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MDH identifies cause of food poisoning that sickened 46 in Jessup

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Maryland health officials identified a cause that sickened some four dozen people in Jessup.

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Caterer fined S$1,200 after 107 people at MindChamps preschools fall ill with gastroenteritis

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A total of 107 people - 96 children and 11 staff members - reported symptoms of gastroenteritis after eating food prepared by Nosh Cuisine in May last year.

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Ignore the link below, changed to this one

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Nearly 550 sick in Salmonella outbreak in Vietnam

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Almost 550 people were hospitalized in Vietnam earlier this year after a Salmonella outbreak linked to a type of sandwich sold at a bakery. The outbreak

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51 fall sick after eating food from Stamford Catering; company suspended amid MOH, SFA probe

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Those affected either sought outpatient treatment or self-medicated. Read more at straitstimes.com.

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SINGAPORE: Investigations are underway after a mass food poisoning incident at the Singapore office of TikTok owner ByteDance on Tuesday (Jul 30).

A total of 130 people reported having gastroenteritis symptoms, the Ministry of Health (MOH) and Singapore Food Agency (SFA) said on Wednesday.

In response, the health authorities have suspended the food business operations of Yun Hai Yao at Northpoint City and Pu Tien Services at Senoko South Road. Both caterers had supplied the food that was consumed by ByteDance employees, they added.

The Singapore Civil Defence Force (SCDF) deployed 17 ambulances to the scene in response to the incident.

ByteDance employees recounted seeing vomit on the floor and colleagues wincing in pain. A 28-year-old employee who declined to be named told CNA that the "whole office smelled like vomit".

Fifty-seven people were taken to the hospital on Tuesday and 17 remain hospitalised but are in stable condition.

The suspected cause? Food from a canteen on the 26th floor of One Raffles Quay, which the affected employees had consumed.

What could have caused such severe bouts of food poisoning, and how can it be avoided?

What causes food poisoning?

According to Ms Chan Fong Ying, the senior food safety consultant and trainer at consultancy ISRC, severe food poisoning cases are often linked to "high-risk" foods and conditions that facilitate the growth and transmission of harmful pathogens.

"High-risk foods include undercooked meats, raw poultry, seafood, unpasteurized dairy products, and prepared salads like coleslaw and pasta salads," said Ms Chan.

She said that these foods can harbour bacteria such as salmonella, E. coli, listeria, and staphylococcus aureus, which produce toxins that can cause intense gastrointestinal symptoms.

In addition, improper food handling practices, such as inadequate cooking, poor refrigeration, and cross-contamination of raw and cooked food, can significantly increase the risk of contamination.

Food prepared by individuals with poor hygiene or those who are unwell can also introduce pathogens into the food supply.

Likewise, conditions such as warm temperatures and prolonged storage at unsafe temperatures can promote bacterial growth in food, and contribute to the severity of the illness, she added.

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CNA Explains: Why was the ByteDance mass food poisoning case so severe, and how does it compare to previous incidents?

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Catered food prepared off-site could have contributed to the severity of the incident, said one expert.

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Woman dies, about 150 people in Japan fall ill in Yokohama food poisoning bout

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They had eaten eel from a popular restaurant. Read more at straitstimes.com.

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E. coli Infection (Escherichia coli)

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Investigation Update: E. coli Outbreak, McDonald’s Quarter Pounders - October 22, 2024

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Learn more details about this outbreak investigation.

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SINGAPORE: Food operations at the Edge buffet restaurant in Pan Pacific Hotel have been suspended after 16 diners fell ill.

The Ministry of Health (MOH) and the Singapore Food Agency (SFA) said on Saturday (May 25) that they are investigating six incidents of gastroenteritis. A total of 16 people fell ill after eating food prepared by the restaurant between May 2 and May 18.

"Those affected either sought outpatient treatment or self-medicated. None were hospitalised," said the authorities.

The restaurant had first received feedback from diners experiencing gastroenteritis symptoms and undertook measures such as the health screening of food handlers and deep cleaning of premises.

In view of the suspected ongoing transmission of the disease, SFA has suspended the food business operations of Edge from May 24 until further notice.

"The licensee is required to clean and sanitise the premises, including equipment and utensils, and dispose all ready-to-eat food and perishable food items," said MOH and SFA in a joint media release.

All food handlers working on the premises are required to reattend and pass the Food Safety Course Level 1 and test negative for foodborne pathogens before they can resume work.

The appointed Food Hygiene Officer must reattend and pass the Food Safety Course Level 3 before they can resume work.

A picture circulating online showed an email from Pan Pacific Dining Privileges informing members that the Edge restaurant would be closed due to "unforeseen circumstances". It also apologised for any inconvenience.

"Food safety is a joint responsibility. SFA would like to remind food operators to observe good food and personal hygiene practices at all times," said the authority.

"SFA will not hesitate to take firm action against anyone found to be in violation of the Environmental Public Health Act."

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Edge buffet restaurant at Pan Pacific Hotel suspended after 16 diners fall ill

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The Health Ministry and the Singapore Food Agency are investigating six incidents of gastroenteritis, with 16 people falling ill after eating food prepared by Edge restaurant between May 2 and May 18.

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Bakery Owner Faces Severe Penalties After Massive Food Poisoning Incident in Vietnam | Food Poisoning News

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Last week, Food Poisoning News reported on a large-scale incident of foodborne illness related to consumption of traditional vietnames banh mi sandwiches from

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The UK Health Security Agency ( UKHSA), Public Health Scotland, Public Health Wales and Public Health Agency Northern Ireland ( PHA), in collaboration with the Food Standards Agency ( FSA) and Food Standards Scotland ( FSS) have been working together with local authorities to investigate an outbreak of Shiga toxin-producing Escherichia coli ( STEC) O145 identified through the analysis of whole genome sequencing ( WGS) data in May 2024.

A potential outbreak was first identified in England on 22 May 2024 through UKHSA's routine surveillance, with a rapid ten-fold increase in the number of faecal samples from patients testing positive for non-O157 STEC toxin genes referred from the NHS to the national reference laboratory.

On 24 May, reference laboratory polymerase chain reaction ( PCR) test results indicated the increase was likely driven by a strain of STEC which possessed the stx2a, eae+ virulence gene profile but was neither serotype O157 or O26 (defined as 'probable cases') and increased hospital emergency department attendances for gastrointestinal illness ( 1). Concurrent increases for similar surveillance indicators were reported in Wales and Scotland. A national incident was declared on 24 May.

Subsequent WGS analysis available on 28 May showed that the majority of these probable cases had illness caused by STEC serotype O145 with a specific genetic profile ('genetic fingerprint'). These confirmed outbreak cases with a 5-single nucleotide polymorphism ( SNP) termed 't5.206', were distinct from other STEC O145 outbreaks recently investigated and from sporadic cases. This was a re-emergence of a STEC cluster investigated in 2023, where no source could be conclusively confirmed. No international cases of a similar genotype were reported on global databases and information was shared through established international communication platforms with other countries.

Between 25 May and 24 June there were 275 confirmed cases reported (273 primary cases and 2 secondary cases (Figure 1)). Cases were geographically dispersed in all regions of England (182), in Scotland (58), Wales (31) and Northern Ireland (4), with no notable geographic clustering. However, evidence suggests that cases resident in Northern Ireland likely acquired their infection in England. Primary cases were predominantly female (57%) and had a median age of 30 years (range: 1 to 89 years). The most affected age groups were 20 to 29 and 30 to 39 with 30% and 23% of cases respectively.

The STEC O145 t5:206 outbreak strain possesses a virulence gene profile (stx2a, eae+) which is associated with more severe disease and an increased likelihood of Haemolytic Uraemic Syndrome ( HUS), a clinical syndrome associated with STEC which can lead to kidney failure and death.

Among confirmed t5:206 outbreak cases (Table 1):

81% have reported bloody diarrhoea

49% of cases have been admitted to hospital

10% attended A&E for their symptoms

Of the 122 hospitalised cases, 57% were female and had a median age of 35 (with a range of 6 to 85 years).

To date 7 cases of HUS have been confirmed to be associated with this outbreak. Of the 7 HUS reported cases:

5 were resident in England

2 were resident in Scotland

their ages ranged from 12 to 59

the majority were female (n=6)

These HUS cases all reported onset of illness in mid to late May. There have been 2 reported deaths in patients within 28 days of confirmation of infection with the STEC outbreak strain t5:206. Neither of these patients were diagnosed with HUS, both were adults and had underlying medical conditions. Based on the information available, one of these deaths is likely linked to STEC infection.

Early epidemiological analyses indicated that the cases were widely geographically dispersed across the UK with a rapid increase in confirmed cases consistent with a nationally distributed food product as the cause of the outbreak. The FSA and FSS therefore were involved from the start of the investigation. In the initial phase of the investigation, analysis of available information on reported cases, including routinely collected case questionnaire data (which captures clinical symptoms and environmental plus a wide range of food exposures ( 2), indicated a higher than expected proportion of cases reported consuming pre-packaged sandwich products during the 7 days prior to becoming unwell.

The hypothesis that sandwiches containing lettuce were the likely main cause of the outbreak was confirmed through multiple different epidemiological studies which showed a statistically significant association between illness and consumption of these products.

Food chain investigations were carried out by FSA and FSS, informed by the food histories of cases and alongside the epidemiological investigations carried out by the UK public health agencies. Lettuce was the main focus as the likely contaminated sandwich ingredient. The FSA and FSS initially identified one supplier of the potentially contaminated lettuce, investigations are still ongoing at 2 other lettuce suppliers at the grower stage of the supply chain.

Further investigations carried out by FSA and FSS with the identified sandwich product producers and salad growers indicated that these food business operators ( FBOs) had detailed and robust hazard analysis and critical control points ( HACCP) plans and biosecurity in place. Enhanced testing at these FBOs was carried out in response to the investigation. While all test results were negative for STEC, general or 'indicator' E. coli was identified in sandwich and lettuce products, indicating a possible contamination event had occurred. As a result of the epidemiological and food chain investigation outcomes, the FBOs elected to undertake a voluntary withdrawal and recall of all potentially associated ready to eat products (sandwiches, wraps and salads) - first on 14 June and then, following further findings, on the 15 and 16 June ( 3, 4, 5) . Investigations into the root cause of the outbreak are still ongoing.

There are challenges in the investigation of any foodborne disease outbreak of STEC as previously reported ( 6). In the case of short shelf life and highly perishable products such as salad products, microbiological confirmation of the outbreak strain (the same WGS profile) in the foods implicated in the outbreak is very difficult as the foods have usually already been consumed and there is no residual product to test. As performed in this investigation, environmental and food testing may be useful for the detection of E. coli as an indicator of a potential contamination event, as well as detection of specific toxin genes present in STEC which causes food poisoning.

Rapid response based on early surveillance indicators prior to an outbreak being confirmed, and subsequent rapid confirmation of the outbreak (via routine implementation of WGS for characterisation of STEC and other major bacterial pathogen causes of foodborne disease) is crucial for the protection of public health. Early collaboration and communication with UK government agencies and international counterparts identified that the outbreak was limited to the UK, supporting the epidemiological and food chain investigations findings that a UK produced salad product was the cause of the outbreak.

STEC is a zoonotic pathogen (meaning a bacteria transmissible between humans and animals) and is naturally present in the intestines of animals, especially ruminant animals such as cattle and sheep. It is not always possible to determine the reasons for or causes of contamination of food products with zoonotic pathogens that can cause food poisoning outbreaks. Ready-to-eat salad vegetables can be contaminated with pathogens at the pre-harvest level (via flooding, rainwater run-off or irrigation water containing animal faeces) or post-harvest during washing and packaging.

As of 24 June, newly reported confirmed cases have now markedly declined (Figure 1) and the surveillance indicators for probable cases have now reduced back down to expected levels for this time of year. The majority of the recently reported probable cases are not part of the O145 t5:206 outbreak, but rather are small numbers of sporadic cases. A small number of cases may be reported in the short term due to the time lag between:

when people become ill

when they visit their GP or hospital

when a sample is taken for testing

when this sample is referred to the national reference laboratories for further typing

the availability of WGS results

Based on available data, the ongoing public health risk is minimal.

Public health agencies are continuing to monitor surveillance and WGS data for confirmed cases and follow up cases to identify any common links. The FSA and FSS continue to work with the relevant local authorities, salad growers, sandwich suppliers and manufacturers to identify the root cause of the outbreak so that actions can be taken to prevent a re-occurrence.

Figure 1: Confirmed cases by week sample collection and country of residence (n = 267)

Note:

sample date is unavailable for 8 cases

the 4 confirmed cases in NI probably contracted their infection while in England

primary cases are those individuals with illness who are assessed to have contracted their infection from exposure to a common source or food, while secondary cases have contracted infection through person-to-person transmission through contact with a primary case or the environment that has been contaminated by a primary case - secondary cases were excluded from epidemiological studies

Table 1: Clinical information for confirmed cases including reported symptoms (n=249), UK

References

1. UKHSA. Emergency department: weekly bulletins for 2024: week 20

2. UKHSA. Shiga toxin-producing Escherichia coli: questionnaire

3. FSA. Greencore Group recalls sandwiches, wraps and salads because of possible contamination with E. coli

4. FSA. Samworth Brothers Manton Wood recalls sandwiches and wraps because of possible contamination with E. coli

5. FSA. THIS! recalls Chicken and Bacon wrap because of possible contamination with E. coli

6. UKHSA. Health Protection Report volume 18 issue 2: news

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Investigation into an outbreak of Shiga toxin-producing E. coli (STEC) O145 in Great Britain, May to June 2024

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The UK Health Security Agency ( UKHSA), Public Health Scotland, Public Health Wales and Public Health Agency Northern Ireland ( PHA), in collaboration with the Food Standards Agency ( FSA) and Food Standards Scotland ( FSS) have been working together with local authorities to investigate an outbreak of Shiga toxin-producing Escherichia coli ( STEC) O145 identified through the analysis of whole genome sequencing ( WGS) data in May 2024.

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Nearly 300 people have fallen ill in Singapore after eating food from a catering company.

Two incidents affected 284 people who reported symptoms after consuming food prepared by Rasel Catering Singapore between Nov. 8 and 16.

The Ministry of Health said patients either sought outpatient treatment, treated themselves, or recovered without help and none were hospitalized. The agency told the company that two staff members were infected by norovirus and one tested positive for Salmonella infection.
Operations halted
The Singapore Food Agency (SFA) suspended operations at Rasel Catering Singapore until further notice. The caterer is required to clean and sanitize the premises, including equipment and utensils, and dispose of all ready-to-eat and perishable food items.

All food handlers working at the premises need to re-attend and pass a food safety course and test negative for foodborne pathogens before they can resume work. The appointed food hygiene officer at the site must re-attend and pass a food safety course before they can go back to work.

SFA said operators must observe good food and personal hygiene practices at all times and added it would not hesitate to take action against anyone violating the Environmental Public Health Act.

Rasel Catering apologized to affected clients and said it was still conducting preliminary investigations while assisting SFA and MOH in their investigations.

"At Rasel, the well-being of our clients is of paramount priority. We will heighten our vigilance in upholding hygiene and cleanliness practices and standards. We understand this incident has posed significant discomfort and inconvenience to the affected clients. We wish the affected clients a speedy recovery," said a company statement.
Penalty after outbreak
Meanwhile, in October, Lao Huo Tang Group Pte, licensee of ENG's Wanton Noodles, was fined $3,300 (U.S. $2,400) in court for selling food unfit for consumption.

In May 2021, the SFA received complaints involving 68 people who had suspected gastroenteritis symptoms after consuming food at one of ENG's Wanton Noodles sites.

An investigation with the Ministry of Health found that ready-to-eat food items such as char siew and Choi sim did not comply with the microbiological limits in the Singapore Food Regulations. SFA suspended operations at the branch of ENG's Wanton Noodles from mid-May to late June 2021.

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Almost 300 sick in Singapore linked to a catering company

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Nearly 300 people have fallen ill in Singapore after eating food from a catering company. Two incidents affected 284 people who reported symptoms after consuming food prepared by Rasel Catering Singapore between Nov. 8 and 16. The Ministry of Health said patients either sought outpatient treatment, treated themselves, or recovered without help and none were hospitalized.

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Investigation status: Closed

CDC and partners investigated a multistate hepatitis A outbreak linked to frozen organic strawberries imported from Baja California, Mexico from November 24, 2022 to May 27, 2023. The outbreak investigation is over.

United States

Cases: 10

Confirmed cases: 10

Hospitalizations: 4

States: California, Hawaii, Oregon, and Washington

CDC and partners investigated a multistate hepatitis A outbreak linked to frozen organic strawberries imported from Baja California, Mexico from November 24, 2022 to May 27, 2023. The outbreak investigation is over.

Situation summary

Illnesses started on dates ranging from November 24, 2022 to May 27, 2023, among people aged 38-64 years old (median age=56.5 years), and 30% of ill people were female. Of the 10 people with available information, four (40%) were hospitalized. No deaths were reported.

The strawberries were sold to a variety of retailers under multiple brand labels. See r ecalled items section below.

Outbreak investigation summary

In April 2023, CDC, the US Food and Drug Administration (FDA), and state public health and regulatory officials in several states investigated an outbreak of hepatitis A linked to frozen organic strawberries. They reported a total of 10 cases from four states. CDC declared the outbreak over in September 2023.

Source of the outbreak

During the outbreak, investigators discovered that the hepatitis A virus (HAV) strain causing illnesses in this outbreak was genetically identical to the strain that caused a  foodborne hepatitis A outbreak in 2022, which was linked to fresh organic strawberries imported from the same farm in Baja California, Mexico, and sold at various retailers. This single farm supplied strawberries to multiple importers across both outbreaks and some recipients processed fresh strawberries into the frozen berries consumed in the 2023 outbreak.

Recalled items

There were multiple recalls issued during this outbreak. Details can be found at:

What you should do

If you learn about an outbreak, follow advice from health officials.

In this outbreak, CDC recommended returning or throwing away frozen organic strawberries affected by the recalls listed in the recalled items above.

If you think you've been exposed‎

If you've eaten these recalled frozen organic strawberries within the last 14 days and are not vaccinated against hepatitis A, contact your local health department or health care provider to discuss treatment, including postexposure prophylaxis.

Resources

About Hepatitis A

Hepatitis A is a liver infection caused by HAV. Hepatitis A spreads when someone consumes the virus, typically through close personal contact with a person who is infected or from eating something contaminated. Hepatitis A is preventable through vaccination.

Symptoms of Hepatitis A

Symptoms of hepatitis A usually appear 2-7 weeks after exposure and can include:

Dark urine or clay-colored stools

Diarrhea

Feeling tired

Fever

Joint pain

Loss of appetite

Nausea, stomach pain, throwing up

Yellow skin or eyes (jaundice)

Not everyone with hepatitis A has symptoms. Adults are more likely than children to have symptoms. People who get hepatitis A might feel sick for a few weeks to several months but usually recover completely.

In rare cases, hepatitis A can lead to hospitalization, liver failure, and even death. This is more common in older people and in people with other serious health issues, such as chronic liver disease.

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Hepatitis A Outbreak Linked to Frozen Organic Strawberries

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Information about an outbreak of hepatitis A potentially linked to frozen organic strawberries.

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Deadly food poisoning outbreak linked to recall of Boar’s Head deli meats

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As of early August, 43 people had gotten sick and three of them died

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66 Guests Contract Severe Salmonella Poisoning From Contaminated Wedding Cake

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In a recent study published in “BMC Infectious Diseases,” researchers highlighted how 66 wedding guests contracted severe food poisoning after consuming a raw cake that had sat out for three days at room temperature prior to the celebration. Get all of the details on the unfortunate incident here.

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Orion ordered to recall Custard pastries over bacterial contamination

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Orion has been slapped with an order to stop selling and recall its long-surviving Custard pastry products after bacteria was detected in some of the products, according to the Ministry of Food and Drug Safety, Wednesday.

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6 Wendy’s customers describe severe food poisoning as CDC reports more people sickened

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The CDC has linked 84 E. coli cases to an outbreak in four states. Romaine lettuce from Wendy’s is suspected as the culprit.

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Cause found in food poisoning case that hospitalised over 400 people in Vĩnh Phúc

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The food poisoning incident in Vĩnh Phúc saw 438 people rushed to hospital following a company lunch, although all of them were discharged after a week of treatment.

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https://search.app/WBiUdnSt5LPa7npA7

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Tung Lok subsidiary fined $3,000 after salad made on its premises found to contain E. coli

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An SFA inspection was conducted after a complaint of gastroenteritis was made at an event at CHIJMES that Tung Lok Millennium had catered for. Find out more.

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Two people have died in a Listeria outbreak in Italy that could be linked to cheese.

Italian officials reported 33 people have been affected and two deaths are part of the outbreak. Asiago Pressato cheese is one line of inquiry as investigators try and find the source.

An Italian National Institute of Health (ISS) spokesman told Food Safety News the outbreak investigation was at an early stage when asked for details.

"The Ministry of Health (Ministero della Salute), along with the ISS, the IZS, and all the regional authorities are coordinating the investigation, collecting all the information about the cases and the potential sources of exposure. The research about the epidemiological aspects and the genomic correlations is ongoing," he said.

The spokesman added the cheese was used as part of a recipe with many more ingredients that are also being investigated as the outbreak source.

The Istituto Zooprofilattico Sperimentale (IZS) is made up of 10 institutes across the country and is involved in diagnostic activities, epidemiological surveillance, research, and training linked to areas including disease transmissible and food safety.

In 2020, 224 strains of Listeria monocytogenes from 15 of the 20 Italian regions were sent to the ISS.

Italy recorded three outbreaks and 147 listeriosis cases in 2020 as opposed to 202 cases in 2019, according to the European Union One Health Zoonoses report.

About Listeria infections
Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause serious and sometimes life-threatening infections. Anyone who has developed symptoms of Listeria infection should seek medical treatment and tell their doctors about the possible Listeria exposure.

People should monitor themselves for food poisoning symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop.

Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache, and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses.

Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections, and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn, or even stillbirth.

(To sign up for a free subscription to Food Safety News,)

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Italian officials try to find the source of a deadly Listeria outbreak

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Two people have died in a Listeria outbreak in Italy that could be linked to cheese. Italian officials reported 33 people have been affected and two deaths are part of the outbreak. Asiago Pressato cheese is one line of inquiry as investigators try and find the source.

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3rd person dies in listeria outbreak linked to deli meat, more than 40 hospitalized across U.S.

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As of Thursday, the CDC says, 3 people have died and 43 have been hospitalized in 13 states amid the outbreak that started in May.

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Nha Trang chicken rice eatery blamed for poisoning 367 diners - VnExpress International

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Many parts of the meal at a chicken rice eatery in the central city of Nha Trang have been found to be infected with bacteria that caused food poisoning among 367 diners last week.

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Search for an article online or in the newspapers on a recent food poisoning case within 3 years (i.e. on or after year 2022) from any country.

Please post the article link or picture under your own name.

The case study must not be repeated within the class.