Georgia public health teams are investigating an outbreak of E. coli in Stephens County that sickened almost a dozen people who ate at a barbecue restaurant in the first week of May.

As of May 23, District 2 Public Health, the Stephens County Health Department and the Georgia Department of Public Health (DPH) identified 10 Georgians and one South Carolina resident who were infected with E. coli 0157:H7 after eating at the BBQ Shack in Toccoa. An additional seven people were probably infected, although their illnesses haven't been confirmed with lab results.

Cherie Drenzek, D.V.M., DPH state epidemiologist, said public health officials consider outbreaks of this strain of E. coli to be public health emergencies since the infections can have severe clinical complications.

"This is a big one, as far as E. coli outbreaks go. It's kind of an all hands on deck situation," Drenzek said.

Seven of the infected patients were hospitalized, five of whom have been diagnosed with Hemolytic-uremic syndrome (HUS), a kind of kidney failure that is a rare but serious complication of E. coli infection.

All of the patients reported their illnesses between May 4 and May 8, and investigators believe everyone was probably sickened sometime between May 2 and May 4.

Now, public health officials are working together to identify the exact source of the contamination, relying on a collaboration between the agencies' epidemiology and environmental health teams and the Georgia Public Health Laboratory.

Drenzek said public health officials learned of the outbreak after a DPH epidemiology surveillance officer noticed a cluster of E. coli cases in lab reports from the Stephens County Hospital - four patients in one week. The Stephens County Health Department had also received complaints about the BBQ Shack after some customers reported being ill after eating at the restaurant. Public health investigators interviewed all the patients who were sick and other diners who ate at the restaurant but did not get sick, tracking them down using credit card receipts. Food samples and environmental swabs taken from the restaurant on May 16 tested negative for any disease.

E. coli 0157:H7 can cause bloody diarrhea, mild fever and abdominal cramps, though some complications, such as HUS, can be more severe. Symptoms usually appear within two to eight days after infection.

To protect against E. coli, wash your hands thoroughly after using the bathroom or changing diapers and before preparing and eating food. Also remember to wash your hands well after touching animals. Washing hands with soap and water is best, but if those are not an option, use an alcohol-based hand sanitizer. Cook meats thoroughly, and avoid eating raw milk, eggs and other unpasteurized foods.