Two children already hospitalized with bloody diarrhea have been confirmed to be the ninth and 10th people infected with E. coli.
But no new cases of people suffering from the severe intestinal illness after eating at a South Salem fast-food restaurant were reported to the county Health Department over the weekend, said Dr. Paul Cieslak, manager of the acute and communicable disease program at the Oregon Health Division.
Still, the number may rise as the weekend ends and communication among patients, physicians and health officials improves.
“It’s conceivable that there’s some in the pipeline and we’ll find out about it (today),” Cieslak said.
In fact, there already may be an 11th case of E. coli in Salem originating from the Wendy’s Old Fashioned Hamburgers restaurant at 2375 Commercial St. SE.
An 85-year-old Salem man had bloody diarrhea Saturday. Robert Pascal’s family said he had eaten three junior bacon cheeseburgers at the restaurant Aug. 16, the last of three days that officials say diners may have been exposed to the pathogen.
Robert Pascal was taken to a Keizer clinic, where staff told his family that he had been infected by E. coli, his son Robert Pascal Jr. told the Statesman Journal.
The restaurant closed temporarily Friday despite getting a clean bill of health from county officials. It remains closed while the source of the infection is investigated. No other Wendy’s outlets are linked to the outbreak.
Concerns now center on a possible secondary spread of the disease through contact, officials said.
Symptoms generally appear three to five days after infection but can appear up to 10 days after. They include nausea, mild to severe intestinal cramps and bloody diarrhea.
“Anybody with bloody diarrhea ought to see a doctor,” said Cieslak. “Bloody diarrhea is fairly serious.”
For everyone who is sick enough to go to the doctor, there are others who were probably infected but who got better on their own and didn’t report it, Cieslak said.
He said those with regular diarrhea should increase their fluid intake.
Officials suspect the bacteria, E. coli O157:H7, was spread by cross contamination, which means that pathogens, usually from meat, are passed to another food because of improper cleaning or handling.
The 10 sick customers ate different foods, which varied from hamburgers to salads to chicken sandwiches.
Results from stool samples showed that the two children — both boys, ages 4 and 23 months — tested positive for E. coli Saturday. They were listed in fair condition Sunday at Oregon Health Sciences University Hospital in Portland.
Elaine Smith, a registered nurse with the Marion County Health Department, said the state Health Division still must confirm the tests, but she’s confident about the results.
Eight other people — seven adults and a child — were confirmed to have the infection Friday. Children and seniors are most vulnerable to a serious illness after being infected.
Three of the adults were hospitalized and released. The others did not need hospitalization, Smith said.
The disease can best be avoided by washing hands and washing cutting boards after handling or preparing uncooked meat, Smith said.
“That’s the message that we want to get out: that you can prevent this,” Smith said.
Seattle attorney Bill Marler, who won millions for several victims of the Jack in the Box E. coli outbreak in 1993, said that he had never heard of an outbreak at a Wendy’s restaurant until this one.
His company has litigated in food-borne illness cases against restaurants such as KFC, McDonalds, Subway and Carl’s Jr. It’s currently suing over contaminated beef served in a school lunch and at an East Coast Sizzler.
Marler cautioned that when an unsolved outbreak occurs, the source could be anything from the meat to the lettuce, some of which may be supplied to other restaurants in the area — and across the country.
“Think twice about eating hamburgers, eating out and make sure that you wash your kids’ hands frequently during an outbreak,” he advised.
Hand washing is vital, he said, because of the risk of secondary exposure. In the Jack in the Box case, two of the children who died had not eaten tainted food but were exposed to E. coli by a sibling and at a day care center.