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E. Coli Questions Linger in Vt.



Valley News Staff Writer
Saturday, October 10, 2015
South Royalton — Though evaluating the same evidence, state and federal investigators disagree on whether undercooked ground beef at a South Royalton restaurant is to blame for a recent E. coli outbreak, which is now thought to have sickened at least 11 people from three states.

That’s two more cases than were identified at the beginning of the week — one newly linked case involves a New Hampshire resident, while the other victim is from Rhode Island, said Bradley Tompkins, a health surveillance epidemiologist with the Vermont Department of Health.

As with the nine previously identified cases, the illnesses involve people who ate at Worthy Burger, which features locally-sourced beef.

Ten of the 11 Worthy Burger diners ate at the restaurant between late August and Sept. 17, when the restaurant voluntarily closed down for five days. During the shutdown, Worthy Burger switched food suppliers, did a thorough cleaning and implemented some other recommendations from the health department. But the restaurant continued to cook hamburgers rare and medium-rare at customers’ request.

Tompkins said on Friday that one of the original nine cases involved a diner who ate at Worthy Burger on Sept. 22, the day that the restaurant reopened. That prompted further visits from state health officials, and led the restaurant to reconsider its practices in regards to rare burgers. Health officials routinely warn that rare burgers have not been cooked to the 155 degrees needed to kill the bacteria.

Worthy Burger co-owner and executive chef Jason Merrill confirmed that the restaurant, which used to advertise its signature burger as “pink in the middle,” is now thoroughly cooking all of its burgers .

“We’re not doing rare burgers,” Merrill said. “What’s happening right now, we’re cooking our burgers all the way through to the USDA-recommended temperature of 155 degrees.”

He said most of the customers have been understanding, and that at least some of those who were sickened during the outbreak have come back.

“They’re just happy that we’re serving good burgers,” he said.

Elizabeth Doherty, a 22-year-old Vermont Law School student who has been diagnosed with E. coli, said she ate a hamburger that she considered to be undercooked at Worthy Burger on Sept. 22, but health department investigators have not yet told her whether her case is the Sept. 22 case that has been confirmed as part of the Worthy Burger outbreak.

Doherty, who first began showing symptoms on Sept. 25, said on Friday that she had made a full recovery, and that investigators have asked her for more information about what she ate before getting sick.

Tompkins said that earlier this week, state workers visited Worthy Burger again to look for possible reservoirs of the bacteria that could have been overlooked during the initial cleaning. For example, he said, workers asked the restaurant to replace a spatula that had a handle that made it difficult to clean.

Merrill said his understanding is that the focus of the investigation has shifted, away from the restaurant and toward its former suppliers.

“I hope they find where the source came from and the people that were responsible are the ones that own up to it,” he said.

However, the evidence has been murky enough that, 22 days after the Worthy Burger first closed its doors, federal and state investigators are still at odds about what caused the outbreak.

Tompkins and the Vermont Health department have identified the ground beef as the likely culprit.

Not only is ground beef the most commonly ingested item among all of those who have gotten sick with the E. coli strain, but ground beef is a known carrier of the type of E. coli found in their systems. Further, when investigators tested beef and lettuce taken from the restaurant around Sept. 17, the beef was the only item that tested positive for E. coli.

To Tompkins, it paints a pretty compelling portrait.

“The totality of the evidence, that to us, points to ground beef,” he said.

But the case against the beef isn’t air-tight, and officials with the United States Department of Agriculture’s Food Safety and Inspection Service say there is too much doubt to close down a processing plant, or order a recall.

“Many foods we eat are complex,” USDA spokeswoman Gabrielle Johnston said in an email responding to questions from the Valley News. “In this specific Vermont case ... patients reported eating a hamburger — which is a complex food, because burgers typically have ground product, tomatoes, lettuce, onion , condiments, and sometimes cheese. All of these food items could be a possible vehicle to carry E.coli O157:H7.”

Johnston said that no test from state or federal investigators have yielded a smoking gun.

“Contaminated meat has not been identified in this investigation, because there has not been a positive E.coli O157:H7 in any of the analyzed samples... ” she said. “Evidence at this time does not implicate ground beef as the source of the outbreak. Test results for other food items of interest are still pending.”

Tompkins, the state epidemiologist, agrees that the unopened packages of beef taken from Worthy Burger tested positive for E.coli O157, which is a different strain than E.coli O157:H7, the one found in at least seven confirmed patients.

The beef had DNA of shiga toxin, but not the shiga-toxin producing strain of E. coli found in the patients, he said.

“It’s not conclusive,?? he said. “It’s not the nail in the coffin.”

But, he said, the most likely explanation is that two strains of E. coli came into the restaurant from the same source point in the supply chain — a farm or slaughterhouse.

Tompkins said that tests on lettuce, which is served with Worthy Burger hamburgers, didn’t show any contamination, which made it an unlikely source of the contamination. He also said his department doesn’t believe other foods commonly served with hamburgers at the restaurant are to blame.

Both agencies are continuing to investigate the outbreak.

Matt Hongoltz-Hetling can be reached at mhonghet@vnews.com or 603-727-3211.