E. coli's wide reach in northeast Oklahoma could grow

By John David Sutter

Published: August 28, 2008

The state Health Department on Wednesday linked a dangerous strain of E. coli bacteria to an intestinal disease outbreak in northeast Oklahoma that has killed one person and hospitalized 41 others.

The discovery is expected to help hospitals care for the outbreak's victims, most of whom have come down with stomach cramps and severe, bloody diarrhea. Some are being treated for kidney failure. The confirmation will also help state officials determine the exact source of contamination.

The type of E. coli found is extremely contagious, state Epidemiologist Kristy Bradley said. Bradley expects more people to become sick as fecal bacteria is transferred between people who do not wash their hands after using the rest room, or who prepare food.

"It takes as few as 10 bacteria to potentially make someone ill, and this is why hand-washing is so important,” she said, "and if someone does have diarrhea, they should not be preparing food.”

Tests indicate that it is likely food was contaminated at the restaurant rather than before it arrived at the restaurant, Bradley said.

Based on interviews with victims, it appears that several types of foods at the restaurant were contaminated, she said.

Two workers at Country Cottage are among the ill, Bradley said. More tests are needed to tell whether the workers became sick from the food, or if they caused the contamination, she said.

Country Cottage's spokeswoman, Amanda Clinton, said workers often eat the restaurant's food before or after their shifts, and that it would be unfair to assume they had caused the contamination.

The restaurant's owners feel "relieved” to know the source of contamination, but remain distraught and saddened by the situation, Clinton said. It's unclear whether the restaurant will open again, she said.

State health officials determined E. coli to be the source of contamination by testing stool samples of the outbreak victims. At least 10 of the outbreak's victims have tested positive for a type of Shiga-toxin-producing E. coli bacteria related to the dangerous E. coli O157. The state health officials, however, could not isolate exactly what strain of E. coli is to blame. Samples were sent Wednesday to the Centers for Disease Control and Prevention for further analyses.

Those tests could take several days and results will help health officials determine the exact source of contamination, Bradley said.

At least seven of the victims of the outbreak are children, and many of them are on dialysis because they are experiencing kidney failure, according to a school official and pediatrician.

The future for those children is uncertain.

"Once a child goes into renal failure and has to be placed on hospital dialysis, it is not uncommon for them to have to remain on dialysis for several weeks,” Bradley said, "and sometimes that kidney damage is permanent.”

A disproportionately high number of E. coli illnesses hit children and older people. Children in Oklahoma have an E. coli disease rate six times higher — 7.62 cases per 100,000 children — than adults, according to the state Health Department.

Concern about E. coli has risen over the years, but rates of infection are steady, said Lola Russell, a spokeswoman for the Centers for Disease Control and Prevention in Atlanta. An estimated 2,100 hospitalizations and 61 deaths are attributed to E. coli illnesses each year in the United States, according to the state Health Department.

In Oklahoma, 44 cases of E. coli were reported in 2006. That was the highest annual number reported since 1994, when such reports became mandatory. The number of cases of E. coli rose 10 percent between 2005 and 2006.

The state medical examiner has not determined a cause of death for Chad Ingle, the 26-year-old who died Sunday in connection with the outbreak.

The newlywed gospel singer's funeral is to be held today in Pryor.

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