The King County Health Department has announced that they are investigating an E. coli outbreak associated with the Matador restaurant in Seattle, Washington. There have been 10 people sickened in the outbreak. Five of those sickened in the outbreak are from King County. Two other people from Washington, but not from King County, have also reported illnesses. There have been 3 reports of E. coli infections from other states as well. Many of the reported cases began in late August, although some of the illnesses took place in early to mid-September. Three people have been hospitalized because of their illnesses. One person has developed a rare but serious side effect of E. coli poisoning, HUS. Most of those affected by the outbreak have recovered from their illness.

Health officials began their investigation on August 22, 2016, after receiving word of E. coli infections around Seattle. Laboratory testing then revealed that there were quite a few people with similar strains of E. coli. To discover other cases of illness, health officials used a technique called pulsed field gel electrophoresis, or PFGE. PFGE separates a bacteria’s DNA, allowing it to be catalogued as a “DNA fingerprint”. Since every strain of bacteria has a different fingerprint, the PFGE system make it easier for investigators to link together different cases of illness based on similar strains of bacteria. In this case, PFGE revealed that most of the people that reported illnesses had a similar strain of E. coli. Analysis of the DNA fingerprint also linked illnesses to the outbreak that did not originate in Washington. Investigators also use interviews with ill people to help pinpoint the source and extent of foodborne illness outbreaks. During these interviews, investigators discovered that as many as 7 of them ate at the Matador restaurant before their illnesses began. These findings led health officials to shut down the Matador pending the results of the investigation.

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An inspection of the Matador revealed that there was a high likelihood of cross contamination based on the practices and procedures of the restaurant. Food service workers had not adequately cleaned the food processing machines, and they did not properly wash produce. Although there is no evidence saying that either of these violations caused the outbreak, they still increase the risk of an outbreak taking place. The Matador’s agents thoroughly cleaned and sanitized the restaurant during its closure. All potentially contaminated products have been disposed of, and all employees have reviewed proper health and safety practices. After an inspection by local health officials, the agency granted the Matador permission to reopen on September 15. Health officials have announced that there will be a follow up inspection in two weeks to make sure that the Matador is keeping up with food safety standards. Also, because the last illness reported in the outbreak was in late August, many health officials believe this outbreak is no longer causing illnesses. Because E. coli cases can take weeks before medical providers and state agencies can detect and diagnose them, the amount of people sickened in the outbreak may continue to increase.

Even though health officials have linked the Matador restaurant to the outbreak, health officials have yet to find the exact source of the outbreak. They do not have a suspect ingredient either. There have not been any reports of illness from Matador employees, and environmental samples taken from the restaurant are being tested. Investigators worry that because many items on the Matador’s menu contain the same ingredients, a source for the outbreak may never be found. The search for an outbreak source is only made harder by the fact that 3 of those sickened in the outbreak reported that they did not eat at the Matador restaurant prior to their illness.

E. coli is a family of bacteria that live in most environments. The large majority of E. coli strains are harmless to humans. In fact, many beneficial strains of E. coli live in the intestines of humans and other animals. Some E. coli, though, produce toxins that can cause illness in humans. While there are six different categories associated with disease causing E. coli, the most common is Shiga toxin-producing E. coli, or STEC. Shiga toxin-producing bacteria are the cause of the Matador outbreak. These bacteria most commonly contaminate items such as beef, other meats, raw milk, apple cider, and cheese made with raw milk. E. coli can also to contaminate fruits, vegetables, and water. E. coli infections are one of the most common forms of foodborne illness. The CDC estimates that about 265,000 E. coli infections occur each year in the United States. While E. coli infections can affect people from any age group and background, young children and the elderly are at an increased risk of developing a serious infection or even HUS.

When contaminated food exposes someone to pathogenic E. coli bacteria, they can expect to see symptoms within an average of 3 or 4 days. Sometimes the bacteria could produce symptoms as early as one day or as late as ten days after the initial exposure. Symptoms of E. coli poisoning can vary, but most develop vomiting, fever, stomach cramps, and diarrhea. Doctors may test to confirm the presence of E. coli, but in most cases the best treatment for E. coli is rest and hydration. In most cases, an E. coli infection will subside on its own within a week. However, some cases of E. coli infections can be life threatening.

In about 5 to 10% of E. coli poisoning cases, a complication called hemolytic uremic syndrome (HUS) arises. HUS is a complication that damages red blood cells in the bloodstream. These damaged cells undergo a filtration process and the kidneys dispose of them. Filtering these HUS-affected blood cells can cause damage to the kidneys, and could even lead to kidney failure. HUS can cause other symptoms, including decreased frequency of urination, loss of color in the eyes and cheeks, and fatigue. If you or a loved one begins to show the symptoms of E. coli poisoning or HUS, contact a medical professional.

 

Sources:

http://www.cdc.gov/ecoli/general/index.html

http://kingcounty.gov/healthservices/health/communicable/diseases/outbreak/matador.aspx