Nate Howard for The New York Times
Quality Pork Processors, right, adjacent to Hormel, left, employs 1,300 in Austin, Minn.
T.C. Worley for The New York Times
When some workers at the plant, which kills and butchers 19,000 hogs a day, developed neurological problems, health officials were called in.
And the disease that confronted doctors at the Austin Medical Center here last fall was strange indeed. Three patients had the same highly unusual set of symptoms: fatigue, pain, weakness, numbness and tingling in the legs and feet.
The patients had something else in common, too: all worked at Quality Pork Processors, a local meatpacking plant.
The disorder seemed to involve nerve damage, but doctors had no idea what was causing it.
At the plant, nurses in the medical department had also begun to notice the same ominous pattern. The three workers had complained to them of "heavy legs," and the nurses had urged them to see doctors. The nurses knew of a fourth case, too, and they feared that more workers would get sick, that a serious disease might be spreading through the plant.
"We put our heads together and said, ‘Something is out of sorts,’ " said Carole Bower, the department head.
Austin’s biggest employer is Hormel Foods, maker of Spam, bacon and other processed meats (Austin even has a Spam museum). Quality Pork Processors, which backs onto the Hormel property, kills and butchers 19,000 hogs a day and sends most of them to Hormel. The complex, emitting clouds of steam and a distinctive scent, is easy to find from just about anywhere in town.
Quality Pork is the second biggest employer, with 1,300 employees. Most work eight-hour shifts along a conveyor belt — a disassembly line, basically — carving up a specific part of each carcass. Pay for these line jobs starts at about $11 to $12 an hour. The work is grueling, but the plant is exceptionally clean and the benefits are good, said Richard Morgan, president of the union local. Many of the workers are Hispanic immigrants. Quality Pork’s owner does not allow reporters to enter the plant.
A man whom doctors call the "index case" — the first patient they knew about — got sick in December 2006 and was hospitalized at the Mayo Clinic for about two weeks. His job at Quality Pork was to extract the brains from swine heads.
"He was quite ill and severely affected neurologically, with significant weakness in his legs and loss of function in the lower part of his body," said Dr. Daniel H. Lachance, a neurologist at Mayo.
Tests showed that the man’s spinal cord was markedly inflamed. The cause seemed to be an autoimmune reaction: his immune system was mistakenly attacking his own nerves as if they were a foreign body or a germ. Doctors could not figure out why it had happened, but the standard treatment for inflammation — a steroid drug — seemed to help. (The patient was not available for interviews.)
Neurological illnesses sometimes defy understanding, Dr. Lachance said, and this seemed to be one of them. At the time, it did not occur to anyone that the problem might be related to the patient’s occupation.
By spring, he went back to his job. But within weeks, he became ill again. Once more, he recovered after a few months and returned to work — only to get sick all over again.
By then, November 2007, other cases had begun to turn up. Ultimately, there were 12 — 6 men and 6 women, ranging in age from 21 to 51. Doctors and the plant owner, realizing they had an outbreak on their hands, had already called in the Minnesota Department of Health, which, in turn, sought help from the federal Centers for Disease Control and Prevention.
Though the outbreak seemed small, the investigation took on urgency because the disease was serious, and health officials worried that it might indicate a new risk to other workers in meatpacking.
"It is important to characterize this because it appears to be a new syndrome, and we don’t truly know how many people may be affected throughout the U.S. or even the world," said Dr. Jennifer McQuiston, a veterinarian from the disease centers.
In early November, Dr. Aaron DeVries, a health department epidemiologist, visited the plant and combed through medical records. The disease bore no resemblance to mad cow disease or to trichinosis, the notorious parasite infection that comes from eating raw or undercooked pork. Nor did it spread person to person — the workers’ relatives were unaffected — or pose any threat to people who ate pork.
A survey of the workers confirmed what the plant’s nurses had suspected: those who got sick were employed at or near the "head table," where workers cut the meat off severed hog heads.
On Nov. 28, Dr. DeVries’s boss, Dr. Ruth Lynfield, the state epidemiologist, toured the plant. She and the owner, Kelly Wadding, paid special attention to the head table. Dr. Lynfield became transfixed by one procedure in particular, called "blowing brains."
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As each head reached the end of the table, a worker would insert a metal hose into the foramen magnum, the opening that the spinal cord passes through. High-pressure blasts of compressed air then turned the brain into a slurry that squirted out through the same hole in the skull, often spraying brain tissue around and splattering the hose operator in the process.
ILL Susan Kruse, 37, worked at Quality Pork for 15 years but for the past year has been too sick to work. "I had no strength to do anything I used to do," Ms. Kruse said. She had not known that her illness might be related to her job.
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Susan Kruse, a former employee, being treated at Austin Medical Center.
The brains were pooled, poured into 10-pound containers and shipped to be sold as food — mostly in China and Korea, where cooks stir-fry them, but also in some parts of the American South, where people like them scrambled up with eggs.
The person blowing brains was separated from the other workers by a plexiglass shield that had enough space under it to allow the heads to ride through on a conveyor belt. There was also enough space for brain tissue to splatter nearby employees.
