Oklahoma E. coli O111 Outbreak: A Final Report

The Oklahoma State Department of Health has issued a final report on the E. coli O111 outbreak that struck the northeastern part of the state this past summer. 

The outbreak sickened 341 people, including 56 children (under 18 years old). The youngest victim was 3 months; the oldest was 88 years. Seventy-two (21%) of the victims were hospitalized, and one person died as a result of his infection.

The outbreak was traced to the Country Cottage restaurant in Locust Grove, OK, and included individuals who patronized the restaurant between August 15 and August 24th.

The outbreak investigation was unable to trace the source of the pathogen. Neither environmental sampling of working surfaces in the restaurant, nor water samples from the well on the property, nor samples of the restaurant's food supplies yielded E. coli O111. And exhaustive interviews of victims and healthy restaurant patrons failed to point to a specific food item. The conclusion?

"While no single food item was found to be the source of illness at the restaurant, the Oklahoma State Department of Health believes several different foods became contaminated with the E. coli 0111 bacteria, leading to exposure of restaurant customers Aug. 15-24."

The Country Cottage has been given permission to reopen, following a successful inspection on November 12th and after meeting a series of conditions that included, among others:

• disconnecting the on-site well from the restaurant's water supply;
  
• not permitting employees with diarrhea to work in the restaurant;
  
• installing additional hand-washing sinks;
  
• ensuring that all bathrooms are operational and monitoring employee hand-washing;
  
• requiring each employee to complete a food handler's class; and
  
• requiring the kitchen manager and owner to obtain a Food Service Manager's Certificate.
  

The tone and content of the list of requirements for reopening the restaurant, together with the DOH conclusion that "... several different foods became contaminated..." leads me to believe that an infected food handler was the source of the contamination. Inattention to appropriate food handling and sanitation practices, and poor temperature control – as detected in an earlier inspection – allowed the contamination to spread. Inadequate cleaning and sanitation of food contact surfaces and utensils enabled the pathogen to linger. 

This, of course, is pure speculation. I have no proof. But nothing else makes sense.