The salad bars at St. Louis-based grocery store chain Schnucks have been at the center of an E. coli investigation in St. Louis, where 26 individuals have confirmed cases.
Although no illnesses have been reported in Cape Girardeau, Schnucks has voluntarily removed items in question from its salad bars company wide as a proactive measure, said Schnucks spokeswoman Lori Willis.
The Missouri Department of Health and Senior Services has been leading a team of local, federal and state public health experts in investigating the cause of the E. coli outbreak that hit the St. Louis region last week.
Items tested from Schnucks include strawberries, lettuce and Caesar dressing taken from several St. Louis-area stores.
The State Lab tested 17 food samples taken from individuals' homes and St. Louis area Schnucks salad bars. That testing indicated that none of these samples contained E. coli or shiga toxin, its harmful by-product, state health officials said in a news release.
"We're doing everything we can to ensure the safety of our salad bar," Willis said. "At this point and time, it would suggest that Schnucks is not the source. We sold those products, but we didn't grow them."
Human and food samples continue to be tested, state health officials said.
To date, investigators have discovered that 85 percent of the E. coli patients, 17 out of 20, who reported shopping at Schnucks stores also reported buying food from the salad bar.
While this suggests a source, investigators cannot yet say with certainty that they have identified the source, as they continue to search for an explanation for the remaining cases, state health officials said.
As of Monday, there were 26 probable or confirmed cases in Missouri, 20 of which have occurred in St Louis County. Of those 26, 19 have been hospitalized, but none of the cases have been fatal.
Typically, symptoms start within seven days of digesting E. coli, said Victoria Adjovu, an internal medicine physician at Cape Primary Care. Symptoms of E. coli include severe abdominal cramps and watery or bloody diarrhea and multiple bowel movements a day, Adjovu said. These symptoms last two to five days.
She said most of the time they recommend a lot of fluids. "There is no special treatment. We typically watch for complications," she said. The most common complication with E. coli is dehydration.
E. coli are a group of bacteria commonly found in the intestines of cattle.
"E. coli is most commonly associated with ground beef," said Amy Morris, supervisor of the Cape Girardeau County Health Center's environmental health program. Ground beef must be cooked to an internal temperature of 155 degrees to reduce bacteria to safe levels, she said.
"Why a lot of people end up dying from it is that it can lead to Hemolytic Uremic Syndrome, which leads to kidney failure," Morris said.
The county health center staff routinely inspects salad bars at restaurants throughout the Cape Girardeau area to ensure food is kept at proper temperatures. Cold foods must be kept at or below 41 degrees Fahrenheit, while hot foods must be at or above 135 degrees Fahrenheit.
In addition to cooking and storing foods at the proper temperature, Morris encouraged people to wash their hands and wash fruits and vegetables thoroughly before consuming them to help prevent E. coli contamination.
19 S. Kingshighway, Cape Girardeau, MO