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Dec
03

Shiga toxin-producing E. coli O26 Infections Associated with Torero’s Mexican Restaurant in Renton, WA

AT-A-GLANCE
Cases 3
Hospitalizations 0
Deaths 0
Status Investigation is complete
Location Torero's Mexican Restaurant, 920 N 10th St, Renton, WA 98057
Meal dates September 3 and 7, 2022
Range of dates reported September 8, 2022 – September 16, 2022
Prior food safety inspections and current rating? EXCELLENT

Highlights, updated October 26, 2022

Summary

Public Health is investigated an outbreak of Shiga toxin-producing E. coli (also known as STEC) associated with diarrhea and abdominal pain at Torero's Mexican Restaurant in Renton.

We did not identify how STEC was spread within the restaurant. This is not uncommon for STEC outbreaks, because the bacteria can spread through contaminated food items, environmental surfaces, and from person to person.

Illnesses

Since September 5, 2022, 3 people from 3 separate meal parties reported becoming ill after eating food from Torero’s Mexican Restaurant in Renton on September 3, 2022 and September 7, 2022. All of the people developed one or more symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. We did not identify any ill employees.

Public Health actions

Public Health conducted interviews with the people ill with STEC to identify potential common exposures. On September 29, 2022, Public Health identified Torero's as a common food source for all three individuals.

Environmental Health Investigators visited the restaurant on September 30, 2022. Investigators identified inadequate handwashing facilities and improper storage of raw meats as potential risk factors for this outbreak. All critical violations were corrected during the inspection. On October 3, 2022, Environmental Health Investigators revisited the facility and ensured proper compliance with food handling practices.

No ill employees were identified at the time of the inspection. Investigators reviewed with restaurant management the requirement that ill staff are not allowed to work until they are symptom-free for at least 24 hours. Investigators provided education about preventing the spread of STEC — including proper handwashing, preventing bare hand contact with ready-to-eat foods, and preventing cross contamination during food preparation.

Laboratory testing

All of the cases had confirmatory testing indicating infections with Shiga toxin-producing E. coli (STEC) via culture. All confirmed cases had the same strain of STEC, based on genetic fingerprinting (whole genome sequencing or WGS) at the Washington State Public Health Laboratory.

About STEC

E. coli germs (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.

STEC and other foodborne infections occur throughout the year but may increase during late spring and summer months.

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 shed STEC for as long as 3 weeks.
  • Around 5–10% of those who are diagnosed with STEC infection develop a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). Clues that a person is developing HUS include decreased frequency of urination and feeling very tired. People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems. Most people with HUS recover within a few weeks, but some suffer permanent damage or die.
  • Ill people with suspected STEC infection should not work in food handling, patient care, or childcare settings, and ill children 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 STEC infections who work in or attend these sensitive settings must be cleared by Public Health before returning.

Prevention

General advice for reducing risk of getting STEC:

  • Avoid eating high-risk foods, especially undercooked ground beef and other beef products, goat products, and sheep products, unpasteurized (raw) milk or juice or cheese, and raw sprouts.
  • Wash hands with soap and water before preparing food for yourself or your children, before eating food, after handling raw meats, after going to the bathroom or changing diapers, and after contact with cows, sheep, or goats, their food or treats, or their living environment.
  • If soap and water aren't available, use an alcohol-based hand sanitizer with at least 60% alcohol (check the product label to be sure). These alcohol-based products can quickly reduce the number of germs on hands in some situations, but they are not a substitute for washing with soap and running water.
  • Thoroughly wash fresh produce before eating.
  • If washing "pre-washed" or "ready to eat" produce items, be sure it does not come into contact with unclean surfaces or utensils.
  • Wash cutting boards and counters used for meat or poultry preparation immediately after use to avoid cross contaminating other foods.
  • Cook all meats thoroughly, especially ground beef. Use a food thermometer to make sure meats have reached a safe internal temperature.
    • Cook ground beef and pork to a minimum internal temperature of 160°F.
    • Cook beef steaks, beef roasts, goat, and lamb to an internal temperature of at least 145°F and allow to rest for 3 minutes after you remove meat from the grill or stove.

More information

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