How to Respond to Food Borne Outbreaks

A guide for restauranteurs and customers in reporting and responding to food borne outbreaks.

Delays in the Prompt reporting of disease outbreaks could lead to a failure to identify and eliminate health risks.

Food service operations should take customer complaints seriously as this can affect your business.

Take steps to show you care will help, even when your operation may not be responsible.

Due diligence demonstrates reasonable cue to present problems.

When food poisoning is reported the following step are suggested

   Name, address and phone number of complainant.

   List of all foods consumed.

   Date food eaten.

   Time between purchase and consumption.

   Symptoms of illness.

   Determine if doctor confirmed illness. If so what diagnosis?

   Determine if public health is involved. If not involved you may notify public health or have customer notify them.

Investigate the Complaint

   Determine what foods may be involved.

   Determine if the staff is involved.

   If any suspect food remaining, remove it from consumption and label it. Keep it refrigerated for health authorities.

   Check if other complaints received, with similar foods?

   Work with health authorities to find if suppliers involved.

   Keep records of outcome investigation and if changes mad to operation. Keep records for 2 years.

   Check if there are patterns to complaints you receive.

   Determine what could be done to improve operations.

Example of Major Foodborne Illnesses

Salmonellosis (Salmonella)

Incubates 6-48hrs. May last 1-2 days or longer.

Symptoms- abdominal pain, headache, nausea, vomit, diarrhea.

Source- domestic and wild animals, humans or carriers.

Foods- Poutry/poultry salads, meat, fish, shrimp, sliced melons, shied tomatoes, mile, shell eggs, egg custards and sauces.

Prevention- Avoid cross-contamination. Refrigerate food thoroughly. Cook poultry to at least 73.4 o C for 15 sec. rapidly cool cooked meats.

Shigellosis (Shigella) - Incubates in 12-50hrs.

Duration -variable

Symptoms- diarrhea (sometimes bloody), abdominal pain, fever, vomiting, chills, lassitude, dehydration.

Source- flies and human carriers.

Foods- salads (potato, tuna, shrimp, chicken and macaroni), lettuce, raw vegetables, milk, dairy products, poultry, moist and mixed foods.

Prevention- Avoid cross-contamination and fecal contamination. Good hygiene and water sources. Control flies and rapidly cool foods.

Listeriosis (Listeria monocytogenes)

Incubation 2-3 days-3 weeks

Indefinite, depends on treatment; high fatality rates in immuno-comprimised individuals.

Symptoms- Nausea, vomiting, diarrhea, headache, persistent fever, chills, backache, meningitis.

Source- Soil, water, mud, humans, domestic and wild animals, fowl, damp environments.

Foods- Unpasteurized milk and cheese, ice cream, raw vegetables, poultry and meats, seafood, and prepared chilled, ready-to-eat foods.

Prevention- Use only pasteurized milk and dairy products, cook foods to proper internal temperatures, avoid cross-contamination, clean and sanitize surfaces, avoid pooling water.

Staphylococcus (Staphylococcus aureus)

Incubates 2-3 days

Symptoms- Nausea, vomiting, abdominal cramps; in more sever cases, headache, muscle cramping, changes in blood pressure and pulse rate.

Source- Humans (skin, hair, nose, throat, infected sores), animals.

Foods- Ham and other meats, poultry, warmed-over foods, egg products, milk and dairy products, custards, potato salads, cream-filled pastries, and other protein foods.

Prevention- Avoid cross-contamination from bare hands, practice good personal hygiene, exclude food service employees with skin infections from food preparations, properly refrigerate food, rapidly cool prepared foods.

Clostridium Perfringens (Enteritis Clostridium perfringens ).

Incubates 8-22 hrs. 24 hrs (may last 1-2 weeks)

Symptoms- Abdominal pain, diarrhea, dehydration.

Source- Humans (carriers), animals, soil.

Foods- Cooked meat, meat products, poultry, gravy, beans that have been cooled slowly.

Prevention- Use careful time and temperature control in cooling and reheating cooked meant, poultry, and bean dishes and products to (73.9 o C) for at least 15 seconds within 2 hrs.

Bacillus Cereus Gastroenteritis (Bacillus cereus)

Incubates ½-6hrs. (emetic type); 6-15 hrs. (diarrheal type).

Symptoms- Nausea and vomiting, occasional abdominal cramps and/or diarrhea, abdominal cramps, pain, nausea (diarrheal).

Source- Soil, dust

Foods- Rice products, starchy foods (potato, pasta, and cheese products), sauces, puddings, soups, casseroles, pastries, salads (vomiting; meats, milk, vegetables, fish (diarrheal).

Prevention- Use careful time and temperature control and quick-chilling methods to cool foods, hold hot foods at (60 o C) or higher, reheat leftover to (73.9 o C) for at least 15 seconds within 2 hrs.

Botulism (Clostridium botulinum)

Incubates 18-36 hrs. (may vary from 4 hrs.-8 days). Illness can go from several days to a year.

Symptoms- Lassitude, weakness, vertigo, double vision, difficulty speaking and swallowing, constipation.

Source- Soil, dust.

Foods- Improperly processing canned low acid foods, garlic-in-oil products, grilled sautéed onions in butter sauce, leftover baked potatoes, stews, meat/poultry loaves.

Prevention- Do not use home-canned products, use careful time and temperature control for sours vide items and all large, bulky foods, purchase garlic and oil mixtures in small quantities for immediate use and keep refrigerated, cook sautéed onions on request, rapidly cool leftovers.

Campylobacteriosis (Camphylobacter Jejuni)

Incubates 2-5 days. Illness can go from 7-10 days (relapses common).

Symptoms- Diarrhea (watery or bloody), fever, nausea, abdominal pain, nausea, headache, muscle pain.

Source- Domestic and wild animals (intestinal tract).

Foods- Unpasteurized mile and dairy products, poultry, pork, beef, lamb, non-chlorinated water.

Prevention- Thoroughly cook food to minimum safe internal temperatures, avoid cross-contamination.

E. coli O 157:h7 (Escherichia coli)

Incubates 2-9 days. Illness can last up to 8 days.

Symptoms- Diarrhea (watery, could become bloody), severe abdominal cramps and pain, vomiting, occasional low-grade.

Source- Animals, particularly cattle, humans (intestinal tract).

Foods- Raw and undercooked ground beef, imported cheeses, unpasteurized milk, roast beef, dry salami, apple cider, commercial mayonnaise.

Prevention- Thoroughly cook ground beef to at east (68.3 o C) for 15 seconds, avoid cross-contamination from food service employees by practicing good personal hygiene.

Norwalk Virus Gastroenteritis (Norwalk and Norwalk-like viral agent)

Incubates 24-48 hrs. Illness lasts from 24-60hrs.

Symptoms- Nausea, vomiting, diarrhea, abdominal pain, headache, low-grade fever.

Source- Humans (intestinal tract).

Foods- Raw shellfish, raw vegetables, salads, prepared salads, water contaminated from human feces.

Prevention- Obtain shell fish form approved, certified sources, avoid fecal contamination from foodservice employees by practicing good personal hygiene, thoroughly cook foods to minimum safe internal temperatures, use chlorinated water.

S kylark Medical Clinic

264 Tache ave.

Winnipeg MB R2H 1Z9

204.453.9107