A 2-year-old Tacoma boy died today from an infection linked to contaminated hamburgers from a fast-food restaurant.
It is the first death among more than 100 people sickened by the food-poisoning epidemic that has hit mostly the Puget Sound area this month. The outbreak is linked to Jack in the Box restaurants.
The Tacoma boy died at Children's Hospital Medical Center in Seattle of heart failure stemming from kidney failure caused by the bacteria E. coli 0157:H7. He was identified by the King County medical examiner's office as Michael Nole.
In Tacoma, the boy's grandfather, Joseph Nole, today identified the child's parents as 30-year-old Michael Nole, a roofer, and Diana, who works at St. Joseph Hospital there. The boy was their only child.
"He wasn't really awake the last couple of days, but last night we went in and talked to him and he seemed to know us. He'd squeeze your fingers," Joseph Nole said. "I can't believe he's gone. He was such a little sweetheart."
Nole said his grandson ate a cheeseburger on Jan. 11 at a Jack in the Box restaurant near his son's home on the south side of Tacoma. "He loved hamburgers," he said.
Joseph Nole said his grandson felt nauseated that night, developed diarrhea the next day and then progressively grew worse.
Joseph Nole said his family is "very, very angry" about the boy's death. "Someone's going to pay for this," he said. "It's just not right." He said parents of another sick child have contacted an attorney and asked his son if he wants to join in a lawsuit.
Nine other children are still in Children's, including eight on kidney dialysis. A 9-year-old girl is in critical condition and two others are in the intensive-care unit.
"We're still fighting hard . . . trying to treat these children," said Dr. Ellis Avner, director of Children's kidney unit. "We still feel we're ahead of the game. But this is pretty devastating."
The most seriously ill in the outbreak have been children. And, Avner said, they are significantly more affected by hemolytic uremic syndrome (HUS), kidney failure which results in about 10 percent of those infected with E. coli 0157:H76.
"It appears to be a very severe outbreak," said Avner.
Most patients who suffer from HUS become very ill and need kidney dialysis; some may die or have chronic kidney failure, needing lifetime dialysis or a kidney transplant.
State health officials have found massive amounts of contamination in raw hamburger recalled from Jack in the Box restaurants early this week, confirming that the food-poisoning outbreak originated in the chain.
"These are very high numbers, exceedingly high numbers" of fecal bacteria in the hamburgers, said Bert Bartleson, a food expert with the state Department of Health.
Hamburger patties from 10 Seattle-area Jack in the Box restaurants are being tested for the E. coli 0157:H7 bacteria.
About 70 people are confirmed by tests to have the bacteria and about another 30 people are strongly suspected of having it. All but two of those cases in Washington state are in the Puget Sound area.
The latest round of tests pinpoint the bacteria family, but not the specific strain. Bacteria are killed if meat is adequately cooked.
Jack in the Box officials are now worried their hamburger supplier, Vons Cos. of Arcadia, Calif., also may have shipped contaminated meat to its Commerce, Calif., warehouse.
That Los Angeles-area warehouse - which stocks 400 Jack in the Box restaurants in Southern California, Nevada, Hawaii, Mexico and Hong Kong - recently received meat from Vons.
Officials of the U.S. Department of Agriculture and Centers for Disease Control and Prevention have been working since Monday to trace the specific source of the contamination and determine where else the meat was distributed.
E. coli bacteria are found in the intestines of cows and other animals. If the intestines break open during slaughtering the bacteria can contaminate the meat.
Health officials in San Diego County, California, said five children there have tested positive for E. coli 0157:H7 since about mid-December. One child died late last month, but officials there still are awaiting autopsy results to learn the cause of death.
Dr. Michele Ginsberg, an epidemiologist with the San Diego County Health Department, said investigators have found no common means of E. coli exposure among the children, one of whom remained hospitalized in serious condition yesterday. They ate at several different restaurants, she said.
Dr. John Kobayashi, Washington state's chief epidemiologist, said the Department of Health has dozens more reports of bloody diarrhea, the first major symptom of the illness, along with severe stomach cramps.
"We're still sorting out whether these are E. coli 0157:H7 or not," he said.
Kobayashi said the most serious confirmed cases are at Children's Hospital, although there also have been other hospitalizations possibly linked to the outbreak. .
State health officials have said they found in tests since the outbreak that Jack in the Box procedures didn't always allow hamburger patties to cook to 155 degrees, as required by state regulations.
Bob Nugent, Jack in the Box president, said new procedures, equipment checks and retraining ensure the temperature is reached.
"We're highly confident the food in our restaurants is now safe and wholesome," said Nugent.
Washington last May became the first state to increase the required temperature from the federal standard 140 degrees to 155 degrees. It was an extra safety measure, health officials said.
But Nugent says the first his company heard of it was this week.
Bartelson, the state Health Department's food expert, said it's entirely possible the San Diego-based company didn't get the word. He said fast-food restaurants weren't targeted first for the information because they haven't had problems with such contamination.
Nugent said the 4,000 pounds of meat in question was processed by Vons Cos. last Nov. 19. Of 164 cases shipped to Washington, 64 were recalled in time; 100 were consumed. Of the 29 cases shipped to the Jack in the Box warehouse in Commerce, six were recalled, 23 were consumed.
Vons and the companies that supply it issued strong denials that their procedures could have led to the contamination. All spoke of U.S. Department of Agriculture officials who inspect their plants.
"Vons believes its processing did not contaminate the patties," the company said in a statement.
Jack in the Box said three packing or slaughterhouse companies shipped the meat to Vons: Monfort Meat Co. of Greeley, Colo.; Service Packing Co. of Los Angeles; and Orleans International of Detroit, which imports frozen beef from Australia.
Monfort and Service Packing representatives said they follow strict inspection procedures for their plants. Officials of Orleans could not be reached for comment.
Trading today in the stock of Jack in the Box's parent, Foodmaker, was halted on the New York Stock Exchange shortly before 10 a.m. The stock, in volume of more than 10 times its norm, had plummeted $2.50 a share to $9.50.
Foodmaker traded at $13.625 a share when news first broke of the food contamination Tuesday. The drop to $9.50 means the stock has lost nearly $160 million in market value.
Foodmaker owns 680 Jack in the Boxes and 174 Chi-Chi's Mexican-style restaurants throughout the West.
-- Times business reporter Greg Heberlein contributed to this story.