Numerous E. coli outbreaks have been traced to the consumption of foods purchased from restaurants. The sources of such outbreaks include cross-contamination, intact cuts of meat, ground beef products, contamination of food by ill food workers or service staff, and E. coli-contaminated produce. Occasionally, investigators from public health departments and environmental health agencies are unable to determine how restaurant food came to be contaminated with E. coli, and outbreak sources are unknown.
The first widely publicized E. coli outbreak associated with food served at a restaurant was the 1993 Jack in the Box E. coli outbreak. Over 600 people who had eaten at 73 Jack in the Boxlocations in Washington, Idaho, California, and Nevada became ill with E. coli infections after eating under-cooked hamburgers served at the restaurants. The outbreak strain of E. coli O157:H7 was isolated from 11 lots of hamburger patties produced by Von Companies, and Jack in the Box initiated a recall of all potentially contaminated hamburgers in its restaurants. At least 171 individuals who had become ill with E. coli O157:H7 infections after eating at Jack in the Box were hospitalized; 41 developed hemolytic uremic syndrome (HUS), and four people died. See Jack in the Box E. coli Outbreak Lawsuits and Litigation.
Between December of 2011 and March of 2012, a multi-state E. coli O26 outbreak was traced to clover sprouts served on sandwiches at Jimmy John’s restaurants in 5 states. At least 29 people, including 6 who were hospitalized, became ill with Shiga toxin-producing E. coli O16 infections during the outbreak. Nearly all victims were female.
An E. coli O157:H7 outbreak was traced to the consumption of food prepared at the Boulder, Colorado, Jimmy John’s restaurant in 2008. The Boulder County Public Health Department (BCPH) investigated the outbreak associated with this restaurant, and counted 12 individuals who cultured positive for an indistinguishable strain of E. coli. This number included two employees who became ill with E. coli infections, yet continued to work at the restaurant in a food-handling capacity while symptomatic. Using a cohort study, BCPH determined that the most likely initial source of the E. coliO157:H7 outbreak was sprouts. It is also notable that BCPH inspectors observed improper hand washing during an inspection of the restaurant, which could have contributed to the spread of E. coli from ill employees to restaurant patrons. See Jimmy John’s E. coli Outbreak Lawsuit & Litigation.
In 2008, an E. coli O111 outbreak was traced to the Country Cottage buffet restaurantin Locust Grove, Oklahoma. The outbreak is believed to be the largest E. coli O111 outbreak in US history, and sickened at least 341 people, hospitalized 70, and killed one. Public health officials were unable to determine how the E. coli entered the restaurant or was spread. In its final report, the Oklahoma State Department of Health stated that:
Apart from whatever mode the bacteria was introduced into the restaurant, the epidemiologic findings suggest that foodborne transmission of E. coli O111 through various food items—either contaminated with the bacteria by foodhandlers or by cross-contamination from food preparation equipment, counter surfaces, or storage areas – occurred at Country Cottage from August 15 – 24.
In October of 2006, lettuce served at Taco Bell restaurants in Delaware, Pennsylvania, New Jersey, and New York was identified as the source of an E. coli O157:H7 outbreak among Taco Bell customers. Public health officials from the states, along with investigators from the Centers for Disease Control and Prevention, identified 78 probable and confirmed cases of E. coli O157:H7 associated with consumption of lettuce at Taco Bell restaurants. At least 53 victims were hospitalized and 8 developed HUS. A trace-back of the lettuce used at the restaurants revealed that the E. coli-contaminated lettuce responsible for the outbreak was grown in California’s Central Valley. See Taco Bell E. coli Outbreak Lawsuits.
Shortly thereafter, in December of 2006 Minnesota and Iowa public health officials investigated an E. coli O157:H7 outbreak associated with the consumption of foods prepared at Taco John’s restaurants. At least 81 people became ill during the outbreak, including 33 Minnesotans, 47 Iowans, and one Wisconsinite. Twenty-six people were hospitalized, two with HUS. Iceberg lettuce supplied to Taco John’s by Roma Foods was determined to be the source of the E. coli outbreak at the Taco John’s restaurants. See Taco John’s E. coli Lawsuits.
In 2003, the Saint Clair, Illinois, County Health Department (SCCHD) investigated an E. coli O157:H7 outbreak among patrons of the Habaneros restaurant at the St. Clair Square Mall. SCCHD interviewed 64 people who had eaten at the St. Clair Square Habaneros restaurant during the exposure period, and learned that 30 had become ill with diarrheal illness following their meals at the restaurant. Five were culture-confirmed with E. coli O157:H7 infection. Three people were hospitalized, ten sought medical care through ER visits, and six contacted their primary healthcare providers regarding their illness. Pico de gallo prepared at the restaurant tested positive for E. coliO157:H7, but SCCHD investigators were unable to determine how the pico de gallo had become contaminated. See Habaneros E. coli Outbreak Lawsuits.
In 2000, a large E. coli O157:H7 outbreak was traced to two Milwaukee Sizzler restaurants. The Wisconsin State Department of Health (WSDOH) ultimately identified 551 probable cases, and another 122 possible cases of E. coli. Dozens of people were hospitalized; four developed hemolytic uremic syndrome, and one person died. An indistinguishable strain of E. coli was isolated from case-patients, samples of raw chunky taco meat, and sirloin tri-tips at one sizzler restaurant. This meat was manufactured by Excel Corporation, then remanufactured at the local Sizzler restaurants according to procedures defined by Sizzler USA. WDOH concluded that watermelon that had been cross-contaminated with raw sirloin tri-tip was the source of the E. coli outbreak. See Sizzler E. coliOutbreak Lawsuits.
Also in 2000, an E. coli O157:H7 outbreak was traced to cross-contamination between ground beef and multiple other food items at a Wendy’s restaurant in Salem, Oregon. Inspectors from the Marion County Health Department (MCHD) found several food-handling problems that likely resulted in E. coli’s cross-contamination to other foods. Wendy’s employees had soaked lettuce in the same sink that was used to rinse pans in which raw hamburger patties were held, without cleaning and sanitizing the sink between uses. Staff had also used a dry towel to wipe a shelf holding raw hamburger patties, then used the same towel for hand wiping in the grill area and the sandwich assembly area, where raw products were placed on cooked burgers. These opportunities for cross-contamination of E. coli were accompanied by an observance of poor hand washing practices. In total, MCHD identified 35 confirmed and presumptive E. coli cases associated with this outbreak caused by cross-contamination. See Wendy’s E. coli Outbreak Lawsuits.