[E. coli O111] Outbreak's origin a mystery
The source of a rare pathogen that killed one man and sickened dozens eludes investigators.

Source of Article:  http://www.tulsaworld.com/news/article.aspx?subjectid=11&articleid=20090122_17_A9_Themys243073&allcom=1

By KIM ARCHER World Staff Writer
Published: 1/22/2009  2:33 AM
Last Modified: 1/22/2009  10:14 AM

The mystery of how the largest E. coli O111 outbreak in U.S. history came about will never be known, lead investigator Dr. Kristy Bradley said.

"Unfortunately, it's not uncommon to be unable to pinpoint exactly a bacteria's entry to a restaurant," said Bradley, the state epidemiologist for the Oklahoma State Department of Health.

The final report on the five-month investigation into the northeastern Oklahoma outbreak will be released in mid-February. The findings were first reported on tulsaworld.com.

In late August, more than 300 people fell ill after eating at the Country Cottage restaurant in Locust Grove. About 70 people were hospitalized, and a Pryor man, Chad Ingle, died after contracting the bacteria.

"We feel we did a very complete epidemiological investigation," Bradley said. "We looked at numerous specimens from employees who had fallen ill, to water, to the food and environmental surfaces."

The U.S. Centers for Disease Control and Prevention was called in early in the investigation to help determine what bacterium was sickening so many people.

It was the CDC that finally narrowed the source to the rare and virulent form of E. coli that Bradley called "a very bad actor."

Ten children and a few adults required dialysis because their kidneys shut down. Some were in the hospital for weeks.

E. coli O111 is a shiga toxin-producing form of E. coli, a type of enterohemorrhagic bacteria that can cause illness ranging from mild intestinal disease to severe kidney complications, Bradley said.

Although the investigation will never reveal the origin of the bacteria, Bradley said officials are certain that people were exposed at the restaurant in Locust Grove.

"We knew Country Cottage was where the people were exposed," she said. "But we can't say specifically how it spread."

Investigators might have been able to determine its origin had investigators actually found the organism among the many environmental specimens tested, Bradley said.

But searches for an actual organism after exposure and outbreaks are rarely successful, she said.

Bradley said the bacteria could have come in on somebody's boots and have been spread by restaurant patrons and food handlers alike.

Cindi Moore, a member of the family that owns the restaurant, said the outbreak and its fallout have been "emotional for everyone involved."

The restaurant's owners, Dale and Linda Moore, expressed deep sadness about the outbreak in numerous written statements.

The restaurant closed Aug. 25 after it was determined to be the source of the outbreak. It reopened in late November.

Under an agreement with the state Health Department, the restaurant had to meet 11 requirements, including disconnecting a private well on the premises, thoroughly cleaning and disinfecting every surface in the restaurant, and implementing a new hand-washing monitoring system. Each employee also was required to complete a food safety class.

When the restaurant opened again, Bradley said, the problem had been remedied.

"There is no more risk of acquiring E. coli at that restaurant than at any other restaurant," she said.


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