Within 48 hours of the first reported E. coli infection associated with the consumption of foods from the Country Cottage buffet, the restaurant was closed for inspection and cleaning. Epidemiologic and environmental investigations were conducted by staff from the Oklahoma State Department of Health, Mayes County Health Department, and Centers for Disease Control and Prevention (CDC).
A specific food-source was never determined to be the source of the outbreak; however, investigators listed several avenues that foodborne transmission of E. coli O111 could have occurred, including cross-contamination from food preparation equipment, counter surfaces, or storage areas.
In all, OSDH reported that at least 341 people had become ill with E. coli O111:NM during the outbreak traced to Country Cottage Restaurant. Seventy people were hospitalized, and one person died as a result of E. coli infection in what is believed to be the largest community outbreak of diarrheal illness and HUS attributable to E. coli O111:NM ever reported.