ST. LOUIS COUNTY -- County health officials on Tuesday said the E. coli outbreak last month that sickened dozens here has been tied to a wave of cases in six other states.
Twenty-five local cases, they said, have been genetically linked to Andre's Banquets & Catering, the company that officials said provided food to multiple events in question.
In total, officials have now identified 115 people who got sick, 13 who were hospitalized and three who contracted a serious condition that can damage kidneys.
Investigators released the update Tuesday, saying the probe into the outbreak was winding down. They called it the "largest of its kind identified in the area."
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Additional cases with matching whole genome sequencing profiles have been reported in Kansas, Illinois, North Dakota, South Dakota, Ohio and Indiana.
"At this time, the genetic data and food histories continue to suggest leafy greens as an exposure factor, although the attack rates from the St. Louis events are notably higher than those in other areas," said Sara Dayley, a spokesperson for the St. Louis County Department of Public Health.
Escherichia coli bacteria live in the intestines of healthy people and animals. When shared, most types are relatively harmless. But 0157, the strain in the St. Louis County outbreak, produces a toxin that can cause severe diarrhea and lead to kidney failure, especially in young children or older adults.
St. Louis County officials on Tuesday said there were three cases of hemolytic uremic syndrome, a serious condition that causes blood to clot and can damage kidneys and other organs. Two people with the syndrome remained hospitalized.
Officials have maintained throughout the investigation that people who got sick ate food served at events catered by Andre's Banquets.
"With 25 cases tied to one specific business and no significant increase in new cases expected, we are confident that we are nearing the conclusion of this outbreak investigation," said county health department Director Dr. Kanika Cunningham.
But a spokesman for Andre's noted on Tuesday that health officials were "still working to find the cause of our local outbreak."
"We have said all along that it was unfair to name Andre's before the lettuce was tested and before the investigation was complete," said spokesman Ed Rhode.
Andre's found itself at the center of the outbreak Nov. 15, when county health officials said that 64 suspected or confirmed E. coli cases were tied to two Rockwood Summit High School events catered by the chain early in November.
A few days later, county officials said the outbreak was connected to a total of five events -- including an Oakville High band banquet and two funeral-related gatherings -- all catered by Andre's, as the number of recorded cases continued to increase.
John Armengol Jr., the second-generation owner of Andre's, repeatedly, adamantly denied the outbreak was tied to Andre's.
And, late last month, the state health department said an unopened package of iceberg lettuce collected from his business was not infected with the bacteria.
But lawyers have said that despite the negative E. coli results, Armengol can still be held legally liable for serving the tainted food under the state's strict product liability law.
And lawsuits against Andre's have continued rolling in.
As of Tuesday, the caterer was facing eight suits.
The most recent: On Nov. 25, High Ridge resident Gary Swearingen sued Andre's on behalf of his son, who fell ill Nov. 11 and was hospitalized for five days.
Two days later, Kimberly Everding sued. She said on Nov. 8 she attended a funeral at Andre's South on Telegraph Road, where she ate a roll, salad, green beans, pasta, mashed potatoes and roast beef. She fell ill with E. coli and was hospitalized for nine days.
The last suit came Monday, when Andrew and Kristi Gordon sued the cater after their daughter fell ill after eating at one of the Rockwood events. She is one of the three E. coli patients who fell ill with hemolytic uremic syndrome, the suit said.
She "underwent multiple blood transfusions and days of dialysis" and remained hospitalized Monday, the suit said.
Bill Marler, a Seattle-based food poisoning lawyer who has filed five of the suits, said on Tuesday he anticipated filing more.
Andre's has been served in his existing cases, he said.
"(We are) waiting on who is going to be defense counsel," Marler said.
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