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Behind the Kitchen Door: Stories from the Frontlines

Welcome back to National Food Safety Month 2024! Last week, we explored the pathogens that most commonly cause foodborne disease in the United States. This week, we’re taking a closer look at what goes on behind the scenes of a foodborne illness outbreak.

But there’s another piece of the puzzle still missing: what happens to restaurants after an outbreak occurs? Is it possible to bounce back from an outbreak and if so, what steps do food service professionals need to take to regain trust?

Anonymous stories from past outbreaks help us understand the best way to handle an outbreak. Let’s take a look at some real outbreak scenarios.

When Outbreaks Occur

The U.S. Food and Drug Administration (FDA) states that a foodborne illness outbreak occurs when two or more people get the same sickness from the same contaminated food or drink.

Some conditions in restaurants will allow for pathogens to grow to unsafe levels unless those conditions are controlled correctly. Because foodborne pathogens can easily spread without being detected, it’s not uncommon for more than one person to get sick from contaminated food.

This means restaurants are the perfect breeding ground for outbreak conditions – a single mistake could lead to contamination that spreads to dozens or even hundreds of people within hours.

Stories from the Frontlines: Responding to Outbreaks

Suffice to say that restaurants have an important role to play in preventing the spread of foodborne illnesses and outbreaks. But it’s also fair to say that few restaurants can completely avoid spreading any potentially harmful pathogens. That’s why it’s crucial for restaurants to understand how foodborne illnesses occur so we can prevent potentially harmful outbreaks.

What we can learn from past examples, then, is not only how to limit exposure to germs but also how to quickly react to their presence before an outbreak begins or worsens.

The following stories draw inspiration from real-life events but have been changed for anonymity and the sake of clarity.

ONE INCIDENT SPIRALS INTO ANOTHER – THEN ANOTHER

Sometimes, the causes of foodborne illness are hard to determine. For instance, an employee who has been exposed to a pathogen but doesn’t show symptoms may unknowingly pass the germs on to customers. But in other cases, a lack of adherence to food safety standards can have devastating results.

One restaurant chain experienced several food safety incidents over a period of two to three years, some of which spanned multiple states and locations. It became clear that the issue was not specific to a particular store, but a deeper problem.

Things kicked off when customers and employees at one location reported becoming ill after visiting the restaurant. A few weeks later, an employee at the location was sent home due to vomiting. And though it was company policy for employees to report foodborne illness symptoms (as outlined by the FDA’s Food Code) to restaurant leadership, an additional two days passed before the location took action.

This hesitation would prove to have significant consequences, with hundreds of people linked to the outbreak developing symptoms of Salmonella. But before restaurant leaders could fully evaluate what went wrong, another outbreak developed at a different location in a whole new state.

This time, over 100 people reported symptoms of norovirus, one of the most contagious pathogens known to cause foodborne illness. As an investigation began, it became clear that the most likely cause of the outbreak was a single sick employee who continued working before eventually electing to stay home.

Over the next several months, the company was faced with several more outbreaks of other pathogens, including the bacteria Clostridium perfringens, which can rapidly grow when food is not held at safe temperatures. This, too, indicated a lack of compliance with the company’s safety policies.

As a result of numerous instances of food poisoning, the restaurant was subject not only to scrutiny from public health officials, but also criminal charges and investigations. In response to the incidents, the company decided to close affected locations for thorough cleaning and retraining of local staff.

Still, it was clear that a company-wide approach would be necessary to prevent future outbreaks. Ensuring that employees followed company policies both in and outside of the workplace was key.

After developing a new comprehensive food safety compliance program, the company rolled it out to all its locations. The goal was to give employees the information and confidence they needed to prioritize safety above all else.

Training employees to understand the severity and seriousness of an outbreak was also a key priority. Ensuring workers stay home from work when they are sick and conducting more frequent and rigorous food safety training were just a few steps the restaurant took to bounce back.

In this case, the cause of outbreaks was not a single supplier or issue. It was a systemic issue in which employees didn’t have the knowledge or resources they needed to prioritize food safety standards.

A series of illness outbreaks showed that the company needed to reevaluate its approach to training and educating. It also indicated that creating a more inviting work environment, one where employees felt comfortable being honest about their symptoms, was critical.

VOLUNTARILY CLOSING HALTS AN OUTBREAK IN PLACE

Many outbreaks happen so quickly that restaurant management may not act until it’s too late. That’s what happened to one local sushi restaurant in the southern U.S., where a single weekend of business led to hundreds of cases of illness. But the situation could have been much worse.

One Friday afternoon, a parent phoned their local health department to notify officials that their adult child and the child’s friend had become sick with nausea, diarrhea and vomiting shortly after visiting their favorite sushi restaurant. Soon after the complaint came in, public health officials contacted a manager at the location to get more information.

The manager reported that on the same day, two other customers had called in to report similar symptoms. Both had consumed a specific menu item made with tuna, which led the manager to discard all the tuna currently in the restaurant. However, the outbreak didn’t stop there; later that same day, more illness reports came in from people who had eaten menu items that did not contain tuna.

After speaking to officials, the restaurant manager began conducting an internal investigation. All employees were interviewed to determine if anyone had been potentially sick while working. Though some reported being sick after working, no one claimed to have been experiencing symptoms on the job.

The manager quickly hit dead end after dead end and there was no clear answer to how and why people were becoming sick. In the coming days, additional complaints streamed in from across the county.

By the following Monday, the number of complaints had reached nearly a dozen. As public health workers began reaching out to sick people to interview them, lab testing results on stool samples provided by some customers revealed the culprit behind the symptoms: norovirus.

Once the news reached restaurant management, those in charge had a decision to make. At the suggestion of health officials, the manager decided to voluntarily close the location for deep cleaning, disinfecting, and employee training.

A few days after its closure, the restaurant successfully reopened without any new incidents of illness from employees or customers. Still, reports of the outbreak brought in dozens of new complaints from people who realized their sudden illness may have been linked to the restaurant.

In total, nearly 300 individuals reported symptoms of illness after eating at the restaurant, and it’s possible that hundreds more were unknowingly impacted by the outbreak.

Despite thorough investigations, local disease detectives were unable to identify the true source of contamination. Nearly everything on the restaurant’s menu had been consumed by a sick person at least once, and no common ingredients were identified between them.

It’s not uncommon for the cause of a norovirus outbreak to be unclear. In cases like these, a comprehensive action plan is absolutely crucial.

The decision to voluntarily close and spend a few days focusing on cleaning allowed this restaurant to eliminate the mysterious cause of the outbreak before it made anyone else sick. Likewise, a timely response from management helped investigators get information they needed to quickly identify the pathogen and ensure that the right corrective action was taken.

Future visits to the restaurant by health officials revealed no violations or issues, and no new complaints arose. Had the restaurant not closed when it did or not taken the initiative to thoroughly eradicate any pathogens, it’s possible the outbreak could have reached many more customers – or resulted in legal ramifications.

What Can You Do to Respond to Potential Outbreaks?

Learning that your restaurant may have contributed to a potential outbreak can be scary, but how you respond to the situation can greatly impact the outcome.

Want to learn more about what to do in the face of a foodborne illness outbreak claim? Download our eBook, "What Happens When Foodborne Illnesses Become Outbreaks: Behind the Scenes of Managing an Outbreak" for more insights and tips on how to take action.