Presentation on theme: "A Houston area church organization notified the Texas Department of State Health Services of gastrointestinal illness among attendees at its annual bazaar."— Presentation transcript:
A Houston area church organization notified the Texas Department of State Health Services of gastrointestinal illness among attendees at its annual bazaar. Within 19 days of the event, 15 attendees reported illness to the organizers. The event was catered by a volunteer group, had food stands on-site and had members contribute dessert directly. This event was open to the public with over 800 food tickets sold. Despite the scale of the event and the sale of food to the public there was no licensed food manager to oversee food service activities. Texas State law requires the church to have at the minimum a temporary retail food establishment permit with a licensed food manager. This was not known to the organizers before the event.The multiplicity of food sources and lack of licensed food manager oversight compounded outbreak investigation and reveals the potential danger of private events becoming new sources of foodborne illness outbreaks and a weak link in the food safety network Objectives To highlight when a temporary retail food establishment permit is required for an event To highlight the crossover of a private organizational event to a public event requiring professional and legal oversight To highlight difficulties in foodborne outbreak investigations when there are uncoordinated multiple sources of food To highlight potential sources of infection from raw food delivery, storage, preparation and eating in a non-regulated environment Background Figure 1: Frequency table of known food Items eaten by cases Timeline for Food Delivery, Storage, Preparation and Service Notification Delay in reporting: Initial notification was 18 days after the event and onset of illness No permit was sought and provided: No food guidelines provided No central food coordinator to talk to about food provision: The volunteer group (cooks) were not available for interview Too many sources of food to do a proper food frequency analysis No record of the ambient temperature of the delivery truck Cooking the meat 2 days prior to the event, cooling (and refrigerating) and reheating posed additional challenges Organization voluntarily paid for medical expenses of cases Methodology Conclusion Organizations planning events requiring food preparations and consumption need to be aware of when at the minimum a temporary retail food establishment permit is needed. This would ensure not only a legal cover for the organization, but that proper food safety guidelines are provided. This omission could be a potential source of foodborne disease as in this outbreak. Texas Department of State Health Services, Region 6/5 South Anthony Eshofonie; Katherine Blanco; Huai Lin; Randy Valcin; LaTasha Martin A representative of the church organization notified the Texas Department of State Health Services that 15 individuals had called to report illness following attendance at its annual bazaar Interview of known event attendees and event organizers Site visit to event venue, food storage, preparation and serving areas Results Total attendees could not be determined as it was open to the public but over 800 food tickets were sold Forty-one (41) interviews were completed. Interviewees were spread over 6 counties Thirty eight (38) interviewees met the outbreak case definition Main symptoms were diarrhea (97%), abdominal cramps (61%), vomiting (39%), and fever (39%) The incubation period was 5-24 hours. The duration of illness was from 1–17 days. Eleven (11) interviewees saw a health care provider and three of them were hospitalized Ten stool samples were collected and all tested positive for Salmonella Newport with matching PFGE patterns Figure 2: Outbreak epidemic curve Results continued Day 1: DeliveryDay 1: Cooler Day 2: Cooked Day 4: Reheated Raw meat stored in “walk- in- cooler” and mobile truck cooler outside Day 3: Cooler Day 2. Cooked meat left to cool in a room Day 4. Meat served Day 4. Deserts from Parishioners Day 4. On-Site food Vendors Other Sources of food FoodNo. of casesPercent Brisket32/3591 Chicken28/3580 Sausage6/3517 Beans21/3560 Potato Salad27/3577 Cole Slaw19/3554 Bread7/3520 Rolls2/356 Desert20/3557 Tea18/3551 Water11/3531 Outbreak Investigation Highlights and Challenges Event Day: Cases started appearing in the evening When Private Events Go Public: Gastrointestinal Outbreak
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