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Source of illness is E. coli
The state confirms the bacteria is behind an outbreak that has sickened dozens, one fatally.


 
By KIM ARCHER World Staff Writer
Published: 8/28/2008  2:17 AM
Last Modified: 8/28/2008  9:23 AM

The state confirms the bacteria is behind an outbreak that has sickened dozens, one fatally.



An unusual and virulent type of E. coli bacteria caused an outbreak that killed a Pryor man and hospitalized more than 40 other people in northeastern Oklahoma, the State Department of Health confirmed Wednesday.

Specimens from 10 patients were confirmed to be a shiga-toxin producing form of E. coli, a type of enterohemorrhagic bacteria that can cause illness ranging from mild intestinal disease to severe kidney complications, state epidemiologist Dr. Kristy Bradley said.

"These toxins are responsible for the very severe disease that we are seeing in many persons sickened by this outbreak," she said.

Also Wednesday, Bradley directly linked the outbreak to the Country Cottage restaurant in Locust Grove.

State health officials had noted Monday that most of the sickened patients had eaten there.

Bradley said Wednesday that some of the people infected with the bacteria had not eaten at the restaurant but likely were infected by others who had eaten there.

"We know that something at the restaurant led to this foodborne illness outbreak," Bradley added.

A Tulsa World call to Country Cottage owners Dale and Linda Moore was not returned by publication time.

The Moore family said in a statement, though, that the Country Cottage will remain closed indefinitely while the Health Department continues its investigation into the source of the contamination.

In
a written statement, the Moores said, "While we feel somewhat relieved in knowing what the cause is, it is difficult to put into words how heartbroken and distraught we are for our entire community, including our close friends and neighbors who are sick or those who have relatives who are sick."

The Moores declined to reveal the suppliers for their meat, produce and other food products.

However, Bradley said Wednesday that "we think it's much less likely that it was a contaminated food item and more likely cross-contamination."

In other words, state health officials think the source likely was not food that came contaminated from a supplier but something that became contaminated after it was in the restaurant.

Bradley also said she believes that officials are "zeroing in on the source" of contamination and could know within the next day or two.

She said the potential for spreading the diarrheal illness to close contacts or household members is high.

"Only a few bacteria can make a person sick, and these bacteria can be easily transmitted person-to-person if infected persons do not wash their hands after using the toilet or changing diapers," Bradley said.

She urged physicians treating patients with the gastrointestinal illness to refrain from using antibiotics and anti-diarrheal medication.

Such treatments could worsen the illness by releasing the toxins further into the system instead of allowing them to pass through the patient's system.

Bradley said state officials sent the specimens to the federal Centers for Disease Control and Prevention for help in determining specifically what kind of E. coli was present because it "did not match anything we have had previously in Oklahoma."

The incubation period from the time of exposure to this E. coli strain can be as short as two days or as long as 10 days, she said, adding that "conceivably we could continue to see new cases until the end of the month."

"I wish I could say the outbreak is coming to an end," she said, but information from hospitals indicates that new patients are continuing to come in.

"While we cannot predict at this point how long this outbreak will continue, we believe we have prevented the spread of any further cases that may have been connected to eating at Country Cottage at Locust Grove," Bradley said.

The town of Locust Grove had tested its water supply to make sure it was not the source of contamination.

Mayor Shawn Bates said late Wednesday that the samples tested came back free of E. coli or any other dangerous bacteria.

The Oklahoma Department of Environmental Quality also tested water samples this week, but the results of those tests had not come back by Wednesday.




Kim Archer 581-8315
kim.archer@tulsaworld.com




E. coli probe: Health dept. findings



  • State Health Department confirms E. coli strain as cause of deadly illness.


  • Country Cottage restaurant directly linked to the outbreak, state official says.


  • 42 patients now hospitalized in Tulsa; one man has died.





Timeline



  • Sunday, Aug. 17 —Newlywed Chad Ingle eats at Country Cottage in Locust Grove.


  • Tuesday, Aug. 19 — First patients complaining of severe intestinal pain begin arriving at Integris Mayes County Medical Center in Pryor


  • Wednesday, Aug. 20—Chad Ingle and more patients arrive at Integris Mayes County Medical Center


  • Friday, Aug. 22 —St. Francis Hospital reports suspected outbreak to Oklahoma State Department of Health.


  • Saturday, Aug. 23 — OSDH conducts surprise inspection at Country Cottage.


  • Sunday, Aug. 24 — Chad Ingle, a 26-year-old Pryor man, dies at St. Francis Hospital.


  • Monday, Aug. 25 — OSDH releases first public alert about illness, noting that most patients had eaten at Country Cottage in Locust Grove. At this point, the state health department was reporting one death, 14 hospitalizations and 20 other cases under investigation.


  • Tuesday, Aug. 26 — St. Francis Hospital confirms it has 13 children and 23 adults hospitalized with the illness. Four of the children are intensive care and three of those are on kidney dialysis. Two children from St. Francis, a brother and sister, were sent to OU Children's Hospital in Oklahoma City. Officials there declined to release their conditions. OSDH sends out second alert reporting 17 hospitalizations and more than 40 cases under investigation.


  • Wednesday, Aug. 27 — Oklahoma State Department of Health confirms the illness outbreak is linked to an unusual strain of E. coli that causes severe illness. OSDH updates its number of hospitalizations to 42 people.


  • Where the patients are now:



    St. Francis Hospital: 23 adults and 13 children
    • St. Francis Hospital South: 4 adults


    • St. John Medical Center: 2 adults


    • St. John Owasso: 0


    • Hillcrest Medical Center: 0


    • Oklahoma State Medical Center: 0


    • Bailey Medical Center: 0


    • Southcrest Hospital: 0


    By KIM ARCHER World Staff Writer

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    Report Comment
    zanesmomma03+1, Tulsa (8/28/2008 6:49:30 AM)
    I am so sorry to hear this. Working in the food industry is a challenge on many levels. But when an outbreak of this sort is proven to have one source, in this case the Country Cottage, I feel it is necessary to severly punish or reprimand those that are in charge.

    In the restaurant business, people trust us to provide them with safe and nutritious meals. When we do something as professionals to loose that trust, it can be devastating to the business. Sadly, this is probably due to one employee who didn't feel the need to follow the rules (which unfortunetly I see alot of in this industry), but the restaurant will ultimately pay for it.

    When we decide to go into the business of serving others, we have to hold our position and yes our power up with the utmost regards for our customers. We literally hold their lives in our hands (as you have seen from this outbreak). So all I ask is if you are in the food industry, please be overly cautious of what you are doing. You alone can reak havoc in an individuals life just by not following proper sanitation and safety rules. If you are not sure, err on the side of caution. These customers are trusting us with their lives. View that as a compliment and with gratitude and do all you can to protect those you serve.

    Again, I am sorry that this is happening to a great family-owned and operated restaurant that has always been supportive of its community. It truly saddens me to know that this could be its demise, but let this be a lesson to other restaurants that bend or just break the rules. Now we as Oklahoma's truly see firsthand the results that come from cross-contaimination and unproperly handling food and personal hygiene.

    My prayers go out to not only the families and friends of the ill, but also to the owners and workers of this restaurant.
    Report Comment
    jimnsusie, pryor (8/28/2008 7:12:30 AM)
    Yes this is awful, I lost a great friend and a wonderful co-worker, but most of all this could have happened anywhere. We as co-workers need to start taking responsibility for others. When we notice people not following the rules it should be reported. We all need to be responsiby. This could happen again anytime anywhere. Please advice your co-workers, friends, children, family no matter where you work, live or what you do we must wash our hands and get into a habit of singing Happy Birthday through two times and maybe we will stop being in such a hurry to go on do what it is we do. This keeps us all responsible for each other. I know Chad would want us to all take care of each other and pray for the families that have people sick and the ones that are fighting off this illness. Love One Another
    Report Comment
    zanesmomma03+1, Tulsa (8/28/2008 7:45:29 AM)
    Unfortunetly "A",

    I did read the article and it states in paragraph three, and I quote, "Also Wednesday, Bradley directly linked the outbreak to the Country Cottage restaurant in Locust Grove".

    That means the outbreak started at the Country Cottage and those that did not eat there were exposed to the disease by second-hand measures. The only thing they are uncertain of, is the exact source within the restaurant.

    Also I am not condeming the restaurant, if you read my comment, I find it sad that a company will suffer due to the actions, again I am assuming just from being in the industry, of a single employee. I am heart broken to know that this restaurant may be out of business because of this. But it is a lesson for the rest of us.

    I grew up in a small town just like this one, and I know what these little mom and pop shops do for the community. And like I said, my prayers not only go out to the family and friends of the ill, but also to the owners and employees of the Country Cottage.

    My comment was mostly intended to let others in the industry know that there is a real risk to not practicing proper sanitation and food handling. I see too many people daily not take the whole situation seriously. So let this outbreak be a lesson to all of us that no matter what we choose to do in life, someone depends on us to be safe. It is up to us to protect eachother from things such as this.
    Report Comment
    Bubba in Glenpool, (8/28/2008 9:27:20 AM)
    Tulsa World, I am going to give you the benefit of the doubt that you just made a typo in this: in the "Timeline" portion you have Sunday, the 24th listed after Monday, the 25th when we all know that the Sunday comes before Monday and the 24th comes before the 25th. One could make the argument that you are attempting to cover up for the OSDH by making it appear that it didn't take a person's death for them to notify the public that something went awry at the restaurant in Locust Grove, but indeed it did take this young mans life for the public to be notified of this health risk. Will you please change the "Timeline" portion of the article to properly reflect the true timeline of events! Thank you!
    Report Comment
    World Staff Writer Kelly Hines, Tulsa (8/28/2008 9:35:25 AM)
    Bubba in Glenpool: The timeline was correct in our print editions, but online those two days were transposed and the past two days were inadvertently omitted. The errors have now been corrected. Thank you for bringing it to our attention.
    Report Comment
    What were they thinking, bixby (8/28/2008 10:03:16 AM)
    Wow, Kelly responding. This on line thing is really going places. I like it. Oh and good picture too Kelly.

    What we fail to see hear is that , this could have been brought in by a customer, a delivery person. E-coli is very rugged.

    But it does make everyone much more aware of the need to wash there hands more regular.
    Report Comment
    ARC, (8/28/2008 10:14:35 AM)
    Williamjohn, again, you are not reading the article correctly. It could very well have been a customer who contaminated food and not the owner. There is no evidence they were negligent. So please stop blaming the owners. This could happen anywhere.
    Report Comment
    MovedAway, (8/28/2008 10:44:47 AM)
    Would it be possible to have a sink outside of the restrooms where the employees were required to wash their hands under supervision? The supervisor would record the time and initial it.
    It would have saved a life and several illnesses, including dialysis for children.
    Report Comment
    What in the World!, Hometown Tulsa / Edmond (8/28/2008 10:51:52 AM)
    "Bradley directly linked the outbreak to the Country Cottage restaurant in Locust Grove"! Sad story. I think I shall steer clear of buffets from now on!
    I wish those sickened from this have a speedy recovery. My condolences to the family that lost their loved one due to this.
    Report Comment
    mobro, (8/28/2008 11:25:16 AM)
    Does anyone know if the restaurant restrooms had paper towels, or do they have air dryers? An infected employee or customer who doesn’t wash their hands can leave the pathogen on the door handle. By using a paper towel to open the door employees (and customers) can avoid picking up the bacteria left by a previous user. But even this practice doesn’t reduce the chance transmission by using the common server utensils on the buffet.
    Report Comment
    Ray, (8/28/2008 1:02:05 PM)
    We love/loved Country Cottage and drove there at least once a month but one thing that has always bothered us is the location of the restrooms. This should be examined as a possible problem. Both restrooms are in a narrow hallway with doors opening into both the restaurant and the kitchen. I've always asked to be seated away from the restroom because it just seemed unsanitary to have those doors swinging open constantly, with flying germs, real or imagined.
    Report Comment
    matt w, Tulsa (8/28/2008 1:39:05 PM)
    MovedAway and Williamjohn322, They have said that there was no trace of E.coli in the restaurant. They are not sure how it got there. Washing hands may not have been the issue, so no it wouldn't have really saved anyone anything. Why would you bulldoze the place?? Thats just retarded!!
    Report Comment
    Ralph, (8/28/2008 1:43:49 PM)
    One of the things I would like the state and the inspectors to do is follow the way eating establishments are rated in California. It is nice that we can look it up on the internet, but it would be much nicer if they were given a grade sign A, B, C, or D. This sign would have to be displayed in a front window at all times. When we visit California any restaurant with a B, C, or D is not the place to eat. It forces the owners to pay very close attention to the cleanliness and food handling.
    Report Comment
    Stanley, (8/28/2008 2:17:17 PM)
    So, where's the connection to the restaurant? Not all ate there, not even close.
    Report Comment
    Stanley, (8/28/2008 2:23:16 PM)
    I know for a fact that some never ate there and had no contact with anyone who had. How do they explain those cases?
    Report Comment
    grannyofpremie, Inola (8/28/2008 2:25:25 PM)
    Everyone should pray over their food before eating whether in a public place or at home. God blesses our food and protects us if we only ask him to.... I went thru something similar in July with a grandchild, 6 days in the hospital, so I can say, my heart does go out for those involved and instead of condeming the Country Cottage, we should pray for it and the owners also, put yourself in their mocassins, how would you feel if it were you in their mocassins? And by the way, to the Locust Grove Water tester, have you tested the Spring Water over at the park? Is it ok? Alot of people get water from over there, I know that to be facts, get it there myself.... pray one for another, so pray for these who are sick , and their families, but also pray for the Cottage and the owners.....
    Report Comment
    Enough, (8/28/2008 4:08:20 PM)
    Sad to say, but even with rules, signs, extra sinks, continuing education, and the like, there are always those who disregard them and will continue to do so.

    We cannot blame the Moore's, as it is likely that they have all these things in place, but they cannot be held responsible to stand over a person and make them wash their hands.

    This is about personal accountability, and it is at every level; rich or poor, educated or not. I have been in the corporate world for years, eat out regularly, and everywhere that I go, I see people who do not take responsibility for their own hygiene. I am truly amazed at those who use the facilities and walk right past the sink.

    It is buyer beware, folks; assume a worst case scenario and take precautions for you and your family, but never assume that someone who is preparing your meal is worried about you.
    Report Comment
    Bullhead, Stilwell (8/28/2008 7:52:50 PM)
    Maybe they need to have their employees wear those disposable gloves from now on. Everytime they handle food, use the gloves. They are cheap enough you can change them many times during your shift. I would also refrain from hiring people who smoke. Maybe that has nothing to do with this but it seems that them touching the cigarrette to your mouth, near your nose, then go back to work.. just doesn't seem right.
    Report Comment
    ifyouonlyknew, (8/29/2008 10:23:15 AM)
    OK lets set the record straight! For all you health department investigators, news reporters, and local gossipers, I have a direct source to the gruesome details as to what really goes on in this particular restaurant. First of all, the health inspectors have reported that they conducted a surprise inspection. However, there was at least several hours of advanced notice which allowed crucial evidence to be discarded and lack of safe food handling procedures to be corrected. I know for a fact that many safety codes and health department guidelines are disregarded on a daily basis endangering the innocent people that are under the misconception that "this restaurant holds itself to the highest standard and food handling safety."

    Second of all, I know for a fact there is no hot water available in any one of the four restrooms. So how would the owners expect or even assume that their employees hands are sanitized after a trip to the restroom. Is this an example of "Highest standards?"

    Here is yet another gruesome but factual practice. Food that leaves the restaurant for caterings reappears on the buffet line the next day. Meaning any leftovers from caterings are fed to the general public. This is a major violation.

    There are many more violations to numerous to mention, however I believe you get my point. No, I dont believe the Moores sat around plotting an E.coli outbreak, nor do I believe that they ever considered these practices would result in the death of anyone. However, their desire to yield higher profits has brought on much devastation to the community and those directly affected by this outbreak. If and when the restaurant reopens I really hope that the Moores will truly practice these so-called "highest of standards" and will keep in mind that their decisions and short cuts are endangering the lives of many.
     

     
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