The patient count from E. coli infections associated with a San Diego restaurant has risen to 35, according to county health officials

At least 10 of the patients, including four children, have required hospitalization after eating at Miguel’s Cocina in San Diego’s 4S Ranch neighborhood. The restaurant had been closed for 10 days, but reopened Nov. 3.

Since its closure, the restaurant has been disinfected, all food at the restaurant has been replaced and staff have been given food handling training and testing, according to San Diego County Health and Human Services Agency spokesperson Tim McLain.

Sick people reported eating at Miguel’s 4S Ranch location from Oct. 6 to Oct. 18 and developed symptoms from Oct. 13 to Oct. 19, according to the the health department. 

County health officials are still investigating the specific food items that were the source of the Shiga-toxin-producing E. coli (STEC) at the restaurant. At least one of the patients has developed the severe complication called hemolytic uremic syndrome (HUS). It attacks the kidneys and blood system and can result in transplants, brain damage and death.

At the time of the previous outbreak update, the sick people ranged in age from 6 to 87 years old. 

“People who visited the restaurant and are feeling ill should see their doctor as soon as possible,” Wilma J. Wooten, county public health officer, said this past week.

“We want them to get tested and have the results sent to the local health department. Those most at risk from infection are children, adults 65 and older, and people with weakened immune systems.”

about E. coli infections 

Anyone who has eaten at the restaurant and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible exposure to the bacteria. Specific tests are required to diagnose the infections, which can mimic other illnesses.

The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. According to the Centers for Disease Control and Prevention (CDC), others can develop severe or life-threatening symptoms and complications.

about 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. 

Many people with HUS recover within a few weeks, but some suffer permanent injuries or death. This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients. 

People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.