Published Date: 2008-02-28 21:00:16
Subject: PRO/EDR> E. coli O157, restaurant - USA: (HI)
Archive Number: 20080228.0811
E. COLI O157, RESTAURANT - USA: (HAWAII)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 27 Feb 2008
Source: The Honolulu (HI) Advertiser [edited]
Sekiya's Restaurant in Kaimuki dumped all its food and everything
disposable yesterday [26 Feb 2008] and began to disinfect the
restaurant from top to bottom after the worst outbreak of _E. coli_
0157:H7 in the state's history.
6 customers who ate at Sekiya's suffered bloody diarrhea in
December 2007 followed by a 7th in February 2008, even after the
restaurant corrected health inspection violations, said Dr Paul
Effler, state epidemiologist for the Health Department. The head of
Hawaii's restaurant inspectors said the case shows the state doesn't
have enough inspectors to keep restaurants in line.
"This is not surprising," said Peter Oshiro, standards office
supervisor for the state Department of Health. "We're not inspecting
at the frequency we need to be. That's why we get these problems."
When Sekiya's failed a 2nd inspection on 8 Feb 2008, the owners
agreed to the unprecedented steps of cleaning and disinfecting the
restaurant before the Health Department shut it down, Oshiro said.
Employees yesterday [26 Feb 2008] began a 2-day sanitation education
program at the restaurant, which is just one step toward getting the
restaurant reopened someday, Oshiro said.
The customers who fell ill went to their doctors, who then ordered
stool samples, Effler said. Technicians at the state laboratory
created a "DNA fingerprint" of each sample that was checked against a
nationwide database on the Mainland, Effler said. "They didn't match
anything else on the Mainland," he said, "but they matched each
other, which suggests a common source."
In each of the 6 cases, the patients had eaten at Sekiya's within 7
days of their symptoms. "This was not a coincidence," Effler said.
After the positive diagnosis by the 1st 6 Sekiya's customers,
restaurant inspectors spent 4 hours at the restaurant on Christmas
Eve watching the operation. "The conditions of the restaurant were
poor," said Oshiro, the inspectors' supervisor. Among other
violations, employees did not wash their hands. And raw food and
items that touched raw food were mingled with cooked food that was
ready to be served, he said.
Follow-up inspections on 26 and 27 Dec 2007 showed that the
restaurant "corrected all major violations," Oshiro said. "Everything
was good." Inspectors returned to Sekiya's on 8 Feb 2008 after the
7th customer showed the same DNA fingerprint for _E. coli_ 0157:H7.
"Many of the same problems that were there in December  were
noticed in February ," Oshiro said. Health officials suspended
Sekiya's permit to operate and were prepared to shut down the
restaurant when the owners agreed to a series of dramatic steps,
Oshiro said. He said they agreed to:
- hire a private food-safety consultant;
- have the owners, managers, and employees attend a free, 2-day
sanitization course at the restaurant;
- destroy all food and disposable items such as plastic forks,
napkins, and chopsticks;
- sanitize all equipment and interior spaces "from the floor to the
walls to the ceiling"; and
- get rid of anything that could not be sanitized.
[Byline: Dan Nakaso]
[Major deviations from what is appropriate for kitchen hygiene has
been observed in this situation. However, one might have expected not
just O157 disease, but rather a variety of food-associated diseases
to be found. What is missing from this report is the analysis of a
food history among the 7 affected people as compared with a control
group who did not get ill. Such an analysis may go a long way in
establishing the presumed food reservoir involved here. It is
important for a retrospective analysis of illness of patrons of the
facility to be done to better pinpoint the total number of involved
individuals. Many laboratories do not routinely test for _E. coli_
O157. - Mod.LL]