Environmental Public Health Division

Outbreak Can Mean More Than Just A Movie

It's early afternoon, just after lunch, your kitchen is still recovering from the rush, and a health inspector walks in your front door. The health inspector is the last person in the world you want to see right now. And, the purpose of the visit is not a routine inspection. The inspector informs you that several people reported becoming ill after eating at your establishment two days ago. The thought of a possible foodborne outbreak looms before you. What do you need to do?

First, what is a foodborne illness outbreak? A foodborne illness outbreak is defined as an incident where two or more persons, not of the same household, ingested a common food and exhibit a similar disease or symptoms, and have a time, person, or place association. A foodborne outbreak may also be a single case of suspected botulism, vibrio vulnificus, E. coli 0157:H7 or a few other illnesses. The Health Department may learn of the outbreak through one or more consumer complaints, hospital lab or physician reports, or by notification from a food establishment itself.

Just how much foodborne illness occurs? According to the CDC, foodborne illnesses cause an estimated 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. If the Houston area averages the same rate as the nation, that would mean over 750,000 illnesses occur in our community. Reducing foodborne illness is an enormous task for regulators and the food industry alike.

What can you expect from HCPHES You may rest assured that the intent of the Health Department is not to incriminate anyone. The primary objective of the investigation is to halt the outbreak and prevent additional cases by implementing public health measures. HCPHES will make every effort to make the investigation as painless as possible, but a lot of work is entailed. Food investigators, epidemiologists,, and the restaurant operator work in concert to thoroughly describe all aspects of the outbreak by determining the cause of the outbreak and the contributing factors, and to identify all persons at risk of contracting the illness and the implicated food or foods. Based on all of the information gathered, potential pathogens can be identified, and the investigation of when and where the contamination (or exposure) to the implicated food occurred will be facilitated.

When a foodborne outbreak occurs, the inspector will conduct a Hazard Analysis Critical Control Point (HACCP) inspection tracing the implicated food products from delivery through customer service and will ask many questions regarding the health of employees, the functioning of equipment, food-handling practices, and any documentation regarding temperatures or sanitary practices. Food samples, if any of the implicated food is remaining, or, in rare instances, stool samples from employees may be requested.

Law allows the inspector access to credit card receipts in order to contact other diners at the restaurant. Invoices, suppliers' names and phone numbers, and employee work schedules may also be requested. The inspector may question individual employees and may spend long periods of time observing food handling practices. Meanwhile, one or more epidemiologists interview suspected or confirmed cases in an effort to piece the cause of the foodborne outbreak together. The inspector may make several visits as new questions or concerns arise. You can help by providing the inspector with whatever documentation he/she needs, answering questions, and instituting recommended practices.

We fully recognize and appreciate the fact that you will have many concerns so please feel free to discuss them with us.. We do realize that the process may be time consuming, but by working together, we should be able to prevent more foodborne illness in the future.