Cases appear not to be linked to the growing E. coli outbreak linked to romaine lettuce.
Seattle King County Public Health is investigating an outbreak of Shiga toxin-producing E. coli (STEC) potentially associated with four Evergreens restaurants in Seattle. Six of seven people who became ill during November 10–15, 2019, ate dishes containing raw vegetables, including leafy greens, from Evergreens restaurants during November 5–11, 2019. Of these seven E. coli cases, six were in adults and one was in a child. One person was hospitalized and has been discharged. Everyone who reported illness has recovered.
Genetic testing on isolates from four of the seven people (three who reported eating at Evergreens before they became ill and one who did not report eating at Evergreens) identified the same strain of E. coli, suggesting they have a common source of infection. This strain of E. coli is different from the strain currently causing a national outbreak associated with romaine lettuce grown in Salinas, California, which the U.S. Centers for Disease Control and Prevention (CDC) announced on November 22, 2019.
Public Health investigators visited the four Evergreens locations (University District, Pioneer Square, International District, Downtown – 3rd and Marion) where the ill people reported eating. During these inspections, investigators did not observe environmental or behavioral risk factors associated with the spread or proliferation of E. coli, such as lack of handwashing or improper time and temperature control of foods.
This outbreak comes in the context of a national E. coli outbreak associated with romaine lettuce from the Salinas, California growing region, which was announced by the CDC on November 22, 2019. Results of genetic testing on isolates from four of the seven cases doesn’t suggest a link to this national outbreak.
Many of the people who became ill after eating at Evergreens also reported eating raw vegetables, including leafy greens, from sources other than Evergreens in the days prior to their illness, meaning they could share a separate source for their illness, unrelated to Evergreens.
Public Health collected samples of various produce for testing from the four Evergreens locations where the people who became ill ate; results are pending. Public Health is also working with the Washington State Department of Agriculture and United States Department of Agriculture on tracing back the distributors and sources for ingredients consumed by the ills during their meals. Trace back is used to identify other points of contamination up the supply chain.
As per our protocol, Public Health investigators revisited the four Evergreens restaurant locations where ill cases reported eating to confirm that these actions were taken. At this time, Public Health has not identified any employees who experienced similar symptoms before or after meal dates for the ill customers, but we are still surveying all employees. During their visit, investigators reviewed the requirement that restaurant employees are not allowed to work while having vomiting or diarrhea.
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