The Pennsylvania Department of Health is investigating five cases of E. coli O157 reported in four counties that are believed to be linked to eating rare or medium-rare steak at different Hoss’s Steak and Sea House restaurants.

Four of the five cases were hospitalized; none developed kidney failure.

“The Department of Health is working very closely with the Pennsylvania Department of Agriculture and the United States Department of Agriculture to provide any information that can help in identifying the source of the E.coli cases,” state Health Secretary Dr. Calvin B. Johnson said. “We will continue to work with our partners to identify cases in Pennsylvania and, we hope, prevent any additional illnesses.”

The ill persons ate at four different Hoss’s restaurants between March 24- 29, in Centre, Dauphin, Venango and York counties. The restaurant exposures are the only common link among the individuals and suggests that the source of the infections is an item consumed at the restaurants. All confirmed cases ate different cuts of steak; several reported the item was requested and consumed rare or medium-rare.

Because the number of cases is small and the exposure period was several weeks ago, the health department believes the risk to Hoss’s customers is low. However, customers who may have taken home leftover steak should discard it. The USDA has issued a recall of steak products from H-F-X Inc., which is Hoss’s processing and distribution center in South Claysburg, Pennsylvania. The company is fully cooperating with federal and state authorities in the recall and illness investigation. Escherichia coli are bacteria that normally live in the intestines of healthy people and animals. While most strains of the bacteria are harmless, E. coli 0157:H7 is a specific strain of E. coli that causes severe illness, often with abdominal pain and bloody diarrhea. Most healthy individuals can recover completely within a week, but the very young and elderly are at a greater risk of developing a form of kidney failure called hemolytic uremic syndrome (HUS), which can be fatal.

As is the case with many other foodborne infections, the risk for these infections increases if meat is consumed raw or undercooked. The state Department of Health recommends that consumers eat meat only if it is thoroughly cooked. This is especially true for young children, the elderly, and persons with a compromised immune system.

Hoss’s Steak and Sea House is a privately-owned company that operates 41 restaurants under the registered name of Hoss’s Steak and Sea House.