I have been to the Food Safety Summit in Baltimore twice now. Last year I did not attend. In a certain way, I am relieved that I didn’t because there was a foodborne illness outbreak from food served at the Food Safety Summit. Ironic snickering aside, this was real. You can’t make this up.
The Food Safety Summit was at the Baltimore Convention Center on April 8-10, 2014. The Food Safety Summit organizers and its foodservice contract company, Centerplate received phone calls from attendees stating they were ill from the food. On April 11, the Baltimore City 311 program had received three reports of illness from the Summit with symptoms of diarrhea appearing between April 8 and 10. As is standard, these reports were given to Baltimore City Health Department’s (BCHD) Environmental Inspection Services Food Control Section. When these reports were confirmed to be related, an investigation was set up on April 16 by BCHD in conjunction with the Maryland Department of Health & Mental Hygiene (DHMH) Division of Outbreak Investigation on April 16 making this a city/state outbreak investigation.
On April 17, DHMH sent a letter and email survey to those attendees. 400 responses were received. Part of the investigation was to request from the caterer, the full menu served on those days, employee sick records, food preparation processes (all food was discarded after service = no leftovers to be tested) and some ingredients used in the dishes were confirmed to be still available for testing. On April 18, the DHMH of Food Protection and DHMH Division of Outbreak Investigation went to the kitchen to gather those ingredients available for testing. On April 23, BCHD, EIS, DHMH Office of Food Protection and DHMH Division of Outbreak Investigation went back to the Centerplate kitchen at the Baltimore Convention Center to observe food preparation and hot holding methods. The Chef and staff were interviewed in person.
Additionally, those who reported being ill, were asked for stool samples to be tested.
At the end of the Internet and in-person surveys there were 669 respondents and bottom line: 216 were confirmed to be cases. Of those 216 cases, 213 confirmed to have diarrhea, 162 stomach cramps, 22 vomiting and 5 had bloody stools. Stool samples were not conclusive on diagnosis as the testing was done so long after the initial outbreak of illness. Initially, it was thought that Salmonella was the source of the outbreak but after the interviews and surveys, it was presumed that C.perfringens or B. cereus pathogens might have been responsible for the outbreak through the Chicken Marsala dish served at the lunch on April 9. The duration of the illness ranged from quarter of an hour to 225 hours with the average time being sick as 38 hours. The ages of those people who got sick were between 21 and 72 year’s old with the median age being 48 years old. Bottom line: Many people got sick from this outbreak, but there was much luck in this situation that the wrong person in a high risk population didn’t get sick and die as a result of the outbreak.
Eight of the attendees surveyed mentioned that the hot food did not seem hot enough. Two said the chicken appeared undercooked. In the 22-page report written by the Office of Infectious Disease Epidemiology and Outbreak Response Prevention and Health Promotion Administration DHMH found at: www.foodsafetysummit.com/images/PDF/OutbreakReport.pdf (also online with this column at foodservicemonthly.com) it was noted that there were two sick employees who had been sent home around the time of the outbreak. One had vomiting and another had diarrhea. They were both sent home. The description of the food flow to cook the Chicken Marsala was ‘reported’ to be reasonable. The precooked frozen chicken was thawed correctly,, the sauce was made that same morning using a premade frozen demi-glace that was also thawed under refrigeration. The sauce was cooked to a boil, the sauce was poured directly over the cooked chicken. The pans of Chicken Marsala were then plastic wrapped and held in hot holding cabinets with Sternos for an hour and 20 minutes before service. If the temperature check at noon is correct, it appears the Centerplate did a good job of keeping the food out of the Temperature Danger Zone for holding, although the reports shows too few checks of temperature were made. The problem here is we just don’t know the problem. We know there was an outbreak, but we still don’t know the problem – source or pathogen name. It is still a mystery.
There are many lessons to be learned from this situation. Centerplate was notified on April 10 of the potential illness issue. Why didn’t they take some of the food and keep it for samples to be tested if needed at the first hint of trouble. They should have done this right away … you need to know or to test to prove otherwise if it is a false accusation. Plain and simple: they should have held some of the food as samples that might need to be tested.
Additionally, they didn’t call the health department as they are required. Note that the organizers of the event were also notified and they didn’t contact the health department either. These were reportable symptoms and potential reportable illnesses. Earlier investigation might have proven concretely, the food source of the outbreak and name of the pathogen responsible for the outbreak.
As a result of last year’s outbreak, The Food Safety Summit event planning and caterers have a plan. This plan can be found on their website: http://www.foodsafetysummit.com/index.php/media-center/2015-foodservice-oversight-plan
To paraphrase their plan this year to avoid what happened last year:
• Hired an independent contractor as an auditor and they will be on site for the event.
• The Regional Head Chef and a VP of Centerplate will be onsite for the event.
• BHDM has been invited to make additional health inspection visits and to review their HACCP plan as well as be there on the day of the event.
• Hold monthly food safety training with management and staff.
• Hold another refresher food safety class a week before the event.
• Daily reinforcement of education including proper hand washing, safe food and beverage serving.
• Temperature logs will be monitored and recorded.
• City approved HACCP plan will be used.
If you don’t think this can happen to you and this is not a big deal, look at what has happened here. It’s not something that you want to experience. There are no guarantees, but if you have in place good foodservice safety practices, you can identify the problem quickly, share the record keeping with the health authorities to verify your practices and training and minimize the health risks and damage to your customer and your reputation. Download the report for a good example of how a foodborne illness analysis is conducted and how the Chicken Marsala was identified as the most likely source.
The Food Safety Summit this year will have an educational seminar on April 29 at 2 p.m. called CASE STUDY: Outbreak Investigation … The Role of Foodborne Disease Outbreak Investigations in the Proactive Improvement of Food Safety Management. The irony is that last year’s Food Safety Summit is the subject of the case study … for real