San Diego County health officials are warning residents about a statewide E. coli outbreak linked to The Kebab Shop after two local cases were reported, according to East County Magazine and the County of San Diego Communications Office.

The cases are part of a wider California investigation into Shiga toxin-producing E. coli, or STEC, connected to the chain's beef kofta dish. Statewide, officials have identified nine cases across five counties, including six children, five hospitalizations and two cases involving hemolytic uremic syndrome, a serious complication that can damage the kidneys.

County officials said one of the two local patients was hospitalized and has since been released. No deaths have been reported, and health officials said customers are no longer at risk from the product because the restaurant chain stopped selling the beef dish on or before May 18.

For Santee and East County residents, the warning applies to anyone who ate at a San Diego County Kebab Shop location between March 27 and April 30 and later developed symptoms such as severe stomach cramps, watery or bloody diarrhea, or vomiting. Officials said symptoms often begin three to four days after exposure.

The California Department of Public Health is investigating, with support from the county's Public Health Services Epidemiology unit and Department of Environmental Health and Quality. Residents with symptoms are being advised to contact a health care provider.