A plate of raw oysters cost Jose Luis Ruiz his leg, his livelihood and his house.
The night he ate them, the 51-year-old awoke with an upset stomach and pain in his calf. Within two days, he could barely walk.
Doctors told his wife: “If he keeps his leg, he’ll die. If we cut it off, he might live.”
Ruiz is among more than 700 people in the United States since 1989 to become seriously ill from deadly bacteria found in raw oysters from the Gulf of Mexico. Nearly half died.
Other foodborne illnesses sicken far more people, but none is as lethal. Vibrio vulnificus causes excruciating pain as the infection eats through skin and muscle, often leading to amputations and death within days.
Food safety authorities know how to prevent this. California in 2003 prohibited the sale of raw Gulf oysters in the warm, high-risk months of April through October unless they’ve been treated to kill the bacteria. Since then, just one death has been linked to raw oysters in that state.
But when food regulators tried to require treatment of Gulf oysters nationwide, the industry and its allies in Congress quickly defeated the effort. They said the expense would devastate the oyster business. Those who become seriously ill or die, they said, are chronically ill people who should know better than to eat raw oysters.
The industry agreed to practices that have reduced serious illnesses, but it continues to reject the only strategy that has been proven to prevent deaths caused by raw oysters.
Instead, policymakers created regulations that have been difficult to enforce and still leave consumers vulnerable, the Sun Sentinel found. In Florida, oyster harvesters and dealers who violate those rules face minor penalties, if any, even when someone dies.
Seldom is the evidence on a food safety problem and solution so unambiguous.
Michael Taylor, senior adviser to the FDA commissioner
Vibrio vulnificus can cause mild symptoms in healthy people but quickly becomes life-threatening in some with underlying conditions such as liver disease, diabetes, cancer or AIDS. Millions of Americans have conditions that put them at risk, and many may not even know it.
Consuming two to three drinks a day can cause liver damage years before symptoms develop. And many Americans, especially those who are overweight, may have undiagnosed diabetes.
Ruiz, of Chattanooga, Tenn., said he didn’t know he was vulnerable. Doctors discovered he had hepatitis when they amputated his leg.
“There are ways to prevent this, but they’re not doing it,” Ruiz said.
The European Union won’t accept Gulf oyster imports. In the U.S., they account for about half of all oysters sold. Order a dozen in your local seafood restaurant, and there’s a good chance they’re from the Gulf.
Serious infection is rare, even among susceptible people. Still, an average of one person a month has died after eating oysters in the U.S. since 1999, according to government data. More than one-quarter got sick in Florida, where dining out on seafood is part of the fabric of coastal communities.
Researchers have identified raw oysters from the Gulf as the culprit in the vast majority of Vibrio vulnificus food illnesses; the rest came from other shellfish such as raw clams. Cooking kills the bacteria, but some illnesses have been reported in undercooked oysters.
Warnings on restaurant menus are the main line of defense, but time and again they’ve proven ineffective. The required wording varies by state and often appears in small print at the bottom of menus with language as generic as consuming raw shellfish “may increase your risk of foodborne illness.” Florida doesn’t require warnings to be on menus, as long as restaurants post them somewhere visible.
Lenny Buck had seen the warnings but figured at worst he’d get a stomach ache. Though he was diabetic and had undergone cancer treatment, he said he didn’t know that compromised his immune system and put him at greater risk.
“You would think his doctors would tell him, ‘Don’t eat raw seafood,’ but they don’t,” said his wife, JoAnn. “There’s a big gap there in what people need to know.”
Buck ate oysters on the half shell while celebrating his 25th wedding anniversary in July 2014.
What followed were weeks of pain and horror. The infection spread into his bloodstream, creating enormous blisters on his legs and endangering his organs. He underwent seven surgeries on his right foot to scrape away infected flesh, remove tendons and transplant skin. “I was in the ICU for three weeks, in and out of my mind, mostly out,” said Buck, of Duluth, Ga.
The state of Florida used to have a law for motorcycle helmets. They decided people can decide for themselves whether or not they want to kill themselves on a motorcycle if they’re not wearing a helmet. I think it works the same way with food.
Ted Itzoe, restaurant owner
Americans assume food is inspected and safe to eat, said David Plunkett of the Center for Science in the Public Interest in Washington, D.C., a consumer group that is petitioning the U.S. Food and Drug Administration to force oyster safety. “Nobody sits down for dinner with the expectation they’re going to die in three days.”
Surely Raymond Cordes never imagined an appetizer of three raw oysters would kill him. His wife, Carmen, described his death as “the ugliest thing I’ve ever seen.”
The Fort Myers widow said her husband, 81, a retired U.S. Army veteran and insurance executive, was diabetic. He carefully monitored his sugar intake and diet, but was unaware raw oysters were a threat.
Soon after he returned from a vacation in Hilton Head, S.C., two years ago, he couldn’t get out of bed. Carmen was stunned by what the doctors told her: “We have to amputate both legs and his left hand.”
She consented to the surgery, hoping it would save her husband.
But afterward, the doctor “lifted off the blanket, and I saw the stumps. What he was showing me is (the infection) was still traveling up his legs,” she recalled. “In three days, my husband was gone.”
Vibrio vulnificus is naturally occurring bacteria that thrives in the warm waters of the Gulf of Mexico, and is most prevalent in the hottest months of April through October. It is the same bacteria that makes headlines when swimmers or fishermen become infected through a cut or open wound, a growing problem in Florida.
Researchers first identified Vibrio vulnificus in oyster deaths in 1979 and attribute its emergence to three trends: Diseases decimated oysters in the Chesapeake Bay, shifting more of the market to the Gulf; consumer preference for raw oysters increased; and the industry expanded its summer harvesting.
Oysters at one time had been a seasonal delicacy, leading to the adage that they should be eaten only in months ending with an “R.”
“Oyster activity was usually over by May,” said Misho Ivic, owner of Misho’s Oyster Company in San Leon, Texas. “In the ’70s, I saw people selling during the summer, and they were making good money … so the rest of them started picking up on it.”
Florida allowed summer harvesting in the Panhandle’s Apalachicola Bay, where most of the state’s oysters come from, in response to increasing demand.
“You got all these raw bars that have opened up in the last 25 or 30 years,” said David Barber, owner of Barber’s Seafood near Apalachicola.
About 90 percent of Barber’s business used to be shucked oysters sold for cooking. “It’s changed, and now everybody’s eating them raw,” he said.
The Gulf now produces almost as many oysters in the high-risk warm months as it does in the winter. About half are destined for the raw market, studies have found.
“The more you harvested oysters in the summer, the more people were exposed,” said Anita Wright, a biologist at the University of Florida who studies the bacteria.
Fighting against a solution
Some concerned oyster processors in the 1990s began developing technology that kills the bacteria through quick freezing, high pressure and other methods. John Tesvich, owner of the Louisiana-based AmeriPure, pioneered a process that uses low-heat pasteurization but said it was impossible to persuade the “rough and tumble” oyster industry to accept it.
“We came up with what we thought was a great idea,” Tesvich said. “I was blocked at every step of the way by so-called industry leaders.”
California in 2003 began requiring such treatment of Gulf oysters in the warmest months, and deaths dropped from 40 in one decade to just one since.
Citing California’s results, the FDA announced in 2009 that raw Gulf oysters nationwide would be subjected to treatment in the warmest months.
“Seldom is the evidence on a food safety problem and solution so unambiguous,” Michael Taylor, senior adviser to the FDA commissioner, said at the time. “We no longer believe that measures which reduce the hazard, but fall well short of eliminating it … are sufficient.”
But the proposal was immediately resisted by oyster industry representatives, who carry sway through an unusual regulatory arrangement that calls for the FDA to consult with the industry and states on oyster safety policies.
Those representatives said it would cripple the Gulf oyster business, which on average has harvested about $71 million in oysters annually in recent years, roughly 9 percent of the total value of seafood from the region, according to federal fisheries records.
Restaurant plate with oysters Customers eating oysters Raw Gulf oysters, once a seasonal delicacy, are now served year-round.
The Gulf now produces almost as many oysters in the high-risk warm months as it does in the winter, about half of which are destined for the raw market, studies have found
“To be such a tiny industry, they bring together a bunch of congressmen in a heartbeat,” said Andy DePaola, who retired last year as the FDA’s lead seafood microbiologist.
The industry launched a media blitz and persuaded Gulf Coast Congress members to introduce legislation that would bar the FDA from spending money to carry out the regulation.
They said stricter refrigeration requirements would be sufficient to reduce the problem. Those requirements went into effect in 2010, and oyster-related illnesses declined about 40 percent from 2012 to 2013 and remained lower in 2014, according to the most recent figures available.
Eliminating the risk completely, many industry representatives say, is not realistic or necessary. They say at-risk consumers ought to know not to eat oysters raw, and they should be responsible for their health, not the government or the industry.
“If you look at the reports of the people that’s gotten sick,” Barber said, “the person probably shouldn’t have been eating raw oysters in the first place, and they probably knew it.”
Hundreds of thousands of consumers eat raw Gulf oysters “every year with little or no effect,” said Chris Nelson, vice president of Bon Secour Fisheries, a large distributor in Alabama. “I think there is a responsibility by the industry to produce a product that’s as safe as possible.”
The question, Nelson said, is how far should government go to protect the small number of consumers at the greatest risk, especially when some are aware of the danger and eat raw oysters anyway. “I know of one case, they’re on the way to the hospital to get a liver transplant, and stopped for oysters.”
You won’t find treated oysters on the menus of many South Florida seafood restaurants because, owners say, they cost more and don’t taste as good.
The wholesale price is about 25 to 50 percent higher, industry representatives said.
Research has shown that consumers generally can’t taste the difference and find all types of treated oysters acceptable, but connoisseurs say there’s no comparison.
“The difference would be like saying you have a plastic couch and calling it leather,” said Buddy Sherman, co-owner of Southport Raw Bar in Fort Lauderdale. “If you’re going to eat a raw oyster, you don’t want to eat a frozen raw oyster, you don’t want to eat a pasteurized raw oyster.”
No customers at Southport or Tarks of Dania Beach have become seriously ill from Vibrio vulnificus, the owners said. Tarks owner Ted Itzoe rejected treated oysters and instead posts prominent warnings around the restaurant and on menus.
“The state of Florida used to have a law for motorcycle helmets,” Itzoe said. “They decided people can decide for themselves whether or not they want to kill themselves on a motorcycle if they’re not wearing a helmet. I think it works the same way with food.”
Tesvich says the buyers for treated oysters include cruise ships, casinos, and larger restaurant chains that have greater liability.
Red Lobster has featured treated oysters for more than 15 years “so our guests can feel good about dining with us,” a spokeswoman said.
The famed Joe’s Stone Crab in Miami Beach stopped serving treated oysters about four years ago because of customer demand for “gourmet oysters,” said general manager Brian Johnson. The restaurant now buys oysters from the east and west coasts and carries some from the Gulf — but only in cooler months.
‘License to kill’
Victims of foodborne Vibrio vulnificus infections are typically men in their 50s or older, including those with chronic conditions and severe alcoholism. People like Timothy Cox.
Cox, of Panama City Beach, was 55 and a college softball coach with cirrhosis and diabetes. He ate raw oysters at a tournament with his team in April 2011.
Doctors amputated both his legs. As his organs shut down, his sister Terri Jones was the one to tell their 88-year-old father there was no hope.
“I had to pull him out in the hallway and get on my knees and tell him there was nothing they could do for his son,” Jones said. “He never recovered from that.”
She said the industry should embrace any method that gets rid of the threat. Instead, “They’re giving a fisherman a license to kill.”
Cordes, the Fort Myers widow, called it unconscionable that the industry and its regulators have known for more than 20 years how to stop deaths.
“This was the greatest love of my life,” Cordes said. “My husband didn’t have to die.”
Jose Luis Ruiz said he wishes he’d known he was at risk. The restaurant where he ate the meal that nearly killed him three years ago served both treated and untreated oysters, whatever they could get, said his lawyer, Peter Ensign of Chattanooga. But Ruiz never knew to ask.
The European Union won’t accept Gulf oyster imports
Now 54, he lives with constant pain. The stump of his left leg, cut 8 inches below his hip, twitches and pulsates so much it sometimes jolts him from sleep. He uses a motorized scooter and crutches. A prosthetic leg is too painful to wear.
“In the middle of the night, it’s like my leg just comes alive,” he said. “A lot of times, my wife says I just moan and groan.”
He believes he contracted hepatitis C, which compromised his liver and made him susceptible to the bacteria, from two tattoos he received a few years earlier.
“I wish that I never ate that oyster, believe me,” he said. “I lost everything. I’m alive, thank God for that, but it’s really changed our lives.”
Ruiz owned a successful masonry business in Tennessee, building custom stone and brick fireplaces, walkways and walls.
“My business collapsed,” he said. “I couldn’t do it with one leg anymore.”
A bank foreclosed on Ruiz’s house, and he sold the family’s two Hummers and “everything that had value, just to survive.”
Ruiz and his wife, Lourdes, now live on Social Security disability in a two-bedroom apartment. They are suing the restaurant and seafood dealers that supplied the oysters.
Lourdes Ruiz used to enjoy going out dancing with her husband. Now she just tries to spread the word.
“Every time people stare at him, I have to tell them, ‘You know what took his leg? Eating raw oysters,’” she said. “They just stop in their tracks.”