Her most recent job was "backing heads," scraping meat from between the vertebrae. Three people per shift did that task, and together would process 9,500 heads in eight or nine hours. Kruse (pronounced KROO-zee) stood next to the person who used compressed air to blow out the brains. She was often splattered, especially when trainees were learning to operate the air hose.
"I always had brains on my arms," she said.
She never had trouble with her health until November 2006, when she began having pains in her legs. By last February, she could not stand up long enough to do her job. She needed a walker to get around and was being treated at the Mayo Clinic.
"I had no strength to do anything I used to do," she said. "I just felt like I was being drained out."
On the mend
Her immune system had gone haywire and attacked her nerves, primarily in two places: at the points where the nerves emerge from the spinal cord, and in the extremities. The same thing, to varying degrees, was happening to the other patients. Kruse and the index case - the man who extracted brains - probably had the most severe symptoms, Lachance said.
Steroids did nothing for Kruse, so doctors began to treat her every two weeks with IVIG, intravenous immunoglobulin, a blood product that contains antibodies. "It's kind of like hitting the condition over the head with a sledgehammer," Lachance said. "It overwhelms the immune system and neutralizes whatever it is that's causing the injury."
The treatments seem to help, Kruse said. She feels stronger after each one, but the effects wear off. Her doctors expect she will need the therapy at least until September.
Most of the workers are recovering and some have returned to their jobs, but others, including the index case, are still unable to work. So far, there have been no new cases.
"I cannot say that anyone is completely back to normal," Lachance said. "I expect it will take several more months to get a true sense of the course of this illness."
Lynfield hopes to find the cause. But she said: "I don't know that we will have the definitive answer. I suspect we will be able to rule some things out, and will have a sense of whether it seems like it may be due to an autoimmune response. I think we'll learn a lot, but it may take us a while. It's a great detective story."
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