The Minnesota Department of Health (MDH) is investigating 13 cases of foodborne illness associated with a type of E. colibacteria known as E. coli O111. This form of E. coli is in the same family as the more well-known E. coli O157:H7. All of the illnesses were caused by the same genetic strain of E. coli O111, and the ill people do not all share any obvious commonalities; these facts indicate the illnesses resulted from a widely distributed food item.
While seven of the people with E. coli O111 infections reported eating at Applebee’s restaurants in Minnesota between June 24 and 27, there are multiple cases with no apparent connection to the restaurant. Applebee’s is cooperating fully with the investigation, and as a precaution volunteered to remove the Oriental Chicken salad from menus at all its Minnesota restaurants while the investigation continues. The restaurant is also removing specific ingredients of its Oriental Chicken salad from other items on its menu out of an abundance of caution. Health officials are still working with Applebee’s, the Minnesota Department of Agriculture, and other regulatory partners to determine the cause of the outbreak.
Symptoms of illness caused by E. coli O111 typically include stomach cramps and diarrhea, often with bloody stools, but only a low-grade or no fever. People usually become ill two to five days after exposure, but this time period can range from one to at least eight days. Most people recover in five to 10 days. Complications from infection are more common among those with weaker immune systems, including young children and the elderly. MDH investigators note that this genetic strain of E. coli O111 has not been seen in the United States previously.
Health officials say anyone who visited a Minnesota Applebee’s since June 20 and has symptoms of E. coli O111 infection (particularly bloody diarrhea) should contact their health care provider immediately and inform them of their possible involvement in this outbreak. MDH also asks that they contact the department’s foodborne illness hotline at 1-877-FOOD-ILL (1-877-366-3455) to report the potential connection.
Four of the 13 people who became ill were hospitalized, and all have recovered or are recovering. Diarrhea associated withE. coli O111 infection should NOT be treated with antibiotics, as this practice might promote further complications. More information on E. coli infection can be found at www.health.state.mn.us. MDH will share more information with the public as the investigation continues.