Cafe Coyote Shigella Outbreak
On December 4, 2015 staff at the County of San Diego Health and Human Services Agency (SDHHSA) detected an outbreak of Shigella among customers of Café Coyote, a restaurant located in the Old Town district of San Diego. The outbreak was identified through routine interviews with reported case patients. Additional cases were reported by other county/state health jurisdictions and complaints called in to the County of San Diego Department of Environmental Health (DEH). A total of five separate affected parties ranging in size from 2 to 15 persons with 1 to 8 ill persons in the party were identified. Four of the parties dined at Café Coyote on November 24, 2015. The fifth party dined the morning of November 25. Two parties also ate at the restaurant on another occasion between November 23 and November 26. Thirty-six persons were interviewed representing all five parties. There were 19 cases and 17 controls. Six ill persons were cultured confirmed with Shigella sonnei. One patient was positive for Shigella by PCR. There were 12 probable cases.
Genetic testing of isolates cultured from three outbreak associated case patients was conducted by the Microbial Diseases Laboratory at the California Department of Public Health (CDPH). Pulsed field gel electrophoresis (PFGE) showed that all three cases were infected with PulseNet strain J16X01.1166.
Case control data analysis showed that salsa was statistically associated with illness. All of the ill persons consumed salsa versus only 41% of the controls, p. <0.0001. Investigators were not able to determine if there was a contaminated ingredient or if the salsa was contaminated via an ill food handler. DEH conducted an on-site investigation at the Café Coyote on December 7. Salsa was observed to be slightly out of proper temperature holding range. All food handlers including those who prepared salsa denied illness. Many food handlers participate in serving any one table so any one of the 200 food handlers could have potentially contaminated the salsa.
SDHHSA and CDPH reported the outbreak to the Centers for Disease Control and Prevention (CDC) using the Foodborne Disease Outbreak Report form. The local identification number assigned to the outbreak was 15-244.