King County Public Heath is investigating an outbreak of gastroenteritis with abdominal cramps and diarrhea associated with Rancho Bravo Tacos at 1001 East Pine Street on Capitol Hill in Seattle, Washington. Four people from one party got sick soon after eating food at the restaurant on April 22, 2017. None of the patients was hospitalized. 
The symptoms and timing of these illnesses suggest Bacillus cereus or Clostridium perfringens toxin. Those bacteria cause the symptoms of nausea, vomiting, and diarrhea, and illness onset is very quick, usually within thirty minutes to a few hours.
No tests were conducted to confirm which pathogen caused the illness because these illnesses are short-lived and by the time a patient sees a doctor it is too far from exposure to test, according to the press release.
There have not been any other reports of illness from this restaurant. Environmental Health Investigators visited the restaurant in 4/25/17. During the field inspection, improper cooling and hot holding of potentially hazardous foods were identified. Those are factors that may have contributed to this outbreak. Those two bacteria produce toxins when they grow. And they can grow in foods that are held between the temperatures of 40°F and 140°F.
Foods that were prepared over that weekend were thrown out, and improper food handling practices found during the inspection were corrected. The restaurant is working with public health. Inspectors will re-visit the restaurant in 14 days to ensure that the corrected practices remain in place.
Bacillus cereus and Clostridium perfringens bacteria grow rapidly at room temperature and in the danger zone. When cooking potentially hazardous foods, it’s critical that food is kept out of the danger zone. That means keeping cold foods below 40*F, and hot foods above 140°F. Food should be served while it is still hot. Hot foods to be chilled should be divided, placed into shallow pans, and refrigerated immediately.
Last year, there were several outbreaks caused by Bacillus cereus. One was at Mighty Taco restaurants in Erie and Niagara counties in New York that sickened at least 158 people. And there were a few outbreaks in 2016 caused by Clostridium perfringens. One was at the Antioch American Legion in Contra Costa, California. At least 25 people were sickened in that outbreak, and three people died.
