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JAMA. 1966;196(13):1150. doi:10.1001/jama.1966.03100260088026.
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Since bread is such a dietary staple, scientists must have strong proof before implicating it in disease. Recently, in Great Britain, an amazing bit of medical detective work demonstrated contaminated bread to be the source of a peculiar outbreak of liver disease.1

Within a period of about one month, 84 apparently similar cases were identified. The symptoms, which varied somewhat from one individual to another, included features such as pain in the upper abdomen, jaundice, fever, malaise, and generalized "flu-like" symptoms. The blood bilirubin was elevated, in one case as high as 29.3 mg/100 cc. And needle biopsies, performed in four cases, revealed inflammatory and hepatocellular changes of unusual character, not fitting into the customary patterns.

Not only were the clinical and pathological features unusual, but the epidemiology seemed quite extraordinary. The cases often occurred in pairs of adults, as in a husband and wife, or mother and daughter


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