By Christopher Snowbeck

Pioneer Press

ST. PAUL — Thirteen people have been sickened, including four who were hospitalized, with food-borne illnesses linked to E. coli bacteria, state health officials said Monday.

Investigators haven’t linked the cases to a particular food item, according to an announcement Monday from the Minnesota Department of Health. But all the illnesses were caused by the same genetic strain of E. coli O111, the department said.

The patients have recovered or are recovering.

“The ill people do not all share any obvious commonalities,” the health department said in a statement. “These facts indicate the illnesses resulted from a widely distributed food item.”

Seven of the people reported eating at Applebee’s restaurants in Minnesota from June 24-27, according to the health department. But there are many cases with no apparent connection to the restaurant, state officials said.

In a statement, the restaurant company wrote: “Applebee’s restaurants in Minnesota voluntarily and out of an abundance of caution have temporarily removed the Oriental Chicken Salad, as well as other ingredients including green cabbage and shredded carrots, from the menu.”

“Six of the 13 cases of food-borne illness that the state is investigating have no connection to Applebee’s, an indication that the illnesses likely are a result of a vendor produce issue,” the company added.

Those sickened had visited five restaurants in the Minneapolis area, according to Applebee’s.

Health officials said E. coli O111 typically causes symptoms that include stomach cramps and diarrhea, often with bloody stools, but no fever or only a low-grade fever. People usually become ill two to five days after exposure, health officials say, although the period can range from one to at least eight days.

Most people recover in five to 10 days.

Health officials say that E. coli O111 is in the same family as the more well-known E. coli O157:H7.

Minnesota typically sees about 230 to 240 illnesses a year from bacteria in the E. coli O157 family, said Michael Schommer, a spokesman for the Minnesota Department of Health. “Most of these infections are not linked to a specific outbreak or food product,” Schommer wrote in an email.

Anyone who has visited an Applebee’s restaurant in Minnesota since June 20 and has symptoms of this particular E. coli infection — particularly bloody diarrhea — should contact their health care provider immediately, the department said. There is no indication of risk at Applebee’s restaurants outside of Minnesota, the company said.

—Distributed by MCT Information Services