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Outbreak News

Man became ill five days after eating at restaurant

By Kim Archer, Tulsa World

8/29/08

A meal of catfish and sweet potato patties at Country Cottage restaurant in Locust Grove one Friday left 70-year-old Jerry Troglin dry-heaving over his toilet bowl five days later.

"I started passing a little blood," he said of his ordeal. Then his wife rushed him, writhing in pain, to the Integris Mayes County Medical Center in Pryor.

By then, he was passing what seemed like buckets of bright red blood.

The Pryor hospital transferred him by ambulance to Hillcrest Medical Center in Tulsa, where doctors took samples and told Troglin he was suffering from a severe bacterial infection from his esophagus to his colon.

Doctors put him on a morphine pump, which dripped the strong painkiller into his bloodstream every four hours.

"It's no fun. I never want to have that again," the Locust Grove man said. "If I hadn't gone to the hospital when I did, I'm sure I would've ended up in intensive care."

Troglin's meal at Country Cottage came two days before 26-year-old Chad Ingle ate there. The young Pryor man died exactly one week later, on Sunday.

Services

were held Thursday afternoon for Ingle at First United Methodist Church in Pryor.

County Cottage owners Dale and Linda Moore said, in a statement, "Today is a day of mourning for the Ingle family, to whom we send our sincerest thoughts and prayers. They laid to rest a son, brother and husband, and our hearts go out to them, as we are certain they are suffering unimaginable pain."

State health officials have determined that a relatively rare and virulent form of E. coli infected dozens of patrons of Country Cottage over at least a 10-day period, killing Ingle and sickening more than 73 people.

More than 50 of those who fell ill were hospitalized. Five children remain in the pediatric intensive care unit at Children's Hospital at St. Francis. Four are on dialysis. Two other children were sent to OU Children's Hospital. Officials there declined to provide information about their conditions.

On Thursday, the state sent another team to the closed restaurant to take swabs on countertops, work surfaces and other areas as part of a painstaking investigation to pinpoint the exact source of the highly contagious bacteria.

It takes as few as 10 microscopic bacteria to infect someone with this deadly E. coli strain, said state epidemiologist Dr. Kristy Bradley.

"That's why it can be associated with such sizable outbreaks," she said. "We consider it a fairly unusual type of E. coli. It's a pattern that did not match anything we have previously seen in Oklahoma."

Bradley said the E. coli strain is not the commonly known E. coli 0157:H7. Non-0157 strains are more common in South America and parts of Europe, according to the Pediatric Infectious Disease Journal.

The U.S. Centers for Disease Control and Prevention are testing Oklahoma samples to determine what type of E. coli this pathogen is.

The bacteria could have come directly from an animal source, particularly by cross-contamination with a raw meat item, Bradley said. Or, a food handler who didn't wash his or her hands thoroughly could have transferred the bacteria to food items on the buffet, she said.

Bradley also noted the bacteria can be spread through water or person-to-person contact.

Outbreaks have been associated with fecal-oral transmission and consumption of undercooked beef, raw milk, unpasteurized apple juice, contaminated water, red leaf lettuce, alfalfa sprouts and venison jerky.

"If it's been 10 days or longer since people have eaten at the Country Cottage, they shouldn't worry," she said. But people who were exposed since then and have diarrhea should not prepare food, because they could continue to spread the infectious bacteria, she said.

Bradley reiterated this E. coli strain should not be treated with antibiotics or anti-diarrheal medications. Both release the two types of shiga toxins inside an individual's body before the bacteria is able to pass through a person's system, worsening a patient's condition.

State health officials are working night and day to determine the exact cause of the outbreak, she said.

"But it's not like an episode of 'CSI.' The public perception is we have gizmos and gadgets and we put a piece of something in a machine. Then presto, change-o, we've got the answer," she said.

Instead, environmental specialists and scientists are working meticulously and diligently to arrive at the correct conclusion, Bradley said.

"I think we are zeroing in on the source," she said.

More on this outbreak: Country Cottage Restaurant E coli O111 Outbreak

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