Eleven people, including seven employees of Ajuua’s Mexican Restaurant, are confirmed with Salmonella infections related to the restaurant, which reopened Saturday. Ector County Health Department Director Gino Solla said late last week that the root cause of the outbreak was still unknown, but that fresh tomatoes and/or salsa made and served at the restaurant  in Odessa, Texas, were emerging as a common denominator among the victims. Ajuuas-Restaurant-logo“We don’t know if the tomatoes were contaminated when they came into the restaurant,” Solla said, adding that all “open food” at the restaurant had been destroyed after the outbreak was detected. Restaurant owner Julian Rubio told the Odessa American newspaper that none of the seven employees who tested positive had shown any signs of illness. Nine employees tested negative. “These employees never mentioned any signs of being sick or having any symptoms,” Rubio said. “We thought we were going to get everyone back negative.” Rubio closed the restaurant June 6 at the request of the health department. Solla told Food Safety News last week that he had told Rubio he could reopen when he had enough employees test negative to staff a skeleton crew. It is not known if the employees who tested positive for Salmonella carried the pathogen into the restaurant or picked it up there. Three of the restaurant’s patrons required hospitalization because their symptoms were so severe. Solla said they were all dismissed as of Thursday. As many as 23 other possible outbreak victims had been identified as of Monday. Solla said additional outbreak victims could still be identified, but that the possibility decreases every day. Although the restaurant received good scores of 97 and 100 in February and April of this year, respectively, the food safety record of Ajuua’s Mexican Restaurant has been problematic in the past, Solla said. In 2011 the health department had to close the restaurant, which has had the same sanitarian for a number of years, Solla said. “In Texas if a restaurant gets a score below 70 it is a mandatory closure,” Solla said. “Since they’ve had the same sanitarian I think it is a situation where they were OK and then things slipped and then corrected and then slipped again.” The health director told the Odessa American the cause of the Salmonella outbreak may never be known. “It could be three possibilities that come to mind — it could be food in the establishment that was left in a condition to proliferate the bacteria, it could be an employee or someone working in the establishment bringing it in when they are ill, or it could be a food purveyor,” Solla said, according to the newspaper. Solla said that anyone who ate at the restaurant in late May or early June who developed symptoms of Salmonella infection should see their doctor and be tested. Most people infected with Salmonella develop abdominal cramps, fever and diarrhea 12 to 72 hours after being exposed to the bacteria, according to the Centers for Disease Control and Prevention. Children under the age of 5, adults older than 65, and people with weakened immune systems are at increased risk of severe symptoms and death. (To sign up for a free subscription to Food Safety News, click here.)