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Public Health - Seattle & King County

Foodborne illness outbreak investigation summary

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E. coli O157:H7 investigation, June 10, 2016

Update: Laboratory testing confirmed that all three children have the same strain of STEC bacteria. This strain is the second most common type of STEC found  in Washington (1-2 cases per month statewide). Public Health investigators have not identified a common food consumed by all three children. While each ill child ate produce, there is no type of produce that all three report consuming. Investigators are not finding linkages to either meat products or common restaurants. The children became ill on 5/20, 5/28, and 5/29.  No additional illnesses have been reported; one child remains hospitalized.   Because this is a common strain and no common foods have been identified, these cases may be unrelated. Over the past 5 years, King County has had an average of 22 cases of STEC year-to-date and 28 cases this year so far. Most E. coli cases reported to the health department are isolated with causes never identified. Public Health will continue to investigate this outbreak.


Public Health is investigating a cluster of three E. coli infections caused by Shiga-toxin producing E. coli (also called STEC) among young children in King County. Public Health received the first report of illness on 5/26/16, the second report on 6/1/16, and the third on 6/6/16. All the children are under 5 years of age and developed symptoms including diarrhea that became bloody and abdominal cramps. Two children have been hospitalized with complications including a type of kidney injury called hemolytic uremic syndrome (HUS). The third child was not hospitalized and is recovering at home.

Testing (molecular fingerprinting) to determine if the three children have the same strain of STEC bacteria is underway at the Washington Public Health Laboratory at this time. Our investigation is in progress and it is not known at this time whether these cases may be linked through exposure to a common source or are unrelated (sporadic) cases.

STEC and other foodborne infections occur year round but may increase during the summer months. If you or your child develop new painful or bloody diarrhea, contact your healthcare provider to see if testing for STEC is needed.

About STEC:

E. coli bacteria normally live in the intestines of humans and animals. Many strains of E. coli bacteria exist, and most of them are harmless or beneficial to human health. STEC are strains of E. coli that produce Shiga toxin (such as E. coli O157:H7) and can cause serious illness in people.

Infection with STEC can occur through consumption of undercooked ground beef and other beef products; unpasteurized (raw) milk, cheese, and juice; contaminated raw fruits, vegetables, sprouts and herbs; water contaminated with animal feces, or by direct contact with farm animals or their environment. Ready-to-eat foods can also be contaminated with STEC through contact with raw beef or raw beef juices in the kitchen.

Symptoms of STECinclude diarrhea (which often becomes bloody) and stomach cramps, with mild or no fever.  Illness typically lasts several days and people can spread infection to others even after symptoms resolve.

To prevent STEC infection:

  • Avoid eating high-risk foods, especially undercooked ground beef and other beef products, unpasteurized (raw) milk or juice or cheese, and raw sprouts.
  • Use a food thermometer to make sure that ground beef has reached a safe internal temperature of 160° F.
  • Wash hands before preparing food, after diapering infants, and after contact with cows, sheep, or goats, their food or treats, or their living environment.
  • Thoroughly wash fresh produce before eating.

For more information about STEC, see:


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Private event, June 9, 2016

Public Health recently investigated an outbreak of salmonellosis (caused by Salmonella bacteria) associated with a private event that occurred in late March. Three laboratory-confirmed and five probable cases of salmonellosis were reported and interviewed by Public Health; one person required hospitalization.

Several foods for the event, attended by roughly 200 people, were prepared in a private kitchen where cross-contamination, insufficient cooking, and inadequate refrigeration may have occurred and resulted in bacterial contamination of one or more food items served at the event. No single food item was identified as the definitive source of illness. Public Health Environmental Health staff helped provide educational information on safe food handling practices, as well as guidance on how to become a licensed caterer in the county.

About salmonellosis:

Salmonellosis is a bacterial infection that is often spread through the fecal-oral route, through contaminated food and water, or through contact with animals and their environments. Symptoms of salmonellosis include nausea, vomiting, diarrhea, headache, fever, chills, and abdominal cramping. Illness typically lasts several days and people can spread infection to others even after symptoms resolve.

To prevent Salmonella infection:

  • Wash hands with soap and water after going to the bathroom, changing diapers, touching animals, and before eating or preparing food.
  • Cook all meats thoroughly, especially poultry.
  • Wash cutting boards and counters used for meat or poultry preparation immediately after use to avoid cross contaminating other foods.

For more information about salmonellosis, see:


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Miller's Guild (Seattle), June 3, 2016

Public Health investigated an outbreak of gastroenteritis with vomiting, diarrhea, aches and nausea associated with Miller’s Guild restaurant at 621 Stewart Street, in Seattle. Eight people from one party became ill after eating at the restaurant on 5/19/2016; there were no hospitalizations. Symptoms and timing of illness onset are suggestive of a bacterial toxin from Bacillus cereus or Clostridium perfringens. No tests were done to confirm which pathogen caused the illness: bacterial toxin illnesses are typically short-lived and by the time people seek care – if they do at all – it is too far from exposure to test. Commonly consumed food items that may have caused the illnesses include the charcuterie plate and french fries.

Public Health learned of the outbreak on 5/23/16. No other illnesses associated with this restaurant have been reported since then. An investigation of the restaurant found several violations including improper hot-holding, inadequate cold-holding, handling ready-to-eat foods with bare hands, and not having permission to vacuum pack foods. Public Health educated restaurant management on the risks involved in vacuum packing foods, and explained the procedures to obtain the appropriate health permits required to assure it’s being done safely.  Inspectors will return to the restaurant to follow up on these procedures.

B. cereus and C. perfringens are both bacteria that grow rapidly at room temperature. When cooking potentially hazardous foods, it's important to keep food out of the danger zone, which is 41 to 135 degrees Fahrenheit by serving while the food is still hot, refrigerating quickly after cooking, or holding at a minimum of 135 degrees.


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663 Bistro (Seattle), April 27, 2016

Public Health is investigating an outbreak of salmonellosis (caused by Salmonella bacteria) associated with 663 Bistro, 663 S Weller S, Seattle 98104. As of 4/27/16 four people from three separate meal parties became ill after eating at the restaurant between 3/11/16 and 4/08/16; one of the ill persons was hospitalized.

Laboratory testing has indicated that three of the cases are infected with the same strain of Salmonella bacteria, called Salmonella braenderup. In typical years, fewer than five cases of this strain are reported in King County.

Public Health received the first report of illness on 3/28/16. The second case was reported on 4/7/16, and the common restaurant exposure was identified during a case interview on 4/8/16. The most recent case was reported on 4/19/16. Public Health performed a field investigation of the restaurant on 4/12/16, which resulted in temporary closure of the facility. The decision to suspend the restaurant's permit was based on observation of repeat improper food handling practices. The restaurant was permitted to re-open on 4/14/16, a second closure occurred after re-inspection on 4/26/16 because of continued repeat violations. The establishment was reopened on 4/27/2016 after passing a re-inspection. Environmental Health investigators will continue to work with the restaurant owners and employees on maintaining safe food handling practices.

About salmonellosis:

Salmonellosis is a bacterial infection that is often spread through the fecal-oral route, through contaminated food and water, or through contact with animals and their environments. Symptoms of salmonellosis include nausea, vomiting, diarrhea, headache, fever, chills, and abdominal cramping. Illness typically lasts several days and people can spread infection to others even after symptoms resolve.

To prevent Salmonella infection:

  • Wash hands with soap and water after going to the bathroom, changing diapers, touching animals, and before eating or preparing food.
  • Cook all meats thoroughly, especially poultry.
  • Wash cutting boards and counters used for meat or poultry preparation immediately after use to avoid cross contaminating other foods.

For more information about salmonellosis, see:

About S. braenderup:

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Chili's South Indian Cuisine (Seattle), April 26, 2016

Public Health investigated an outbreak of salmonellosis (caused by Salmonella bacteria) associated with Chili's South Indian Cuisine at 4220 University Way NE in Seattle. Two people from separate meal parties became ill with diarrhea after eating at the restaurant between 12/27/15 and 1/06/16; there were no hospitalizations.

Laboratory testing has indicated that both of the people with lab-confirmed infection had the same strain of Salmonella bacteria. In typical years, fewer than ten infections with this strain are reported in King County.

Public Health received the first report of illness on 1/07/16. The second illness was reported on 1/15/16, and the common restaurant exposure was identified during a case interview on 1/28/16. Public Health performed a field investigation of the restaurant on 2/2/16. Although there were no recent reports of employee illness, our food safety experts requested testing of all employees who had recently traveled outside of the country. Additionally, testing was performed on spices that had been imported from India, because review of nationwide data on this strain suggested a pattern of consumption of Indian foods. Salmonella bacteria were not detected in the restaurant employees or any of the spices tested. The restaurant worked cooperatively with Public Health. Several weeks have passed and Public Health has received no additional reports of illness associated with Chili’s. There is no indication of ongoing risk at this time.

About salmonellosis:

Salmonellosis is a bacterial infection that is often spread through the fecal-oral route, through contaminated food and water, or through contact with animals and their environments. Symptoms of salmonellosis include nausea, vomiting, diarrhea, headache, fever, chills, and abdominal cramping. Illness typically lasts several days and people can spread infection to others even after symptoms resolve.

To prevent Salmonella infection:

  • Wash hands with soap and water after going to the bathroom, changing diapers, touching animals, and before eating or preparing food.
  • Cook all meats thoroughly, especially poultry.
  • Wash cutting boards and counters used for meat or poultry preparation immediately after use to avoid cross contaminating other foods.

For more information about salmonellosis, see:

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Stanford's Restaurant & Bar (Tukwila), March 15, 2016

Public Health investigated an outbreak of gastroenteritis with nausea, vomiting, diarrhea, and cramps associated with Stanford's Restaurant & Bar, 17380 Southcenter Parkway, Tukwila 98188. Two people from separate meal parties became ill after eating at the restaurant between 2/14/16 and 2/18/16; neither were hospitalized. Symptoms and timing of illness onset suggested that the cause of the illness was a bacterial toxin. No tests were done with the two ill people to confirm which pathogen caused the illness: bacterial toxin illnesses are typically short-lived and by the time people seek care – if they do at all – it has been too long from exposure to test. Commonly consumed food items that may have caused the illnesses include dishes containing meat, which is frequently associated with the bacterial toxins in question.

Public Health received the first report of illness 2/16/16. On 2/19/16, a second person reported becoming ill from the same venue. Public Health performed a field investigation of the restaurant on 2/26/16. During this investigation, inspectors ensured that no suspect food remained in the restaurant. Inspectors also identified factors that may have contributed to this foodborne illness outbreak, including room temperature storage of potentially hazardous food, inadequate hand washing, & cross contamination. A return inspection on 3/3/16 found that all violations were corrected.

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El Camion 3 food truck (Seattle), March 10, 2016

Public Health is investigating an outbreak of gastroenteritis with vomiting, diarrhea, aches and cramps associated with El Camion 3, a food truck that operates at 5314 15th Ave NW, in Seattle. Two people from separate meal parties became ill after eating at the food truck between 2/29/16-3/7/16; neither was hospitalized. Symptoms and timing of illness onset are suggestive of a bacterial toxin from Staphylococcus aureus ("Staph") or Clostridium perfringens. No tests were done with the two ill people to confirm which pathogen caused the illness: bacterial toxin illnesses are typically short-lived and by the time people seek care – if they do at all – it is too far from exposure to test. Commonly consumed food items that may have caused the illnesses include carne asada, and raw vegetables such as lettuce and tomatoes.

Public Health received the first report of illness 3/1/16. On 3/8/16, a second person reported becoming ill from the same venue. Public Health performed a field investigation of the food truck and its commissary on 3/9/16. During this investigation, inspectors identified factors that may have contributed to this foodborne illness outbreak, including improper cooling and room temperature storage of potentially hazardous food. Given these and other repeated violations, Public Health has suspended the food truck’s permit and destroyed potentially hazardous foods that had been temperature abused. Though Public Health does not permit commissaries for mobile food vehicles directly, when a mobile vendor’s permit is suspended, its entire operation must close until approved to re-open by Public Health. El Camion also operates a brick-and-mortar restaurant located at 6416 15th Ave. NW. This location has not been implicated in the outbreak, but has decided to close on its own.

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Small Frye's (Fall City), March 3, 2016

Public Health is investigating an outbreak of gastroenteritis with vomiting, nausea and diarrhea associated with Small Frye's restaurant located at 4225 Preston Fall City Road SE, Fall City, WA. As many as 4 people became ill after eating at the restaurant on 2/18/16. Public Health learned of the outbreak on 3/1/16.

We do not have laboratory confirmation of the etiology, but symptoms are suggestive of norovirus. Often in norovirus outbreaks no laboratory testing is done. The exact food item that caused the illnesses has not yet been identified, though this is not uncommon for outbreaks of norovirus when multiple food items may be contaminated.

The restaurant is working cooperatively with Public Health. After a field inspection, we identified several factors that could have contributed to this outbreak, including an ill food worker on the premises, inadequate handwashing, and inadequate handwashing facilities. In response, we have suspended the restaurant’s permit so that they may correct these issues, decontaminate the facility, and exclude the ill food worker from the operation.

About norovirus:

Norovirus is a highly contagious virus that is frequently spread person-to-person and is often associated with food. Learn more about norovirus at Public Health's website. Norovirus illness often has a sudden onset of nausea and vomiting and/or watery diarrhea with cramps. A low grade fever, chills, and body aches sometimes occur. Norovirus rarely causes severe complications. Dehydration is the most common complication, particularly among young children and the elderly. No vaccine is available for norovirus. Anyone with norovirus symptoms should wait at least 48 hours after their last episode of vomiting and/or diarrhea before preparing food for others. Wash hands with soap and water after using the toilet or changing diapers, and before preparing food or eating. Because raw seafood can be contaminated with Norovirus, always cook shellfish and other seafood thoroughly before eating.

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Puerto Vallarta restaurant (Federal Way) February 10, 2016

Public Health investigated an outbreak of gastroenteritis with vomiting and diarrhea associated with Puerto Vallarta restaurant located at 35105 Enchanted Pkwy S, #103, Federal Way. As many as 8 people became ill after eating at the restaurant on 1/30/16. We do not have laboratory confirmation of the etiology, but symptoms are suggestive of norovirus. Often in norovirus outbreaks no laboratory testing is done. Public Health learned of the outbreak late on Tuesday, 2/2. The restaurant worked cooperatively with Public Health, and we have discussed norovirus control measures with the person in charge. Public Health has not received any additional illness reports.

Public Health learned of the outbreak late on Tuesday, 2/2. The restaurant is working cooperatively with Public Health, and we have discussed norovirus control measures with person in charge. Public Health staff will be conducting interviews of ill persons. People who are ill with vomiting or diarrhea for more than 3 days, or who have signs of serious illness like bloody diarrhea should see a health care provider.

About norovirus:

Norovirus is a highly contagious virus that is frequently spread person-to-person and is often associated with food. Learn more about norovirus at Public Health's website. Norovirus illness often has a sudden onset of nausea and vomiting and/or watery diarrhea with cramps. A low grade fever, chills, and body aches sometimes occur. Norovirus rarely causes severe complications. Dehydration is the most common complication, particularly among young children and the elderly. No vaccine is available for norovirus. Anyone with norovirus symptoms should wait at least 48 hours after their last episode of vomiting and/or diarrhea before preparing food for others. Wash hands with soap and water after using the toilet or changing diapers, and before preparing food or eating. Because raw seafood can be contaminated with Norovirus, always cook shellfish and other seafood thoroughly before eating.

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Green Leaf Vietnamese Restaurant (Seattle) February 3, 2016

Public Health recently investigated two illnesses associated with Green Leaf Vietnamese Restaurant located at 418 8th Avenue South in Seattle. Two people (both male) ate at the restaurant on 1/18/16 and became ill with gastrointestinal symptoms, fever and headache on 1/19/16; neither were hospitalized. Symptoms and timing of illness onset were consistent with the diarrheal form of Bacillus cereus or Clostridium perfringens. The food source that led to these illnesses is unknown, but both people ate dishes containing meat, which is a frequent vehicle for bacterial toxins such as B. cereus or C. perfringens. No tests were done with the two ill people to confirm which pathogen caused the illness: Bacterial toxin illnesses are typically short-lived and by the time people seek care – if they do at all – it is too far from exposure to test.

Public Health learned of the outbreak on 1/19/16. No other illnesses associated with this restaurant have been reported since then. An investigation of the restaurant found several problems including improper cooling, inadequate cold-holding, and inadequate temperature monitoring of foods that are potentially hazardous. Inspectors held an administrative hearing with restaurant management which included a review of proper cooking, cooling, and food storage. Inspectors will return to the restaurant to follow up on these procedures.

B. cereus and C. perfringens are both bacteria that grow rapidly at room temperature. When cooking potentially hazardous foods, it's important to keep food out of the danger zone, which is 41 to 135 degrees Fahrenheit by serving while the food is still hot, refrigerating quickly after cooking, or holding at a minimum of 135 degrees.

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Maggiano's Little Italy (Bellevue), February 9, 2016 - Final report. We do not anticipate any more updates to this summary

Public Health investigated an outbreak of norovirus-like illness associated with Maggiano's Little Italy restaurant in Bellevue. People from several unrelated private events at Maggiano's reported symptoms consistent with norovirus following meals that were consumed between January 18th and January 23rd. As many as 60 people may have been impacted by the outbreak, though not all were interviewed directly by Public Health. Several restaurant workers also reported being ill with symptoms consistent with norovirus dating back to January 9th and over the subsequent two weeks.

Public Health learned of the outbreak late on Friday, January 22nd. The restaurant worked cooperatively with Public Health; their food business permit was temporarily suspended to allow time for thorough cleaning and sanitizing and the restaurant was reopened on January 27th. No additional reports of illness have been received following the reopening.

About norovirus:

Norovirus is a highly contagious virus that is frequently spread person-to-person and is often associated with food. Learn more about norovirus at Public Health's website. Norovirus illness often has a sudden onset of nausea and vomiting and/or watery diarrhea with cramps. A low grade fever, chills, and body aches sometimes occur. Norovirus rarely causes severe complications. Dehydration is the most common complication, particularly among young children and the elderly. No vaccine is available for norovirus. Anyone with norovirus symptoms should wait at least 48 hours after their last episode of vomiting and/or diarrhea before preparing food for others. Wash hands with soap and water after using the toilet or changing diapers, and before preparing food or eating. Because raw seafood can be contaminated with Norovirus, always cook shellfish and other seafood thoroughly before eating.

How to report possible foodborne illness
If you or others in your party got sick and you think it might have been from food prepared at a King County food service establishment, call 206-296-4774 during business hours (Monday - Friday, 8 am to 5 pm) to report the illness. Learn more about what details we need from you when you call.

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