There may be no food more American than the burger. And according to meat lovers, there may be no health code regulation less American than North Carolina's rare and medium rare burger ban.
From Winston-Salem to Nags Head, meat eaters are unable to order their burgers rare or even medium rare thanks to a state restriction that requires restaurants to cook ground beef to an internal temperature of 155 degrees Fahrenheit.
That's enough heat to sufficiently kill dangerous bacteria like E. coli, according to state health officials. But it's also enough heat to kill all of the flavor, according to Raleigh resident and rare burger aficionado Steven Elliot.
"I don't believe in a nanny state when it comes to food," said Elliot, who told AOL Weird News he would order his burgers "bloody" or "ready to moo" if he could.
"I don't like the government telling us what we can and cannot eat," he added.
Red meat eaters who prefer their meat, well, red, can still legally grill up their own rare burgers at home. But North Carolina's restaurants can't go a step below medium -- or medium well, according to some restaurants -- if they want to stay in the good graces of the state's Division of Environmental Health.
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While North Carolina allows steaks to be served rare, regulators hold ground beef to a higher standard due to possible contamination from bacteria like Salmonella and Escherichia coli O157:H7, a harmful microorganism that "produces large quantities of a potent toxin that forms in the intestine and causes severe damage to the lining of the intestine," according to federal ground beef safety guidelines.
Contaminants on the outside of a cut of meat are typically killed during cooking. But when meat gets ground, bacteria from the outside can be mixed throughout, meaning some bacteria could survive inside a burger patty if the internal temperature isn't high enough during cooking, said Larry Michael, head of the food protection branch of the North Carolina Division of Environmental Health.
"According to North Carolina rules, a hamburger is cooked properly when it reaches an internal temperature of 155 degrees fahrenheit," said Michael. "There are no exceptions."
There might be no exceptions in the eyes of the state, but rare burger fans can still get their fix. In fact, the dining regulation has pushed rare burger eaters underground, sparking a black angus market.
"Some restaurants will make a rare burger for you if you're a regular or if you look hip enough," said Elliot, who founded RareBurger.com in hopes of mapping out the best spots for undercooked meat for fellow burger fans. "They'll ask you if you are a cop or food inspector first."
"There are some places I've been to where they've given me a rare burger because they recognized me. Other times when it's a different waiter, they're like, 'No, we can't do that.'"
Some eateries even skirt the law by speaking in code, according to Elliot.
"They say, 'We'll make it as pink as we're able to,'" he said. "They won't admit they're serving a rare burger, but they'll serve you a rare burger."
Other eateries misinterpret the law by claiming that they have permission to serve rare burgers or medium rare burgers because they grind their own meat in house.
This misconception is so widespread that a server and a chef at different North Carolina restaurants repeated it as fact to AOL Weird News.
But in the state's eyes, that doesn't allow burger lovers to have it their way.
"There is no difference in regulation pertaining to the cooking temperature if a restaurant grinds its own meat or not," said Michael. "It is a common misconception."
Restaurants caught serving rare or medium rare burgers aren't fined, but they receive demerits that can lower their state health grade scores, prominently displayed in all food establishments in North Carolina. Establishments with failing grades can have their licenses revoked.
According to Kathleen Purvis, the food editor of the Charlotte Observer and the journalist who first debunked the meat-grinding myth, officials implemented the rare burger ban in the aftermath of a 1993 E. coli outbreak that claimed the lives of four children who ate undercooked meat served at Jack in the Box restaurants.
"People complain about it," said Purvis, "but I understand where the concern is on undercooked beef. There is a concern about putting your kid at risk."
Though she wants the state to keep undercooked meat from being served to children and the elderly (two groups that face heightened risks of serious infections from E. coli O157:H7), Purvis sees ordering a rare or medium rare burger as the kind of decision adults should have the right to make.
It's actually a decision she made herself during a recent trip to New York City, where she ordered a burger that would have been banned in her home state from Schiller's Liquor Bar in the Lower East Side.
"It was sort of a shock," she said. "I bit into it and I was like, 'Holy cow -- this is a little pink in the middle. It's a juicier burger."
For now, Purvis and other North Carolinians who crave rare and medium rare burgers must make them at home, head out of state or dine at restaurants that violate the regulation.
But that could change soon.
North Carolina might adopt the national food code drafted by the United States Food and Drug Administration, which would allow eateries to serve rare or medium rare burgers so long as their menus featured a disclaimer outlining the potential risks.
Michael told AOL Weird News he hopes the federal code will be implemented in 2012.
"Uniformity is the number one reason for adopting the food code," he said. "We want to be consistent with what other states are allowing."
Legalizing rare burgers, even with a health advisory printed on menus, would please rare burger lovers and chefs alike, according to chef Mario Alipio, of Raleigh's Pickled Onion Bar and Grill.
"It would make things easier. It would inform customers that, yeah, we can do it, but you can't come back and say, 'I got sick,'" explained Alipio, who personally prefers medium rare burgers but only serves patties that are medium well or well done.
Adopting the federal food code would be a major victory for Elliot, but if it happens, the battle won't be over for rare burger eaters.
"The bigger win would be finding cooks who actually know how to make one. For some reason there's this tendency to just take a spatula and press a burger down," Elliot said in disgust.