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Story highlights
- More cases in Washington and in Oregon, bringing total up to 37
- Chipotle says it is doing a deep cleaning and full sanitizing of its restaurants in the area
- Cases are being investigated in connection with eight Chipotle restaurants
(CNN)At least 35 E. coli cases in Washington and Oregon have been linked to the Mexican-themed restaurant chain Chipotle, health officials said, prompting the company to temporarily close dozens of restaurants.
Two other E. coli cases in Washington were not definitively connected to Chipotle, the Washington State Department of Health said.
The restaurant chain has responded by temporarily closing 43 restaurants in the two states affected, "even though only eight restaurants have drawn concern," the company said in a statement Tuesday.
The company is also deep cleaning and sanitizing all of its restaurants in that region, as well as conducting environmental and food testing in those locations, as well as testing in its distribution centers.
"The safety of our customers and integrity of our food supply has always been our highest priority," Steve Ells, chairman and co-CEO of Chipotle, said in a statement. "We work with a number of very fresh ingredients in order to serve our customers the highest-quality, best-tasting food we can. If there are opportunities to do better, we will push ourselves to find them and enhance our already high standards for food safety. Our deepest sympathies go out to those who have been affected by this situation and it is our greatest priority to ensure the safety of all of the food we serve and maintain our customers' confidence in eating at Chipotle."
No one has died in the reported cases of infection, the Washington State Department of Health said. Seven of the Washington patients and three Oregon patients were hospitalized.
A lawsuit was filed in federal court Monday in connection with the outbreak. Charmaine Denise Mode, a pharmacist from Kelso, Washington, ate at a Chipotle restaurant in Vancouver, Washington, on October 21 and started feeling nauseated four days later with "severe diarrhea," according to the lawsuit against Chipotle.
"The next day, the diarrhea became bloody and far more intense," the suit said. She went to the hospital, where she "endured a painful rectal examination," said the suit.
The next day, local health officials linked her case to the Chipotle outbreak, according to the suit, which seeks damages of at least $75,000.
Chipotle did not immediately comment on the lawsuit.
Chris Collins of Portland, Oregon, went to an urgent care center two days after eating at a Chipotle restaurant. "I've never gotten sick like this," he told CNN affiliate KATU. "The excruciating pain in my abdomen was something I've never experienced. It feels like your guts are being ripped out."
The urgent care center sent him to a hospital emergency room.
Photos: Photos: Worst foodborne illness outbreaks
The worst food-borne illness outbreaks – The number of salmonella infections linked to cucumbers continues to soar. Four people have died in this year's ongoing outbreak, according to the Centers for Disease Control, which has reported more than 800 cases.
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Photos: Photos: Worst foodborne illness outbreaks
Tuna – Salmonella in a frozen raw yellowfin tuna product, known as Nakaochi Scrape, sickened 425 people and hospitalized 55 in the spring and summer of 2012. Sushi made from frozen raw tuna is linked to 62 cases of Salmonella this year. Here are some of the biggest foodborne illness outbreaks since 2001.
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Photos: Photos: Worst foodborne illness outbreaks
A Consumer Reports team looked for five types of bacteria that have been found on beef, including E. coli O157, a strain that causes bloody diarrhea and abdominal pain and has been linked with the highest number of outbreaks of foodborne illnesses from beef. Most packages of ground beef in the grocery store contain at least one type of bacteria that could make you sick, according to their survey.
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Photos: Photos: Worst foodborne illness outbreaks
The Food and Drug Administration has issued a ban on some cilantro imported from Mexico after an investigation to determine the cause of hundreds of reported intestinal illnesses in the United States dating back to 2012. People infected with the parasite Cyclospora cayetanensis experienced watery diarrhea, nausea, bloating and cramping. Click here for tips on how to keep your food safe.
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Photos: Photos: Worst foodborne illness outbreaks
Worst foodborne illness outbreaks – Raw milk can contain germs such as E. coli, Salmonella and Campylobacter.
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Photos: Photos: Worst foodborne illness outbreaks
Chicken – In 2013, Foster Farms chicken infected 634 people in 29 states with a multidrug-resistant strain of Salmonella, according to the CDC. Of the 634 cases, 38% involved hospitalization.
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Frozen berries – A hepatitis A outbreak was attributed to Townsend Farms Organic Antioxidant Blend frozen berries in September 2013. A total of 162 cases were reported, and 71 people were hospitalized, according to the CDC. Severe hepatitis cases can cause liver damage. The blend's pomegranate seeds came from a company in Turkey, which was the source of contamination.
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Cantaloupe – Cantaloupes tainted with salmonella infected more than 260 people across 24 states in October 2012. Three people in Kentucky died and 94 were hospitalized. Investigators determined Chamberlain Farms Produce Inc. of Owensville, Indiana, was the source of this outbreak.
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Ricotta cheese – Twenty-two cases were reported of a Listeria monocytogenes infection from the Frescolina Marte brand of ricotta salata cheese in 2012, but 90% of those people were hospitalized, and four people died, according to the CDC.
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Cantaloupe – In September 2011, listeria in cantaloupes left 30 people dead in what was the deadliest U.S. outbreak of a food borne illness since the CDC started keeping track of listeria cases in 1973, according to the agency.
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Ground turkey – Between February and August 2011, the Cargill Meat Solutions Corp. recalled more than 36 million pounds of ground turkey after tests revealed a strain of salmonella. The outbreak killed one person and sickened more than 130.
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Eggs – In summer 2010, more than 1,900 people were reportedly sickened by salmonella found in eggs produced by Iowa's Hillandale Farms, which voluntarily recalled about a half-billion eggs nationwide.
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Celery – Authorities shut down a processing plant in Texas in October 2010 after four deaths were tied to listeria-infected celery produced at the site. The Texas Department of State Health Services ordered SanGar Fresh Cut Produce to recall all products shipped from its San Antonio plant.
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Peppers – Between April and August 2008, 1,442 people in 43 states were infected with salmonella from Mexico-grown jalapeño and serrano peppers. At least 300 people were hospitalized, and the infection may have contributed to two deaths, according to the CDC. Walmart stores in four states recalled jars of serrano peppers as a result.
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Peanut butter – Nine people died from salmonella-infected peanut butter between September 2008 and April 2009. The Peanut Corp. of America had sold the tainted peanut butter in bulk to King Nut, which recalled its products. More than 700 people were infected and 166 hospitalized.
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Spinach – In the summer of 2006, more than 200 people became infected with E. coli from spinach grown on a single California field. Investigators traced the prepackaged spinach back to Natural Selection Foods and baby spinach sold under the Dole brand name. Five deaths were linked to the outbreak.
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Tomatoes – During 2005 and 2006, four large outbreaks of salmonella infections hit 21 states in the United States. Tainted tomatoes being served in restaurants were found to be the cause. Investigators linked the produce to fields in Florida, Ohio and Virginia.
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Roma tomatoes – Pre-sliced Roma tomatoes purchased at deli counters in Sheetz gas stations infected more than 400 people in the summer of 2004. Two other smaller outbreaks in the United States and Canada also occurred that summer and were linked back to a tomato-packing house in Florida.
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Deli meats – Listeria-infected sliced turkey killed eight and infected 46 others in 2002. Three pregnant women had fetal deaths. Two processing plants recalled 30 million pounds of meat following the outbreak.
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Cantaloupe – In 2001, cantaloupe was again the culprit. Salmonella tainted the fruit that killed two, hospitalized nine and infected 50 in an outbreak that started in Mexico.
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Contamination source still undetermined
The source of contamination has yet to be exactly determined, and Chipotle is working with health departments and federal agencies such as the Centers for Disease Control and Prevention and the Food and Drug Administration to help determine the cause of the cases.
On Tuesday, Dr. Tom Frieden, director of the CDC, said the closing down the Chipotle locations was the right thing to do. "[It's] always better to take broad action than narrow it down," he said. "From what we understand so far, they are being very responsible in their actions in response to the cases that have been reported. "
No exact source has yet been identified in this outbreak, but Dr. Kathleen Gensheimer, the FDA's chief medical officer and director of outbreak response, said Chipotle "is sharing all of their records with us, working with us in any way possible to give us information."
Dr. Jeff Duchin, a health officer in King County in Washington, said that these investigations are "really hard" to do since there is overlap in the ingredients used in the different menu items. He's hoping the environmental testing can pinpoint the specific item causing the outbreak. A number of produce items and a few spices have been sent to the lab for testing.
This year, Chipotle also experienced a salmonella outbreak associated with tomatoes, as well as a Norovirus outbreak associated with one of its stores.
"We have seen them associated with clusters this past year, and when the smoke dies down, Chipotle has said they are interested in coming to FDA to discuss what practices might be contributing to these events," Gensheimer said.
More than 20 outbreaks since 2007
Infections with Escherichia coli can cause severe stomach cramps, vomiting and diarrhea which is often bloody. Fever is usually low, if at all present, according to the CDC. Infections can range from mild to life-threatening.
E. coli bacteria are commonly found in human and animal intestines and are a key component of healthy digestion. Most strains are harmless but some are not, according to the CDC. "Infections start ... when you get tiny (usually invisible) amounts of human or animal feces in your mouth," it says.
This happens surprisingly often, the CDC says, and many times no infection results.
Common sources of infection are human and animal contact in the farming industry. In April, at least 25 people became ill with E. coli infections after visiting a dairy fair in Washington state.
But harmful E. coli can also make their way into food ingredients. Food handlers carrying harmful E. coli can pass the bacteria on by not thoroughly washing their hands before performing their work.
The CDC has investigated more than 20 major E. coli outbreaks since 2007. Other common foodborne ailments are caused by listeria and salmonella bacteria.