCA employee for questioning on potential criminal activity, and agents have spoken with family members of some who died in the outbreak.

Officially, however, the DOJ has declined to comment on any possible criminal investigation. Clifford Tousignant's son Marshall has told reporters he would have rather seen Parnell go to jail than have the family receive any money in the class action lawsuit against PCA, now a defunct company.

Both the Marshall and Tousignant families became clients of food safety law firm Marler Clark following the peanut butter outbreaks and received settlements from the manufacturers. Marler Clark underwrites Food Safety News.

Lou Tousignant told Food Safety News in an interview earlier this year that he prefers to honor his father's life instead of dwelling on how he died. He sees a lot of his father's characteristics in his son, he said.

"With that said," he added, "if there were criminal charges filed, I'd be one of the happiest guys alive."

QuoteSpicy Asian Chili Vinaigrette (made with roasted peanuts)

Water, Brown Sugar, Corn Syrup, Rice Vinegar, Peanut Butter (ground roasted peanuts),Chili Garlic Sauce (salted chili pepper [chili peppers, salt], garlic, sugar, rice vinegar, water, modified corn starch, acetic acid), Miso (water, organic soybeans, rice, salt, koji starter [aspergillus oryzae]), Lime Juice (water, lime juice concentrate, lime oil), Cilantro, Soy Sauce (water, soybeans, salt, alcohol), Soybean Oil, Ginger, Sea Salt, Xanthan Gum, Spice, Garlic (dehydrated), Mustard Seed, Extra Virgin Olive Oil, Red Pepper (dehydrated), Oleoresin Rosemary, Yeast Extract. CONTAINS: PEANUTS, SOY.