CHAPTICO -- The number of people sickened by food poisoning at a Southern Maryland church dinner swelled to 622 yesterday, and public health investigators raised the possibility that a second death may be traced to the salmonella outbreak.
St. Mary's County health officials described the second possible victim as an elderly Baltimore woman who died of a heart attack this week after eating dinner Sunday at Our Lady of the Wayside Church in the tiny community of Chaptico.
They were uncertain whether her death was caused by a bacterial infection, however.
Yesterday, neighbors identified the first reported victim as Grace Oatley, 81, of Chaptico.
Investigators said they suspect stuffed ham -- a dish virtually synonymous with St. Mary's County hospitality -- was the source of the poisoning. The traditional dish is cured pork shoulder, hollowed out and filled with kale, cabbage and spices.
"Our study indicates it's the stuffed ham," said Mary Novotny, a county Health Department spokeswoman. She said lab tests could confirm that by tomorrow.
Like much of the food at the church's Fall Festival dinner, where an estimated 1,400 customers were also served roasted turkey and fried oysters, the stuffed hams were prepared by volunteers cooking at home.
Because all the hams were handled at the church, health officials plan to inspect counter surfaces and utensils in the church's kitchen for contamination.
Health officials said the salmonella outbreak may represent the largest food poisoning in Maryland in at least a decade.
While not the most deadly -- a 1970 outbreak in a Baltimore nursing home resulted in 25 deaths -- it may be among the most widespread.
Dr. Martin P. Wasserman, secretary of the Maryland Department of Health and Mental Hygiene, said, "There are lessons the general public can learn from this event. It's a tragedy."
He said the state should not regulate small church dinners, but large-scale events might require some type of monitoring.
Local hospital emergency rooms continued to see new patients yesterday with symptoms typical of salmonella poisoning: nausea, fever, diarrhea, stomach aches and dehydration.
At least 32 people were hospitalized: 16 at St. Mary's Hospital in Lexington Park and 16 at Physicians Memorial Hospital in LaPlata, in neighboring Charles County.
At least 138 people have been treated by emergency room staffs in Southern Maryland hospitals, officials said.
More than 800 people have been interviewed by health officials. Much of the increase in the reported sick -- up more than 450 since Wednesday -- was just a matter of catch-up as nurses, hospitals and doctors returned telephone calls from hundreds of sick patients.
A lab in Baltimore was trying yesterday to raise petri dish colonies of the salmonella bacteria, using microbes from the victims and from the suspected food sources.
Samples from those cultures will be injected into animals to produce antibodies.
Different strains of salmonella produce different antibodies. By comparing the antibodies, researchers can quickly determine whether the salmonella from a given food sample is the same type as that infecting the patients. That information will help trace the route of transmission.
Two state epidemiologists are aiding the county by interviewing people who have reported getting sick, said Dr. Georges C. Benjamin, the state health department's deputy secretary for public health services.
State officials have also talked to the U.S. Centers for Disease Control and Prevention in Atlanta, which offered to provide additional people and lab capacity, if needed.
Over the past five years, state health officials report, Maryland has averaged about 1,200 cases of salmonella poisoning a year, leading to 300 hospitalizations and about 10 deaths. Before the current outbreak in St. Mary's, 1997 had seen 951 cases, with 215 hospitalizations and 20 deaths.
Residents of this waterfront county were stunned by the magnitude of the outbreak, which has sickened people who came to the dinner from as far away as North Carolina. A bus load of seniors from Morrell Park Apartments, a building for the elderly in Southwest Baltimore, attended the dinner.
The county Health Department, normally a dispenser of flu shots and drug lectures, has become ground zero for the search for the sick. Sheriff's deputies, enlisted in the huge effort, had to warn churchgoers not to eat leftovers many had taken home.
The probe is being led by Dr. Ebenezer Israel, the St. Mary's County health officer. By coincidence, Israel formerly was chief of the state's epidemiologists, the disease detectives who track down the source of infectious outbreaks.
Judy Pedersen, an employee in the county administrator's office, said one of the diners who was warned by telephone to throw out leftovers instead gave them to a dog, which became violently ill.
"That's how bad this stuff was," she said.
The depths of the crisis first became apparent at St. Mary's Hospital, whose emergency room workers watched a trickle of sick people Monday night grow to a flood by Tuesday morning.
"They were just steadily coming through the door. That's when we realized something was going on," said Barbara Stepura, the hospital's vice president for patient care services. "We thought it was the flu at first."
The hospital called in extra emergency room workers and stocked up on bags of intravenous fluids, ginger ale and Gatorade to counter the dehydration.
Dawn Weyrich Ceol of the Archdiocese of Washington gathered about a half-dozen church volunteers yesterday afternoon who helped prepare the food. They were interviewed by health officials, who hoped to learn by today where the bad food originated.
The volunteers are upset, Ceol said:
"They're absolutely crushed and really determined to get to the bottom of this. These are their friends, their fellow parishioners, their neighbors and their co-workers, so they're really bummed out."
And as the ill nurse themselves back to health, others wonder what effect the crisis will have on the region's long tradition of annual church dinners -- three of which are scheduled for this weekend.
"I hope that this would not deter people from coming to these dinners," said county Sheriff Richard J. Voorhaar. "A lot of these churches, their livelihood depends on the money they make from these dinners."
Charles T. Biddison of Cockeysville, an 80-year-old retired debt collector, is a regular at Roman Catholic church dinners in Southern Maryland. He and his 81-year-old companion both ate the ham at the Wayside Church on Sunday, and neither got sick.
He's not going to let the salmonella outbreak deter him, he said: "This coming Sunday, I'm going to another one."
Meanwhile, the Rev. John Stack, pastor at Our Lady of the Wayside Church, remained shaken and distraught over the illnesses his annual dinner begat.
"I just feel so badly about it," he said.
Pub Date: 11/07/97