Officials with the State department of health said e-coli might be the cause of one death and at least 40 cases of illness in northeast Oklahoma.

Health department spokesman Larry Weatherford said the office could know today if the illnesses are related to E. coli bacteria.

Those who were sickened include residents from Bixby, Pryor, Sand Springs, Locust Grove, Broken Arrow, Peggs, Tulsa and McAlester. Health officials said many of those who became sick ate at the Country Cottage restaurant in Locust Grove.

The restaurant is about an hour's drive from Miami and cited as a popular eatery for much of northeast Oklahoma.

“It's pretty hard to draw conclusions at this point,” Weatherford said. “Clearly, there's a connection with the people having eaten there, but there's no confirmed source of the problem.”

The Locust Grove eatery normally is closed on Mondays and voluntarily closed on Tuesday, health officials said.

Health officials said the restaurant passed a surprise inspection over the weekend, but online health department records show inspectors discovered nine violations, including two that directly relate to causes of food-borne illnesses.

The inspection report indicates food at the restaurant that should be kept cooler than 41 degrees was heated above that temperature and that food required to be kept warmer than 140 degrees had cooled below that temperature.

"From what I understand, that's a common problem with buffet tables," Weatherford said. "It has to be considered in the context of restaurant inspections. When you say a restaurant passes inspection, it means they are not shut down."

Weatherford said it's common for a restaurant to have numerous violations during an inspection and urged patience from an anxious public.

"While everyone would like an answer quickly, it takes time to put the investigation together," he said.

Health officials say there are several ways disease-causing E. coli bacteria can be spread, including undercooked meat or cross-contamination of other foods, such as salad, fruits or vegetables, by a food handler or contaminated kitchen utensils.

In a statement Tuesday, the department said that while no source of the outbreak has yet been identified, public health officials are using the incident to stress the importance of hand washing for all households and businesses that serve food to the public.