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Shiga toxin-producing E. coli O157 outbreak associated with Tokyo Stop Teriyaki in Bellevue
| AT-A-GLANCE | |
|---|---|
| Cases | 5 |
| Hospitalizations | 4 |
| Deaths | 0 |
| Status | Investigation is complete |
| Location | Tokyo Stop Teriyaki 1504 145th Pl SE, Bellevue, WA 98007 |
| Meal Date Range | November 24, 2025, and November 26, 2025 |
| Illness Onset Date Range | November 26, 2025, through December 1, 2025 |
| Current Inspection Rating | Needs to Improve |
Summary
Public Health investigated an outbreak of Shiga toxin-producing E. coli O157 (called STEC) associated with food from Tokyo Stop Teriyaki in Bellevue. Five King County residents became sick with STEC after eating food from Tokyo Stop Teriyaki. The type of STEC for all five people was determined to be the same using DNA fingerprinting (whole genome sequencing or WGS). It is likely these five people became sick from contaminated food served at Tokyo Stop Teriyaki.
There was one additional person in King County whose illness matches the other five cases by WGS and did not report eating food from Tokyo Stop Teriyaki. It is unclear how this person became infected with the same type of STEC.
A survey posted on December 22, 2025, through January 9, 2026, did not identify additional people who might have been part of this outbreak.
This outbreak appears to be over, and our investigation is complete.
Illnesses
The sick people reported signs of STEC, including nausea, vomiting, stomach cramps, diarrhea (including bloody diarrhea), and fever. Four people were hospitalized and recovered.
We did not find any sick restaurant workers at Tokyo Stop Teriyaki.
Public Health actions
On December 12, 2025, we asked the restaurant to close. We visited the restaurant on December 13 and found several problems that could have contributed to this outbreak:
- Sinks for washing raw meat and vegetables were placed too close together
- Tools and surfaces used for raw meat like chicken, weren’t sanitized properly
We worked with the restaurant to improve their food safety practices and do a full cleaning and disinfection. When we returned on December 15, we confirmed that the cleaning was done properly and that they were following required food safety procedures. Based on this, they were allowed to reopen.
We conducted a follow up visit on December 18, 2025, to collect food source information that was shared with the Washington State Department of Health. At this time, no connections have been made with other similar STEC illnesses.
We posted a survey on our website on December 22, 2025, through January 9, 2026, to find others who may have been part of this outbreak. We received 15 responses and reviewed their symptoms and meal information. Among the 15 responses, we did not identify any additional people who might have been part of this outbreak.
Laboratory testing
All six people who became sick tested positive for the same type of STEC (O157), using DNA fingerprinting (whole genome sequencing or WGS).
About STEC
E. coli germs (bacteria) normally live in the intestines (gut) of humans and animals. Many types of E. coli bacteria exist, and most of them are harmless or beneficial to human health. STEC are types of E. coli that produce Shiga toxin (such as E. coli O121) and can make people very sick.
STEC infections can happen when eating raw or undercooked ground beef and other beef products; unpasteurized (raw) milk, cheese, and juice; contaminated raw fruits, vegetables, sprouts, and herbs; water contaminated with animal feces (poop), or by direct contact with farm animals or their environment. Ready-to-eat foods can also be contaminated with STEC through contact with raw beef or raw beef juices in the kitchen.
STEC and other foodborne infections occur throughout the year but may increase during late spring and summer months.
Signs of STEC include diarrhea (which often becomes bloody) and stomach cramps, with mild or no fever. Illness typically lasts several days and people can spread infection to others even after signs resolve.
- STEC infections usually resolve in 5–7 days but people may still spread the bacteria in their poop when no longer sick. Up to 33% of children may continue to shed STEC in their poop for as long as 3 weeks after they are no longer sick.
- Around 5–10% of people who are diagnosed with a STEC infection can have a potentially life-threatening complication known as hemolytic uremic syndrome (HUS). Clues that a person is developing HUS include decreased frequency of urination (peeing) and feeling very tired. People with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems. Most people with HUS get better in a few weeks, but some suffer permanent damage or die.
- Sick people with suspected STEC infection should not work in food handling (like restaurants), patient care (like hospitals), or childcare/daycare, and sick children with suspected STEC infection should not go to daycare/childcare until they have seen a healthcare provider (doctor) and been tested for STEC infection, even if their sickness is mild. People with STEC infections who work in food handling (like restaurants), patient care, or childcare/daycare or go to childcare/daycare must be cleared by Public Health before returning.
Prevention
General advice to avoid getting sick with STEC:
- Avoid eating high-risk foods, especially undercooked ground beef and other beef products, goat products, and sheep products, unpasteurized (raw) milk or juice or cheese, and raw sprouts.