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Burgers' Smokehouse has again suspended production at its California plant after 21 of its 300 employees have now tested positive for the coronavirus.

The outbreak among employees at the meat manufacturing plant has contributed to Moniteau County's quick rise in reported cases of COVID-19. Darrell Hendrickson, Moniteau County's environmental specialist, told the Associated Press "the majority" of cases in the county of 16,100 residents are connected to those workers, including relatives and friends.

Moniteau County has reported 54 total cases of COVID-19 among residents, 33 of which are confirmed via laboratory test and 21 probable cases, meaning the patients have become ill and have been identified as a close contact of a person with a confirmed case. One county resident is hospitalized, the Moniteau County Health Center reported Wednesday evening. Four patients from the county have recovered from the virus.

Another rural county — Saline County in west-central Missouri — has reported 96 cases as of Wednesday. Both ConAgra and Cargill operate plants in the town of Marshall in Saline County, which is home to about 23,000 residents.

While the vast majority of Missouri cases have been in the largest cities and their suburbs, data provided by Saline and Moniteau counties showed they have the highest per capita rates of infection in the state — 341 cases per 100,000 residents in Moniteau County and 419 cases per 100,000 residents in Saline County.

By comparison, the city of St. Louis has an infection rate of 290 per 100,000 residents, based on data provided by the state health department. St. Louis County has an infection rate of 234 per 100,000, and Kansas City has a rate of 89 per 100,000.

Saline County Health Department Administrator Tara Brewer said some of the county's cases involve plant workers but didn't have a specific number. Brewer said the high per capita rate in Saline County is due partly to aggressive testing. The county offers drive-up testing 24 hours a day and about 800 people have been tested, she said.

In California, Burgers' Smokehouse has suspended all production operations beginning Wednesday, with plans to reopen April 30. The plant had closed temporarily last week and reopened Monday after an initial burst of confirmed cases were reported among about six employees.

All current Burgers' Smokehouse employees will be paid during the temporary closure, as well as employees who were already away from work due to COVID-19-related illnesses, according to a news release from the company.

Burgers' Smokehouse officials said the company will maintain rigorous mitigation efforts, including enhanced wellness checks, required mask use and strictly enforced distancing measures, to maintain a safe work environment upon return to full production next Thursday. In the meantime, Burgers' Smokehouse will maintain limited receiving and shipping.

"It is my wish for a quick and complete recovery for all our employees, their families and the community who have been directly impacted by the COVID-19 coronavirus outbreak," Burgers' Smokehouse President Steven Burger said in the news release.

This article was updated at 1:50 p.m. and 5:45 p.m. April 22, 2020, with additional details and to update Moniteau County case totals.

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