Poisoning by Bacteria Kills Second Child : Epidemic: No obvious link is found to Jack in the Box, where disease was first traced. Inspectors close one of chain’s restaurants for selling undercooked meat.

A virulent strain of bacteria mysteriously claimed the life of a second small child Thursday amid a spreading epidemic of food poisoning first traced to Jack in the Box restaurants.

Meanwhile, a suburban outlet of the restaurant chain was temporarily closed by state health inspectors who said that potentially dangerous undercooked meat was still being served despite widespread safety warnings and Jack in the Box’s promises to alter its procedures. Later, the restaurant was allowed to reopen on the condition that employees check the temperature of each hamburger they cook over the next two weeks and log it in a report.

In yet another foreboding development, local health officials said an employee of the same suburban Seattle Jack in the Box was infected with an entirely different contagious viral disease, hepatitis A, and may have spread it to customers. They urged customers to get injections of immune globulin, which contains antibodies to the liver-damaging disease.

So far in the state of Washington, state health officials have tallied 250 cases, positive and likely, of E. coli 0157:H7, a bacterial infection that strikes children especially hard. A 2-year-old boy died last Friday of complications associated with the infection.

On Thursday a second child infected with the intestinal bacteria died suddenly, but health officials said they found “no obvious connection” to Jack in the Box. The 2 1/2-year-old girl was not known to have eaten at one of the restaurants, nor had any of her relatives, who could have spread the potent bacteria.

At Children’s Hospital in Seattle, another 20 youngsters remain hospitalized with symptoms of E. coli poisoning. One is in grave condition, another in serious condition and six others are receiving dialysis. Infected individuals suffer strong cramps, vomiting and bloody diarrhea. Severe infections can result in kidney failure.

In Seattle, the recent outbreak was first reported Jan. 12 by a physician who had been studying the bacterium, some strains of which occur naturally in the human digestive system as well as in that of animals. Investigators began backtracking and found that some, but not all, victims said they had eaten a hamburger at Jack in the Box.

Investigators found high levels of the bacteria in meat samples taken from the restaurants. Typically, the bacteria is spread when meat comes in contact with fecal matter. Cooking at high temperatures kills the bacteria, but state officials said their tests showed that Jack in the Box did not always heat the meat to the state-required 155 degrees.

The federal standard is lower--140 degrees--and may be inadequate to kill the bacteria.

After the initial outbreak, health officials warned of secondary transmission. This can occur in a variety of ways, a state official said, including something as simple as a brother touching a contaminated hamburger and then touching his sister’s face.

Outbreaks of E. coli poisoning have recently occurred in San Diego and Las Vegas. In Nevada, officials said most of the 175 cases of unusual intestinal disease reported in the last month could be attributed to E. coli , and 100 of them were traced to Jack in the Box.

Nevada authorities said there had been “some consultation” in November with Jack in the Box restaurants in Clark County “related to the question of the desired temperature” of their hamburgers.

In Washington state, health officials cautioned that although there was no question some of the reported cases could be attributed to meat served at Jack in the Box, others may not be. Each year in Washington about 150 cases of this bacteria poisoning are reported from a variety of causes.

The chain said in a statement: “Although we understand that this child did not come in contact with the bacteria at a Jack in the Box restaurant, we are devastated by the news of this death.”

The statement followed full-page newspaper advertisements Monday in which company Chairman Jack Goodall called the poisonings “a horrible event” and extended the firm’s “deepest sympathies” to the family of the 2-year-old boy who died.

“Jack in the Box has taken every step possible to eliminate this problem from our restaurants,” Goodall said in the ad. The advertisement said that cooking temperatures had been raised and that the company “has also retrained all food preparation staff.”

On Wednesday, however, King County health inspectors checked a Jack in the Box on Mercer Island, just east of Seattle, and reported that hamburgers were being cooked to only 138 to 142 degrees--far below the state standard to assure safe food. The outlet reopened Thursday after making written assurances that it would correct the problem.

Carl Osaki, acting chief of environmental health for the county, said the outlet was ordered closed “until they could give us some assurances in writing that this condition was not going to continue.” On Thursday, restaurant officials responded with written assurances and the outlet was reopened.

For the next two weeks, employees will have to check the temperature of every hamburger they cook and log it in a report.

Health inspectors had entered the facility because one employee recently sought treatment for hepatitis A.

Osaki said the infected worker had handled food during four work shifts between Jan. 18 and 23 and may have passed on the disease.

Customers who ate at this outlet during the four days were advised to obtain an injection of immune globulin, which contains antibodies. Jack in the Box officials said they would pay individuals up to $35 for the cost of the injections.