title: Arsenic poisoning caused by intentional contamination of coffee at a church gathering--an epidemiological approach to a forensic investigation.
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.
authors.affiliation: Maine Center for Disease Control and Prevention, Maine Department of Health & Human Services, Station #11 Augusta, ME 04333, USA. Kathleen.Gensheimer@sanofipasteur.com
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Gensheimer
authors.forename: Vicki
authors.initials: V
authors.lastname: Rea
authors.forename: Dora Anne
authors.initials: DA
authors.lastname: Mills
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Montagna
authors.forename: Karen
authors.initials: K
authors.lastname: Simone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001151:Arsenic / Q000032:analysis*; D020261:Arsenic Poisoning / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003069:Coffee / Q000737:chemistry*; D003415:Crime; D003937:Diagnosis, Differential; D005243:Feces / Q000382:microbiology; D005260:Female; D005517:Foodborne Diseases / Q000175:diagnosis; D053593:Forensic Toxicology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013405:Suicide; D014839:Vomiting; D055815:Young Adult
chemical_list: D003069:Coffee; D001151:Arsenic