Lingering nightmare

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A hard-working Grove man's health has never recovered from the rare and virulent bacteria.

His entire life, Kenneth Birkes has worked seven days a week from dawn to dark.

Then he ate a meal in honor of his father's 85th birthday at Country Cottage in Locust Grove. It was Sunday, Aug. 17, 2008.

Five days later, Birkes fell ill. The 61-year-old Grove man hasn't worked since.

"There were seven of us who ate there that day. I was the only one in the family that got sick," he said. Family members tried comparing what each had eaten, but Birkes said he "got a little of everything" at the restaurant's popular buffet.

On the same Sunday the Birkes family ate at the restaurant, 26-year-old Chad Ingle and his wife, Cindy, arrived from church for Sunday dinner. The young RCB Bank teller and his wife had just married in June.

As usual that Sunday, Country Cottage was packed. Over the years, the place had become a kind of tourist destination in that part of northeastern Oklahoma.

By all accounts, the food was great that day and the blue country house welcoming.

"It was good," Birkes said. "We ate there quite a bit."


Five days later, the idyllic scene evolved into a nightmare. People all over northeastern Oklahoma were falling ill with severe stomach cramps and diarrhea. Nobody knew why at first, or how they were all connected.

Ingle had become ill Wednesday night and sought medical help at Integris Mayes County Medical Center.

Then Birkes found himself getting sick on the job.

"I was up in Kansas to get a drilling rig out in the country," he said. "It hit me so quick."

He had just put the rig on a trailer and driven to the town of Edna, all the while calling his wife to tell her he needed help.

"That's really the last thing I remember," Birkes said. His wife initially took him to a hospital in Coffeyville, Kan., but he continued to get worse. He didn't wake up until six weeks later at St. Francis Hospital.


By that Friday evening, St. Francis Hospital had begun to see patients with similar symptoms many of them children. Ingle was one of those transported by ambulance to the Tulsa hospital, which had perplexingly become the central site for patients.

"We never could figure that out," said Lynn Sund, St. Francis senior vice president and chief nurse executive.

Staff there and ambulance crews began to notice that most of the patients coming in were from the far northeastern corner of Oklahoma or had traveled through there recently, she said.

That night, both St. Francis and EMSA's Medical Emergency Response Center contacted the Oklahoma State Department of Health about the cluster of patients coming in with similar symptoms from the same area of the state.

"That cued everybody there must be something happening in that geographic area," said DeAnna Osborn, infection control nurse at St. Francis.

The state Health Department's acute disease division jumped into action that night, said Laurie Smithee, an epidemiologist who heads the unit.

The team quickly put together a questionnaire and began calling people who were hospitalized to ask where they had been and what they had eaten in the last week. They also began surveying other hospitals to determine if other patients were out there.

Late that night, in a conference with her team to compare notes, the arrow began to point to Country Cottage. Six of the first eight patients interviewed said they had recently eaten there.

"We definitely had heightened concerns, but we said, 'Do we have enough evidence to tell them to close their doors?' " Smithee said.

At that point, they didn't. The team asked the Mayes County sanitarian to investigate and inspect the restaurant on Saturday. He did, but there was no indication anything was wrong there.


On Sunday, Ingle died.

That's when Locust Grove Mayor Shawn Bates heard the news. He knew many of the ill.

"I felt sick. Sick for everybody who was sick and sick for the young man who died," he said. "I was thinking, 'How bad is this going to be?'"

On Monday the state ordered the restaurant closed.

Later, the state Health Department team confirmed that the source of contamination was Country Cottage.

"Early on, we were able to point to the restaurant with barely a shadow of doubt," Smithee said.

The following days

The hospital's pediatric dialysis units filled quickly. Both pediatric and adult intensive care units were reaching capacity. "Our patient numbers were climbing," Sund said. Two children were sent to an Oklahoma City hospital for dialysis, and four adults were placed in other hospitals, she said.

By the time everyone was counted, 49 adults and 20 children had been hospitalized at St. Francis. Thirty-five people were seen in the hospital's emergency room and didn't need inpatient care. And 98 patients were seen at outpatient facilities, Sund said.

Just five days after being notified there was an outbreak of some kind, the state Health Department had a definitive answer on what had caused it.

According to tests by the federal Centers for Disease Control and Prevention, the outbreak was caused by E. coli O111, a rare and virulent bacteria. And it was the worst outbreak ever seen in the U.S. caused by that particular strain.

'Never be answered'

The next months were consumed with trying to find out how the contaminant got in the restaurant and whether it was spread through food, well water or by a food preparer. Unfortunately, that question will never be answered, Smithee said.

"It is not unusual to not specifically find the organism," she said. "There were so many food items at least 50 items on the buffet. By the time people got sick, all that food was long gone."

Finally, on Saturday, Nov. 22, the Country Cottage reopened for business after rigorous testing by health officials.

"Daily life has gone on. We want to get back to normal, but we can't forget," Bates said. "We're still tender for those who lost a loved one and for those who were sick and will never be the same."

Ingle's wife has filed a wrongful-death lawsuit against the restaurant. And Birkes is among a group of clients of Seattle attorney Bill Marler asking for a settlement from the restaurant's insurance company.

"If they turn us down, we have no choice but to sue the restaurant and the owners for the policy and all personal assets," Marler said.

Birkes said he went from making $12,000 a month to nothing.

"This pretty well wiped us out," he said. After three months in the hospital, he had to learn to walk again. Now, he has migraines four days a week and is only able to go three hours at a time before needing to rest.

"I'm still alive, and that's all that matters," Birkes said.

Country Cottage no longer has a line of people wrapped around the block to eat there.

"It's not like it was a year ago. It will never be the same," Bates said.


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