Thirteen children and adults who recently ate salads from four Pat & Oscar's restaurants in San Diego County and one in Tustin have been infected with a dangerous E. coli bacteria, according to preliminary tests released yesterday.
A 14th person who ate a salad from the same company that supplies Pat & Oscar's also has became ill, said Dr. Wilma Wooten, deputy county health officer.
It is believed to be the first significant E. coli outbreak in the county in 10 years. The individuals came down with symptoms between Sept. 30 and Saturday.
"There are several potential common sources, but we have particular focus on pre-mixed packaged lettuce used in three salad dishes – the Greek, the lemon-and-chicken and the Cobb salads (plus) the antipasto," Wooten said.
It is not yet clear how the bacteria got in the salad mix, Wooten said, adding that the source might be an unnamed supplier who packaged the "three-times pre-washed" bags of lettuce mix sold to the restaurant chain.
Another less likely route of contamination is through beef that may not have been cooked to the required 160 degrees Fahrenheit, county officials said.
Those who got sick ate at either of two restaurants in Carlsbad, one in Mission Valley, one in El Cajon and one in Tustin, Wooten said.
County officials ask that anyone who experiences abdominal cramping, nausea, vomiting and bloody diarrhea see a doctor and contact county health officials.
They warn that people who are infected can transmit the bacteria a week or more later by not washing their hands after they use the bathroom and then handling food or other objects that go into people's mouths.
In a statement yesterday, Pat & Oscar's officials said that "while the exact source of the illness has not been pinpointed at this time," the restaurant is cooperating fully with health agencies.
The statement said the investigation is focused on "food suppliers, as opposed to the restaurants themselves, and it appears that the suspected product is limited to salad mix items."
In the meantime, the restaurant said it has "removed all products that might be suspected of contamination from its menus."
Wooten said samples from most of the patients have undergone preliminary tests identifying the culprit bacteria as E. coli 0157:H7, the same strain that sickened hundreds of Jack in the Box customers in 1992 and 1993 in San Diego County and Washington state. Four people died, including 6-year-old Lauren Rudolph of Carlsbad in 1992. She had eaten undercooked hamburger.
The latest samples have been sent to state labs in Richmond for confirmatory testing. Physicians treating the patients suspect the bacteria is this strain of E. coli based on symptoms, Wooten said.
Wooten and Gary Erbeck, county Environmental Health Department director, said they were informed about the outbreak by employees of three hospitals who called the health department between Friday night and Monday morning.
"Most of the patients were hospitalized for a least a day, not because of the severity of their symptoms, but to make sure they did not develop complications," Wooten said.
None of the patients died, and as of yesterday, "most are back home and much better," she said.
Karie and Chris Galindo of Carlsbad say their 16-year-old daughter, Kayce, is recuperating slowly after being hospitalized at Children's Hospital from Friday through Sunday.
"What this disease does is a horrendous experience, and we're grateful doctors were able to treat her and get her on the right path," her mother said. The Carlsbad High School varsity volleyball player "is now getting back to normal and craving spaghetti dinners and ice cream."
In a normal year, the county receives one to two reports of E. coli 0157:H7 infections a month, so to have a dozen all at once is unusual, Wooten said.
Patients usually develop symptoms of E. coli two to eight days after they eat contaminated food. The illness can last a week or more, but children can excrete the bacteria for an additional three weeks in fecal material. For adults, the infection period is usually about a week.
The Pat & Oscar's chain started in 1991 in Carmel Mountain Ranch when Pat and Oscar Sarkisian joined their daughter, Tammy, and son, John, to open Oscar's restaurant.
Financed with personal savings and a second mortgage on the Sarkisians' San Marcos home, the business offered a small menu of foods primarily for takeout. The first restaurant seated 18 people, but as the business grew the family moved to another location that could seat up to 200. Pizza, salads, baby-back ribs and breadsticks were the signature items of the business.
Oscar's opened several other restaurants in San Diego County, eventually expanding into Orange and Los Angeles counties as well as Phoenix.
Originally called Oscar's, it changed its name to Pat & Oscar's in spring 2001.