Public Health investigates E. coli outbreak

Public Health is currently investigating an outbreak of E. coli O157 – one of the most serious foodborne illnesses you can contract. Our thoughts are with the families affected by this outbreak, and we appreciate the support of the community as we work to protect the health of the public.

A person can get an E. coli O157 infection from many different sources: by eating or drinking something contaminated with animal or human fecal matter, through animal contact, or through contact with another person who has an E. coli infection. One of our responsibilities at Public Health is to track down these sources. When there are illnesses associated with any one of the more than 12,000 food establishments in the county, we search for contaminated products, ill food workers, or improper food handling.

We follow specific steps to find clues that help us pinpoint the source(s) that may be linked to illness. Here are key steps of this current investigation.

  1. We interviewed people who got sick.

At this time, we know that six people have been infected with the same strain of E. coli (three have been hospitalized). When Public Health determines that anyone is sick from a serious foodborne illness like E. coli, we interview them to determine what may have caused their illness. We do this to find the source of the outbreak and prevent others from getting infected. In this instance, through a few initial interviews with ill people, we determined that everyone who became sick had something in common – they ate food prepared by a local food vendor called Los Chilangos. Public Health took swift action and required Los Chilangos to cease operations.

UPDATE 9/2:
The investigation team is continuing to figure out where the E. coli O157 came from. We expected to find additional people who were exposed to the E. coli O157 linked to Los Chilangos before we closed them. To this point, we are able to say that there are three more people impacted by this outbreak, bringing the total to nine. These are not people who are newly ill, but rather people who were unable to be reached during our initial interview process or people who did not recall eating at Los Chilangos at the time of their interview. None of these nine people became sick after August 21.

UPDATE 9/3:
More interviews have brought the total number of people impacted by this outbreak to 10 individuals. This additional person is not newly ill, but rather someone who was unable to be reached during our initial interview process or someone who did not recall eating at Los Chilangos at the time of their interview.

UPDATE 9/8:
A total of 13 individuals have been impacted by this outbreak. These additional people are not newly ill, but rather people who were unable to be reached during our initial interview process or people who did not recall eating at Los Chilangos at the time of their interview.

UPDATE 9/15:
At this time, all individuals impacted by this outbreak are recovering. The last reported exposure date was more than a month ago, and no additional people have reported illness linked to this outbreak. At this point, we do not believe there is any ongoing risk. The investigation was not able to identify a specific ingredient associated with the illnesses.

We investigated a food business that was associated with the people who got sick.

But we didn’t stop there. Los Chilangos serves food at seven farmers markets in King and Snohomish Counties, operates two food trucks, and also caters events. Los Chilangos utilizes a shared kitchen space, called a commissary kitchen. The kitchen that they use is Eastside Commercial Kitchen, where they share space and equipment with about a dozen other food businesses.

UPDATE 9/2:
The Health Department enforces the food safety code to protect the public’s health. We permit businesses when they meet all of the requirements of the food code and are able to operate safely.

As of today at 12:00 pm, Los Chilangos was reopened. The business has taken all actions that the health department has required to resume safe operations going forward. Some of the key steps include:

· Disposed of all food that could have potentially been a source of the outbreak
· Assured that all food workers are not ill
· Identified and signed a contract with a new commissary, which we have approved following a site inspection
· Washed, rinsed and sanitized all of their equipment before moving it to the new commissary.
· Made all staff available for additional food safety education from public health inspectors including sanitation, cross contamination, and cold and hot holding.

  1. We intervened at the specific site and operation.

The condition of the commissary and the potential for cross contamination were deemed an imminent health hazard, and the health officer issued a cease and desist order to the commissary on Thursday, August 27. Additionally, all of the food vendors permitted by Public Health that use this kitchen were also told to cease operations. Recognizing that this lapse in operation hurts business, our team has worked diligently with these vendors to find new places for them to resume their work and remind them about important food safety measures.

UPDATE 9/2:
Eastside Commercial Kitchen remains closed at this time, pending completion of required corrective action.

UPDATE 9/8:
Eastside Commercial Kitchen reopened on September 4, following the completion of all corrective actions.

  1. Next steps: tracing the source

As of today, the investigation isn’t over. We are still investigating the source of the E. coli.  If we determine that a food contained the E. coli bacteria, we will try to trace it back to stores, suppliers, and even farms to address the root of the problem with corrective actions, if possible.

But, it’s possible that the source of E. coli may never be determined. E coli is often linked to beef, but it can also be linked to produce, such as spinach and sprouts, along with a variety of other foods such as unpasteurized juices, raw milk, game meats, and other common foods.

For outbreaks such as this one, we continue to monitor the situation and look for other common factors among ill people. While we know Los Chilangos is linked, they may not be the only ones involved. For instance, the source of E. coli could be served by other vendors.

We are currently working with all of the businesses connected to this outbreak to make sure that they are not using any products that may have become contaminated and that they have food safety measures in place. This includes having the businesses address needed repairs to their equipment, providing education to their staff, and ensuring their operations are safe to open.

Though Los Chilangos has been linked to this outbreak, they deserve credit for their dutiful cooperation during our investigation. No food vendor wants to make people sick, and we know everyone is very concerned about the people who have become ill. We will be updating this blog as the picture becomes clearer.

UPDATE 9/2:
Due to the seriousness of E. coli O157, we are ensuring that area physicians are aware of the outbreak and our ongoing investigation.

For information about E. coli, visit our website here: http://www.kingcounty.gov/healthservices/health/communicable/diseases/shigatoxin.aspx