When private events go public: Gastrointestinal Outbreak

BACKGROUND: 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 stands on-site and members contributed 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. 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.

METHODS: Individuals who had reported complaints were interviewed using a questionnaire developed based on event activities and available foods items provided. An epidemiologist and a sanitarian made a site visit to inspect the event venue, food storage, and preparation and serving areas.

RESULTS: Forty–one (41) interviews were completed of attendees spanning over 6 counties. Reported symptoms included diarrhea 97%, abdominal cramps 61% and vomiting 39%. Eleven (11) cases saw a heath care provider with three (3) hospitalizations of between 48 and 72 hours. Stool samples from 10 attendees all serotyped as Salmonella Newport with matching PFGE patterns. Food frequency analysis of the cases showed the following, Beef Brisket 91%, Chicken 80%, Beans 60%, Potato Salad 77%, various Deserts 57%. Site visit and a walk through of the process of food storage, preparation and service revealed many potential sources for food contamination.

CONCLUSIONS: The exact source of the salmonella infection for this outbreak could not be detected. However since the entire food service process was not handled by a licensed professional the contamination could have occurred at some point in the process. As food was served to the public by purchase of a ticket, state law required 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. This investigation highlights a gap in our food safety network when intended private events become public and the food service is not professionally coordinated. There is the need to further safeguard food prepared privately that will be shared by both family and non-family members to prevent foodborne disease(s).