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Arsenic Poisoning Caused by Intentional Contamination of Coffee at a Church Gathering—An Epidemiological Approach to a Forensic Investigation
Authors:Kathleen F Gensheimer MD  MPH  Vicki Rea RN  MPH  Dora Anne Mills MD  MPH  Christopher P Montagna MS  MPA  Karen Simone PharmD
Institution:1. Maine Center for Disease Control and Prevention, Maine Department of Health & Human Services, Station #11 Augusta, ME 04333.;2. Present address: sanofi pasteur, 38 Sidney Street, Cambridge, MA 02139.;3. Northern New England Poison Center, 22 Bramhall Street, Portland, Maine 04102.
Abstract:Abstract: An outbreak of apparent food‐borne illness following a church gathering was promptly reported to the Maine Bureau of Health. Gastrointestinal symptoms among church attendees were initially attributed to consumption of leftover sandwiches that had been served the previous day. However, a rapid epidemiological and laboratory assessment revealed the etiology of illness, including the death of an elderly gentleman, was not food‐borne in origin. A criminal investigation determined that deliberate arsenic contamination of the brewed coffee by one of the church members was the source of the outbreak. Public health officials and criminal investigators must be aware that intentional biologic aggression can initially present as typical unintentional disease outbreaks. Practitioners must also consider the need to properly maintain and preserve potential forensic evidence. This case demonstrates the key role public health practitioners may play in criminal investigations.
Keywords:forensic science  arsenic  terrorism  epidemiology  poisoning  emergency response
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