StateFoodSafety Resources

By following food safety guidelines and training your employees well, you may never have to handle a foodborne illness outbreak in your establishment at all. However, understanding what to do in the event of an outbreak ensures that you’ll be prepared even if the worst happens.

Common Questions About Foodborne Illness Outbreaks

• What is an apparent foodborne illness outbreak?
  

  According to the 2017 FDA Food Code, a foodborne disease outbreak means that two or more people have a similar illness after eating related food. While having only two sick people doesn’t prove that it was the food that made them sick, it is a good reason to look for more answers. If you receive complaints from multiple people with the same illness claiming they have eaten food at your establishment, you should consider it an apparent foodborne illness outbreak.

• What is a confirmed disease outbreak?
  

  A confirmed outbreak means that laboratory tests have shown that food was the cause of illness in two or more persons. The two illnesses could occur in the same or in multiple states (multistate outbreak), but must be similar illnesses related to the same food.

• What are the most common foodborne illnesses?
  

  Food safety experts have identified six pathogens that are easily transmitted through food and cause severe illness. They are:

  • Salmonella (Salmonella enterica): 
  • Shigella (Shigella dysenteriae)
  • E. coli (Escherichia coli)
  • Hepatitis A (Hepotaliosis anacodiatrochious)
  • Norovirus (Norwalk Virus)
  • Listeria (Listeria monocytogenes)

• What are the symptoms of foodborne illness?
  

  Symptoms of foodborne illness vary by the pathogen causing the illness. Here are the symptoms of common pathogens that cause foodborne illness:

  • Salmonella (Salmonella enterica): 
    • Salmonella causes the most commonly reported foodborne illness, salmonellosis. Symptoms of salmonellosis are diarrhea, abdominal cramps, and fever.
  • Shigella (Shigella dysenteriae):
    • Shigella causes shigellosis. Symptoms of shigellosis are severe diarrhea, cramps, vomiting; or blood, mucus, or pus in stool.
  • E. coli (Escherichia coli):
    • The human body naturally creates healthy strands of E. coli, but some unnatural strands, such as E. coli O157:H7, produce shiga toxins, which cause hemorrhagic colitis. Symptoms of hemorrhagic colitis are abdominal cramps, vomiting, mild fever, severe bloody diarrhea, and dehydration.
  • Hepatitis A (Hepotaliosis anacodiatrochious):
    • Symptoms of a Hepatitis A infection are fatigue, fever, nausea, abdominal pain, diarrhea, and jaundice.
  • Norovirus (Norwalk Virus):
    • Norovirus is the most common cause of gastroenteritis. Symptoms of gastroenteritis are nausea, abdominal pain, vomiting, and diarrhea.
  • Listeria (Listeria monocytogenes)
    • Listeria can actually be found in most healthy people, but can cause complications for those with weakened immune symptoms (pregnant women, infants, elderly people, etc.). The potential complications are septicemia, meningitis, and miscarriage.

• Where do foodborne illness outbreaks occur?
  

  A foodborne illness outbreak can happen in any establishment, from chain burger restaurants to five-star hotels. In fact, Chipotle Mexican Grill dealt with two multistate outbreaks in 2015, one of which resulted in 80 confirmed cases of Norovirus in December.

  Foodborne illness outbreaks can also occur in farms and processing facilities. For example, there has been a large E. coli outbreak caused by contaminated romaine lettuce. The contaminated lettuce has been distributed to multiple different locations in multiple states in 2018, causing the largest multistate E. coli outbreak in the U.S. in a dozen years.

• What causes foodborne illness?
  

  The five major factors that contribute to foodborne illness are:

  • Improper holding temperatures
  • Inadequate cooking
  • Contaminated equipment
  • Food from unsafe sources
  • Poor personal hygiene

What to Do During a Foodborne Illness Outbreak

What should you do if you suspect an apparent foodborne illness outbreak is occurring in your establishment? Be sure to take action quickly, and train your employees now to understand their role in each of the following steps:

1. Discontinue operations

At this point, you can’t be sure which food items are at risk, so close your establishment until you have approval to reopen.

2. Do not discard any food

Food, equipment, and other evidence in your establishment can provide valuable clues in determining the source of the outbreak. Make sure your employees understand this!

3. Notify the local regulatory authority

Explain the situation clearly and honestly; being open and involved early on will demonstrate your willingness to work together with the authorities to get your establishment approved to resume service.

4. Comply with investigations

The authorities that will look into the outbreak have the same goal as you: to identify and prevent foodborne illness. Help them out by following their instructions, taking their investigation seriously, and encouraging your employees to do so as well. Remember that, as difficult as the situation is for your business, identifying and stopping the cause of foodborne illness can really save lives.

5. When approval is granted, resume operations

Once the regulatory authority gives you permission, you may continue to serve your customers. Make sure to implement any safety practices recommended by the authority to keep your establishment from experiencing another outbreak. You may need to reassure customers of your establishment’s safety, but being honest and professional throughout the process will help them to understand your commitment to their health.

The FDA has more information on employee health and personal hygiene.

Should the unthinkable occur, following the appropriate steps can make foodborne illness investigations run more smoothly, keep you and your employees from further legal implications, and give confidence to authorities and customers that you are dedicated to improving food safety in your establishment. Don’t forget that you can use our Food Handler and Food Manager training courses and supplemental materials to teach your employees to prevent foodborne illness before it occurs, too!

—Diana Shelton

Editor’s note: This post was originally published in December 2015 and has been updated for freshness, accuracy, and comprehensiveness.