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Most King County offices will be closed on Thursday and Friday, Nov. 22-23, 2018, for the Thanksgiving holiday.  
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AT-A-GLANCE

  • Cases: 16
  • Hospitalizations: 1
  • Deaths: 0
  • Status: Investigation is ongoing
  • Locations (2): I Love Sushi and Sodexo's Café Mario, both located at Nintendo of America, 4600 150th Ave NE, Redmond, WA 98052
  • Meal dates: Multiple meals dates
  • Prior food safety inspections and current rating?

Highlights

Updated July 13, 2018

Summary

Public Health is investigating an outbreak of Shiga toxin-producing E. coli (STEC) associated with I Love Sushi and Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. I Love Sushi is a food establishment that operates out of Café Mario once a week. At this time, the source of the illnesses has not been identified.

Illnesses

Since July 2, 2018, we have learned of at least 16 people who have developed symptoms consistent with an STEC illness, including diarrhea (bloody or non-bloody) and abdominal cramps. All of the ill people work at the Nintendo of America campus in Redmond. Illness onsets occurred during June 11-July 5th, 2018.

The 16 ill people all consumed food from Café Mario on multiple days before becoming ill, and only four of the ill people also ate at I Love Sushi before becoming ill.

Public Health actions

On July 3, 2018, Public Health – Seattle & King County Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.

At Café Mario, potential risk factors were identified, including inadequate hand washing practices and improper cold holding temperatures of food; corrective actions discussed with Café Mario’s management. At I Love Sushi, potential risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on the July 4 holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Investigators revisited both food establishments on July 11, 2018, and both were allowed to reopen the same day. Café Mario and I Love Sushi both completed a thorough cleaning and disinfection of their facilities before reopening, and any remaining processed ready-to-eat food products were discarded.

We did not identify any employees of either restaurant who had a recent diarrheal illness. Investigators also reviewed with management of both food establishments the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

Laboratory testing

Four of the 16 people who got sick tested positive for STEC by a healthcare provider. Further testing at the Washington State Public Health Laboratory is pending, but so far three of those tested are positive for STEC O26. We are still waiting for the genetic fingerprint results.

Environmental swabs were collected from both food establishments for laboratory testing and all came back negative for STEC.

Public Health message

This investigation is ongoing and we will provide more information as it becomes available.

STEC can cause serious illness. Anyone who ate at Café Mario and I Love Sushi at Nintendo of America during June 11, 2018 to July 5, 2018, and developed diarrhea (especially bloody diarrhea) within 10 days, should consult with their healthcare provider promptly to determine if testing is necessary.

Report possible foodborne illness

About STEC

E. coli 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.

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 excrete STEC for as long as 3 weeks.  
Ill persons 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. Persons with STECinfection who work in or attend these sensitive settings must be cleared by Public Health before returning.

Prevention

General advice for reducing risk of contracting STEC:

  • Avoid eating high-risk foods, especially undercooked ground beef and other beef products, unpasteurized (raw) milk or juice or cheese, and raw sprouts.
  • Use a food thermometer to make sure that ground beef has reached a safe internal temperature of 160 °F.
  • Wash hands before preparing food, after diapering infants, and after contact with cows, sheep, or goats, their food or treats, or their living environment.
  • Thoroughly wash fresh produce before eating.

More information about STEC

Link/share this page at www.kingcounty.gov/outbreak/mario