Oct. 28 update: As of Tuesday night, Oct. 27,  the number of outbreak-associated cases of Shigella reported to the Santa Clara County Public Health Department stands at 190. There are 151 Santa Clara County residents and 39 people who live in other counties among those sickened. Of the 190 total cases, 92 are lab-confirmed (72 of whom are Santa Clara County residents). There are 20 confirmed cases from other jurisdictions, including the counties of San Mateo, Alameda, Santa Cruz, Marin and Merced. Nearly all of those sickened have reported that they ate at Mariscos San Juan #3 restaurant in downtown San Jose, CA, on Friday, Oct. 16, or Saturday, Oct. 17, 2015. Oct. 26 update: The Shigella outbreak linked to the Mariscos San Juan restaurant in San Jose, CA, is now estimated to involve 182 people, with new cases being reported from Marin and Merced counties. Seventy-two of the cases have been laboratory-confirmed. The downtown seafood restaurant is still closed, and the investigation is said to be focusing on an employee who may have been responsible for the situation. Oct. 22 update: According to the Santa Clara County Health Department, there are now 110 people with illnesses linked to the Mariscos San Juan seafood restaurant in downtown San Jose, CA. Santa Clara County Director of Public Health Dr. Sara Cody said Thursday that the illnesses are beginning to level off. Previous coverage follows: Mariscos San Juan at 205 N. 4th St. in downtown San Jose, CA, was closed Oct. 18 after the Santa Clara County Public Health Department connected the seafood restaurant with an outbreak of Shigella that reportedly may have sickened at least 80 people. MariscosSanJuan_406x250The restaurant remains closed, and Santa Clara health officials say 11 of the Shigella victims have been treated in intensive care units at area hospitals. All of those stricken with the intestinal infection that causes fever, abdominal pain and diarrhea report dining at the San Jose restaurant on either the previous Friday or Saturday. Shigella is a pathogen that usually can be treated successfully with antibiotics. Local health officials said Monday that they expect the number of those sickened will grow, and they issued a request for action by all clinicians in the area. Clinicians treating suspected Shigella patients are being asked to test stool cultures and order antimicrobial susceptibility testing and blood cultures if the person is hospitalized. Doctors were also asked to “tailor therapy based on results of susceptibility testing, recognizing that routine antimicrobial susceptibility tests for Shigella may not include some commonly available oral antibiotics.” Area emergency rooms were reporting they were treating multiple patients with vomiting and fevers as high as 104 degrees F. The downtown Mariscos San Juan is one of the restaurant chain’s three locations in San Jose. The Willow Street restaurant had its permit suspended in August. The third location on Senter Road in San Jose remains open. Santa Clara County has suspended the permits of 81 restaurants during the past six months for a variety of code violations.

(To sign up for a free subscription to Food Safety News, click here.)