By: James Peacock

Health officials in Mississippi have started the new year dealing with an outbreak of E. coli connected to the popular restaurant Captain Al’s Steak and Shrimp. The restaurant, which is in Gulfport, Mississippi, was closed on January 4 by health officials after it became clear that the restaurant was responsible for the dozens of cases of illness that had impacted the surrounding area. The Mississippi State Department of Health has reported that at least 50 people have been sickened because of the restaurant. These cases of illness began to be reported on December 16, 2016, and eventually stopped on December 30, 2016. While the source of the outbreak has been pinpointed as Captain Al’s Steak and Shrimp, health officials have yet to determine the specific food or drink that has been contaminated with E. coli bacteria. More than 20 people have reported needing to see a doctor because of their illness, and one person has required hospitalization. The Mississippi State Department of Health reports that a large majority of the cases have presented with diarrhea and stomach cramps. Chills, headaches, nausea, and fever have also been reported by those sickened in this outbreak. Most of the illnesses began to present symptoms around 24 hours after the infection took place.

Captain Al’s Steak and Shrimp released a statement shortly after the restaurant was closed by the health department. In this statement, found on the restaurant’s Facebook page, states that the restaurant “[closes] to remodel the restaurant, do any maintenance or just deep clean the entire place,” just about every year. The restaurant has been cooperating with health officials, who have been inspecting and investigating the restaurant. Though the investigation is still ongoing, the restaurant has reopened since the news of the outbreak was released. The restaurant was allowed to reopen on January 11, 2017 after being closed for one week. Even though they have reopened, the Health Department will continue to investigate the outbreak, as well as perform periodic inspections on the restaurant in order to determine whether Captain Al’s Steak and Shrimp has the potential to cause more illnesses.

The process of investigating an outbreak usually occurs after there is a spike in illnesses. Health officials have studied for years the average rate that specific pathogens cause illness, and are able to track when these background infections suddenly change. When a random spike in illnesses is detected, health officials can then investigate the outbreak, usually by taking samples and by conducting interviews. There is sometimes a correlation between interview answers, which can help investigators locate a source. Although interviews can help locate potential sources, the best way for health officials to learn more about an outbreak is through the testing of samples. When medical providers retrieve samples from ill people or from the environment, the samples undergo testing to learn more about them. This type of testing reveals is the bacteria’s DNA fingerprint. This fingerprint, a solution of the process of pulsed field gel electrophoresis, is unique to the bacteria and strain involved in the outbreak. The DNA fingerprint is then uploaded to the PulseNet system. The PulseNet system is a database of DNA fingerprints maintained by the CDC. If a saved sample matches another sample, there may be a connection between the two. When multiple samples match through the PulseNet system, it is another clue to investigators about the origin and size of the outbreak.

E. coli infections are one of the most common forms of foodborne illness. The CDC estimates that around 265,000 E. coli infections occur annually in the United States. There are a wide variety of E. coli bacteria, but the ones that most commonly cause outbreaks are known as Shiga toxin-producing E. coli, or STEC. In this outbreak, though, the pathogen responsible for these illnesses is not STEC, but rather enteropathogenic E. coli, or EPEC. While this is a different type of E. coli, the progression of the illness and treatment options are very similar. One of the main differences between EPEC and STEC is that EPEC will sometimes not show up on a stool test, while STEC will most of the time. Many EPEC infections require a special test called a PCR test to confirm the illness. A PCR test simply copies the DNA of a target sample over and over, making it easier to spot bacteria and viruses. When someone is exposed to pathogenic E. coli bacteria via contaminated food or water, they can expect to see symptoms within an average of 3 or 4 days. Most of the time, 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 of the time they include 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 a majority of instances an E. coli infection will subside on its own within a week. However, some cases of E. coli infection can be life threatening. While E. coli infections can affect people from any age group and background, young children, the elderly, and those with suppressed immune systems are at an increased risk of developing a serious E. coli infection or even hemolytic uremic syndrome.

In about 5 to 10 percent of E. coli poisoning cases, a complication called hemolytic uremic syndrome (HUS) arises. HUS is a complication that damages red blood cells. These damaged blood cells eventually travel to the kidneys, where they are filtered out of the bloodstream. Filtering these HUS-affected blood cells and removing them from the bloodstream 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. Health officials with the Mississippi State Department of Health have recommended that anyone who experienced diarrhea within ten days of attending the Captain Al’s Steak and Shrimp should contact them. If you or a loved one begins to show the symptoms of E. coli poisoning or HUS, contact a medical professional.