In July 2018 Public Health Seattle King County (PHSKC) announced an outbreak of Shiga toxin E. coli (STEC) infections associated with I Love Sushi and Sodexo's Café Mario at Nintendo of America campus in Redmond, Washington. Café Mario is operated by Sodexo and is not open to the public. I Love Sushi is a food establishment that operates out of Café Mario once a week. Four laboratory confirmed cases were identified.

At Cafe Mario potential risk factors were identified including inadequate hand washing practices and improper cold holding temperatures of food. At I Love Sushi, potential risk factors included improper temperature storage of foods. Investigators did not identify any employees of either restaurant who had a recent diarrheal illness.

Queries of NCBI and PulseNet identified 8 additional isolates that either were indistinguishable by one or both enzyme patterns or were highly related to the Seattle cluster. A total of 8 additional isolates were identified from WA (2), CA (1), KY (1), PA (1), TN (2), and WI (1). Of the 12 cases identified in this cluster, 2 were hospitalized and no one died. Cases experienced illness onset between June 22, 2022 and July 31, 2022.

A hypothesis generating questionnaire was administered to the additional cases and 5 were returned. No commonality among the cases were identified.

NORS Report ID 2018-109; CDC Cluster ID 1809WAEVC-1