Health officials expect the number of cases of E. coli infections linked to Chipotle restaurants in Washington and Oregon to increase.

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The number of people sickened by an E. coli outbreak linked to Chipotle restaurants in Washington and Oregon is expected to grow, health officials say.

As of Friday, 19 people in Western Washington, including four in King County, and three people in the Portland area had become sick from E. coli. Seventeen of them had eaten at a Chipotle restaurant during the past few weeks.

Eight people have been hospitalized — including two in King County — but no deaths have been reported.

What you should know

Symptoms of E. coli infection include diarrhea, abdominal cramps, nausea and vomiting.

The best defense against the bacterial illness is to thoroughly wash hands with soap and water, health officials say.

James Apa, a spokesman for Public Health — Seattle & King County, said at least one of the two King County hospitalized residents had been treated and released.

Marisa D’Angeli, medical epidemiologist with the state Department of Health, said she expects more people will see their doctors as word spreads of the outbreak investigation and could join the list of potential cases.

“We actually would expect there might be a jump in cases on Monday,” she said.

Symptoms of E. coli infection include diarrhea, abdominal cramps, nausea and vomiting. Health officials say the best defense is to thoroughly wash hands with soap and water.

D’Angeli encouraged anyone who has been sick with intestinal symptoms and has eaten at Chipotle since mid-October to go see their doctor and get tested. She also said anyone with bloody diarrhea should go to the doctor whether they have eaten at Chipotle or not.

Disease detectives have not determined the source of the contamination behind the infections.

“We’re very early in the investigation,” D’Angeli said.

The source of the E. coli was most likely a fresh food product, she said, because it probably could not be traced to one sick individual or one instance of cross-contamination of food as the cases are connected with so many restaurants.

D’Angeli noted that Chipotle has been cooperative and voluntarily shut down all its restaurants in the two states.

Chris Arnold, a spokesman for Chipotle, said in an email Sunday that its 43 restaurants in Washington and Oregon remain closed while the investigation continues. So far, health officials have informed the company of E. coli cases linked to six Chipotle sites.

People have reported symptoms of infection in Clackamas and Washington counties in Oregon, and Clark, King, Skagit and Cowlitz counties in Washington.

There are hundreds of E. coli and similar bacteria strains in the intestines of humans. Most are harmless, but a few can cause serious problems.

In the 1990s, three people died and hundreds were infected by E. coli O157: H7 linked to ground beef from Jack in the Box restaurants.

The type of E. coli implicated in the Chipotle outbreak has not been confirmed, but officials believe it is a strain of Shiga toxin-producing E. coli similar to E. coli O157: H7

On Sunday, the U.S. Department of Agriculture announced that Omaha-based All American Meats, Inc. was recalling 167,427 pounds of ground-beef products it made on Oct. 16 and shipped to retailers nationwide because they may be contaminated with E. coli O157: H7.

The recalled products show the establishment number “EST. 20420” inside the USDA mark of inspection, the agency said. The USDA didn’t say which states might have received the products.

Arnold, the Chipotle spokesman, said the company doesn’t use any ground beef in its restaurants.