One person died and more than 30 were infected in November 2017 in a Salmonella outbreak among customers of a Colorado restaurant, but the public wasn’t notified at the time and the restaurant remains open for business.

A Nov. 27 inspection report for the implicated restaurant, La California on Peoria Street in Aurora, CO, shows the Tri-County Health Department did not find any violations at that time. However, reports for inspections on Dec. 6, 8, 15 and 19 show multiple critical violations.

A number of those violations, such as holding foods at the wrong temperatures and not keeping raw chicken separate from other foods, are known to allow Salmonella bacteria to grow rapidly and to cause cross contamination of other foods.

Thursday the health department confirmed details about the outbreak for reporter Erika Gonzalez of the KDVR-TV Channel 31 news department. It was not clear Thursday evening why public health officials did not alert the public of the outbreak at the time.

Laboratory tests showed the restaurant’s family meal combo was likely the source of the Salmonella. However, health officials told multiple Denver area media outlets that they had not been able to isolate which food or foods in the meal combo were specifically contaminated.

One restaurant employee tested positive for Salmonella infection, according to the CBS News affiliate in Denver. All of the other outbreak victims were customers of La California. All of the illnesses began between Nov. 4 and Nov. 26, 2017, the health department reported.

The department reported 13 of the 33 cases are confirmed. Twenty of the sick people are probable cases. Twenty-five of the sick people ate at the restaurant within a five-day period from Nov. 10 to 14, 2017.

Violations observed during the Dec. 6 health department inspection of La California restaurant included:

  • Cross-contamination — A container of raw chicken was stored on-top of a box of raw shelled eggs in the walk-in refrigerator. A box of eggs was stored on a box of tortillas in the walk-in refrigerator.
  • Hand washing —  A cook line employee was observed cracking raw shelled eggs but failed to properly wash their hands and change their gloves before handling ready to eat tortillas and ready to eat cheese.
  • Food temperature control — Three large containers of refried beans were 50 degrees F after cooling overnight on the shelf beneath the preparation table across from the preparation sink. A large pot of cooked tomatillos and jalapeños was 47 degrees F after cooling at room temperature overnight on the floor. A small pot of tamale salsa was 53 degrees F after cooling overnight in the 4-door reach in refrigerator. A large pot of basole was 48 degrees F and a large pot of beef soup was 48 degrees F after cooling overnight in the walk-in refrigerator.

The U.S. Food and Drug Administration, the Centers for Disease Control and Prevention and the U.S. Department of Agriculture warn that foods should not be held at temperatures between 40 degrees and 140 degrees.

Violations observed by public health inspectors during the Dec. 8 follow-up visit included:

  • Personnel hygienic practices — An employee was observed rinsing their food probe thermometer in the hand sink located on the cook line. Utensils were stored in the basin of the cook line hand sink.
  • Food temperature control — Cooked, ready-to-eat carnitas were measured between 124 degrees and 132 degrees F on the cook line hot holding table. Cooked rice measured 127 degrees F on the cook line hot holding table.

One violation was observed by public health inspectors during the Dec. 15 follow-up visit: Hand washing — Paper towels were not available at the hand sink by the food preparation sink.

One violation was observed by public health inspectors during the Dec. 19 follow-up visit: Personnel hygienic practices — A red plastic basket was observed in the basin of the hand washing sink located on the cook line.

A follow-up inspection on Dec. 26, 2017, showed no violations.

Symptoms of Salmonella infection usually include diarrhea, fever and abdominal cramps, beginning from 12 to 72 hours following exposure, according to the U.S. Centers for Disease Control and Prevention.

In most cases, symptoms last for four to seven days, and most victims recover without treatment. However young children, the elderly, and people with weakened immune systems may be prone to more serious illness, including severe diarrhea, which can result in severe dehydration.

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