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The
Oklahoma State Department of Health (OSDH) Issues Final Report on E. coli
0111 Outbreak Linked to Food Served at Country Cottage Restaurant in Locust
Grove
Outbreak Statistics
At a Glance
Source of Outbreak:
Country Cottage Restaurant, Locust Grove, OK
Outbreak Organism: E.
coli 0111:NM
Vehicle of Contamination:
Unknown
Method of Spread:
Foodborne transmission
Confirmed Outbreak
Period: Aug. 15-24, 2008
Cases: 341
Hospitalizations: 70
Deaths: 1
The Oklahoma State
Department of Health (OSDH) released its final
report today on the investigation of the largest E. coli O111 outbreak
ever documented in the United States. The outbreak, which occurred in late
August 2008 in northeastern Oklahoma, sickened 341 people and resulted in
one death.
The report detailed the
agency’s extensive epidemiological investigation into the outbreak that
included laboratory testing, personal interviews, and an in-depth
environmental investigation. While the source of the outbreak – the Country
Cottage restaurant in Locust Grove, OK, – was quickly identified, the
vehicle for contamination was never found.
Laboratory analyses of
specimens provided by those who became sick allowed the OSDH and the
federal Centers for Disease Control and Prevention (CDC) to pinpoint E.
coli 0111 as the bacterial organism responsible for persons’ illnesses.
However, microbiological testing of food products and food preparation and
serving surfaces in the restaurant, as well as testing symptomatic restaurant
employees, samples from a private water well located on the property, water
filters, and the Locust Grove municipal water supply, found no E. coli
0111. The OSDH released multiple situational updates during the
investigation that reported no E. coli 0111 had been identified in its
extensive testing process. Because the disease-causing organism was not
found, the OSDH was unable to eliminate from consideration any of the
potential vehicles for transmission of the bacteria into the restaurant,
including well water. Even so, analysis of data collected during the
investigation suggests there was ongoing foodborne transmission of E. coli
O111 to restaurant customers from Aug. 15-24, 2008.
“What is important to
remember is that when responding to an infectious disease outbreak, our
primary objective is to rapidly identify the source of the infection to
contain the outbreak and prevent any further spread,” said State
Epidemiologist Dr. Kristy Bradley. “Within 48 hours of being notified of
increased cases of persons with bloody diarrhea being admitted to Tulsa
area hospitals, we identified the Country Cottagerestaurant as the common
source of transmission. The restaurant closed voluntarily and the outbreak
was contained.”
According to the CDC,
only 10 outbreaks involving E. coli 0111 had been reported nationally prior
to Oklahoma’s outbreak. The bacteria are from the family of Shiga
toxin-producing E. coli bacteria, or STEC. Persons who ingest STEC may have
a diarrheal illness ranging from very mild and non-bloody to severe with
very bloody stools. The infectious dose is very small and STEC are often
spread by ingesting food items contaminated with fecal matter that are not
subsequently cooked. Person-to-person transmission, direct animal contact,
and waterborne transmission, either from contaminated drinking water or
recreational water, are other exposure routes.
State health officials
said as of March 16, 2009, OSDH personnel have reported 6,481 hours of
total accrued time and effort dedicated to the E. coli O111 outbreak
investigation. This does not take into account the time and effort provided
by Tulsa Health Department personnel, student volunteers, or medical staff
at various hospitals and clinics who provided surveillance information.
Posted
on April 9, 2009 by E. coli Lawyer
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