By Tony Thornton, Randy Ellis and Nolan Clay Modified: October 19, 2008 at 2:27 pm •  Published: October 19, 2008
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photo - A sign advertising its fare stands in front of the Country Cottage restaurant in Locust Grove, Okla. Tuesday Sept. 16, 2008. The restaurant is linked to an  E.  coli outbreak in Locust Grove that sickened more than 300 people and killed one person, according to state health officials. (AP Photo/Brandi Simons)
A sign advertising its fare stands in front of the Country Cottage restaurant in Locust Grove, Okla. Tuesday Sept. 16, 2008. The restaurant is linked to an E. coli outbreak in Locust Grove that sickened more than 300 people and killed one person, according to state health officials. (AP Photo/Brandi Simons)
State Health Department officials allowed a Locust Grove restaurant to stay open temporarily — even after confirming six of eight initial food poisoning victims had eaten its food, internal documents show. That decision may have resulted in additional people getting sick.

Health Department officials admitted last week there is no set threshold in such cases for closing a restaurant suspected of being the source of an outbreak.

The August outbreak ultimately proved to be the nation's largest of a rare strain of E. coli. One person died, 72 were hospitalized and 241 others got sick before the outbreak was contained.

“Obviously, with an outbreak this large in scope, there will be lessons learned that we can apply to future outbreak investigations,” Health Department spokeswoman Leslea Bennet-Webb said.

Health Department officials were dispatched to northeastern Oklahoma the night of Aug. 22 in response to multiple reports of food poisoning.

E-mail records show that by the next day, health officials determined that three of four sick people interviewed had eaten at the Country Cottage restaurant. By Aug. 24, it was six out of eight.

Still, they held off in notifying the public or ordering the restaurant to close.

“We do not have enough info at the current time to implicate this establishment as the likely source,” one health official wrote in an e-mail just after noon Aug. 24.

“This may leak out to the media today, though.”

One or more of the E. coli victims ate food prepared by the Country Cottage on Aug.


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E. coli outbreak by the numbers

Total known cases: 314

In-patient hospitalizations: 72

Patients who required dialysis for renal failure: 17

Deaths: One

People interviewed: 1,843

Victims who ate food provided by Country Cottage in Locust Grove: Every known case

State and county health workers involved in response and/or inquiry: At least 135

Other revelations from documents

The e-mails also indicate that until the outbreak, Country Cottage hadn't been inspected since Oct. 31, 2007, even though agency standards suggest four inspections a year for a buffet-style restaurant of its size. A shortage of inspectors caused the variance, one health official wrote.

Health Department officials and the state medical examiner's office investigated a second possible E. coli death — an elderly man who, while hospitalized after an appendectomy, received food from the Country Cottage owner. The man died several days after leaving the hospital. The medical examiner's office found no trace of E. coli and determined the man died of heart disease.

The FBI contacted Oklahoma health officials after the outbreak, concerned that it “might be a criminal situation ... related to several outbreaks recently (in the U.S.).”

When Country Cottage owner Linda Moore said she would close voluntarily, she thought it would be “for a couple of days. ... She doesn't understand that she will be closed for a long time,” one health official said during a crisis meeting.

Health officials were denied entry at a Tulsa hospital Aug. 26 while trying to interview outbreak victims. The next day, health officials arranged to set up a room at the hospital to meet with victims and families.

Uncertain of how widespread the outbreak would become, health officials pondered sending victims to hospitals as far away as Little Rock, Ark., and Wichita, Kan.

At least one ill food handler at the Country Cottage refused to give a stool sample, prompting a Health Department attorney to say the person could be compelled to provide one.

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