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AT-A-GLANCE

  • Cases: 22 WA cases
  • Hospitalizations: 1
  • Deaths: 0
  • Status: Investigation is completed
  • Locations: Sodexo's Café Mario, located at Nintendo of America, 4600 150th Ave NE, Redmond, WA 98052
  • Meal dates: Multiple meals dates
  • Prior food safety inspections and current rating?

Highlights

Updated April 4, 2019

Summary

Public Health investigated an outbreak of Shiga toxin-producing E. coli (STEC) associated with I Love Sushi and Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. I Love Sushi is a food establishment that operates out of Café Mario once a week.

This outbreak appears to be over. After a thorough investigation, we do not have enough evidence to connect I Love Sushi to this outbreak.. No single food item prepared by Café Mario has been identified as the source of the illnesses. Everyone who reported illness has recovered.

Illnesses

Since July 2, 2018, we have learned of 22 people in WA (20 in King County and 2 in Snohomish County) who developed symptoms consistent with an STEC illness, including diarrhea (bloody or non-bloody) and abdominal cramps. All 22 of these ill people are adults who work at the Nintendo of America campus in Redmond. Illness onsets occurred during June 11-July 5, 2018.

The 22 people who got sick all ate food from Café Mario on multiple days before becoming ill. Only four people who got sick also ate at I Love Sushi.

We learned of two additional people from King County who tested positive for E. coli infections with the same bacterial strain as the cases associated with Café Mario. However, these two people had no known connection to Café Mario or Nintendo, and we could not identify any other potential sources of exposure in common with any of the other people who got sick. We are not including these two people in the overall case count of this outbreak.

Public Health actions

On July 3, 2018, Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.
At Café Mario, investigators identified possible risk factors for cross contamination and spread of bacteria, including improper hand washing practices and improper cold holding temperatures of food; corrective actions were addressed with Café Mario’s management. At I Love Sushi, possible risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on the July 4 holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Investigators revisited both food establishments on July 11, 2018, and both were allowed to reopen the same day. Café Mario and I Love Sushi both completed a thorough cleaning and disinfection of their facilities before reopening, and any remaining processed ready-to-eat food products were discarded.

We did not identify any employees of either restaurant who had a recent diarrheal illness. Investigators also reviewed with management of both food establishments the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

Laboratory testing

Four of the 22 people who got sick tested positive for STEC O26 with the same genetic fingerprint, suggesting that they have a common source of infection. The remaining people who got sick were not tested for STEC, but their symptoms are suggestive of STEC.

Environmental swabs were collected from both I Love Sushi and Café Mario for laboratory testing and all came back negative for STEC at the Washington State Public Health Laboratory.

Report possible foodborne illness

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 STEC include 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.
  • STEC infections usually resolve in 5–7 days, but recovered individuals may still spread the bacteria. Up to one third of children may continue to excrete STEC for as long as 3 weeks.

  • People sick with suspected STEC infection should not work in food handling, patient care, or childcare settings, and children sick with suspected STEC infection should not attend daycare until they have seen a healthcare provider and been tested for STEC infection, even if their illness is mild. People with an STECinfection who work in or attend these sensitive settings must be cleared by Public Health before returning.

Prevention

General advice for reducing risk of contracting STEC:

  • 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.

More information about STEC

Link/share this page at www.kingcounty.gov/outbreak/mario