State health officials say the Sterling restaurant implicated in recent E. coli outbreak has corrected sanitation problems and reopened.
The Mad Moose Cafe scored a nearly perfect 99 in an Aug. 3 inspection, said Jerry Farrington, an environmental health officer for the Alaska Department of Environmental Conservation. The only defect was the lack of a thermometer in a restaurant refrigerator.
"They corrected everything in their report," he said.
The Mad Moose reopened last Friday.
Meanwhile, Jeff Moore, who owns the Mad Moose with his wife, Leana, questioned whether their restaurant was really the source of the recent outbreak from a virulent strain of E. coli bacteria.
"It's never been traced to the Mad Moose," he said. "The only thing wrong with the Mad Moose is that three of our waitresses had it. The chefs didn't have it. All the food checked out."
He said state officials told him it could simply be that someone off the street entered the restaurant and picked up a ketchup bottle without washing his hands.
Authorities were led to the Mad Moose Cafe after nine of 10 people initially sickened by E. coli 0157 bacteria were interviewed.
"The only common exposure identified by the ill persons was ... the Mad Moose," Dr. Michael Beller, a medical epidemiologist at the state's Division of Public Health in Anchorage, said last month.
A July 27 Section of Epidemiology report said there were nine laboratory-diagnosed cases of E. coli 0157 in people who ate at the Mad Moose between July 7 and July 19.
Another 10 people who ate at the Mad Moose between those dates reported symptoms consistent with E. coli, such as severe abdominal cramping, diarrhea or bloody diarrhea. Laboratory tests were pending for seven of those people, and specimens were not available from three.
Since July 21, another five people with diarrhea were reported from the central peninsula. They were still being evaluated, the report said. Two people who live with family members diagnosed with E. coli also had contracted the disease.
The owners voluntarily closed the Mad Moose on July 19 after a DEC inspection turned up sanitation problems. Farrington said knife marks in a formica counter suggested it had been used as a cutting board. Because it was built-in, it could not be adequately cleaned, he said.
The DEC inspection also determined that the Mad Moose stored raw steak and hamburger in a refrigerator where their juices could drip onto vegetables that could be served raw.
DEC also questioned whether employees were adequately washing their hands and questioned whether there could be cross-contamination between foods. For example, Farrington said, if an employee makes hamburger patties, then handles lettuce without washing his hands, contamination from the raw hamburger could spread to the lettuce.
Beller said tests of food sampled from the restaurant failed to detect E. coli 0157.
However, he said, negative findings do not clear the restaurant. A person who eats a contaminated meal may not get sick until eight days later. He may wait to visit the doctor, and wait again before visiting the hospital for tests. Once cases are confirmed, it takes time for authorities to pin down the likely source and take samples.
"By the time we took the samples, it was two weeks from the time people ate," Beller said.
There were sanitation problems at the restaurant, he said, and three employees tested positive for the same strain of E. coli.
"That, to us, was absolute confirmation of the source of the problem," Beller said.
Jeff Moore said the formica counter was used for a cutting board only briefly, just after the restaurant opened.
Now, employees use a separate cutting board and disinfect that with bleach.
"The only common thing was that some of the people (who got sick) ate there," he said. "We're so popular, everyone eats there. If it came from our restaurant, it would not have been five or six people. It would have been hundreds of people."
Farrington said, though, that just because the contamination is there does not mean that everyone who eats at the restaurant will become sick.
"It's like making a potato salad and putting an M&M in it," he said. "If you serve it to everyone, someone will get the M&M."
In addition, the very young and the very old are more susceptible, he said.
Moore said several people became ill with E. coli who had not eaten at the Mad Moose. In addition, one girl who got sick supposedly ate at the Mad Moose on July 19, a day the state sampled food from the restaurant.
Beller said finding E. coli in food from the restaurant would be very convincing, but negative results prove nothing. It is never possible to test the food that made someone sick, he said, because it is gone.
"Sometimes the reason it's gone is that the person ate it. That's what happened on the 19th," he said. "Did it come from the restaurant? Absolutely. There's not a shred of doubt about that."
He said there was only one recent case of E. coli in a person who had not eaten at the Mad Moose. That was in Anchorage, and the person had a different strain of E. coli.
"He can count his blessings that there weren't hundreds of people infected," Beller said. "This is potentially fatal, and there could have been deaths. Whatever was there was present at a low enough concentration that it didn't infect hundreds of people."
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