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34
Fifteen members of a social organisation were ill after consuming steak and kidney pie, with potatoes,
which was followed by ice cream and apple tart. On the day of the meal, 18 containers of steak and kidney
pie were received from the company's production kitchen (not in Westminster), and following defrosting
were re-heated in two lots for 1½ hours. The pies were then cut into portions and plated. This was
completed by 6 p.m. when the vegetables were added, and the plates inserted into the hot plate for service
at 7 p.m. The symptoms and circumstances relating to the preparation of the meal were suggestive of C1.
welchii outbreak, and this was supported by the bacteriological examination of faecal specimens obtained
from those affected. The company concerned was advised as to effective safeguards to be introduced
including the techniques of temperature control.
Two unconnected persons had salmon sandwiches at a snack bar. Later both vomited. Both were
admitted to hospital, but specimens taken there did not reveal any causative organism. Specimens of salmon
and mayonnaise obtained from the establishment concerned revealed the presence of staph, aureus in small
numbers in the tinned salmon. Swabs from the staff were negative, but the symptoms of both patients
together with the ingestion onset period were typical of a staphylococcal food poisoning occurrence.
C1. welchii organism was isolated in specimens from two patients who had consumed curried lamb.
Temperature control requirements were emphasised to the management, and later visits to the premises
confirmed these were being maintained.
Beef curry with pilau rice was the only dish common to five persons who were ill. Two were positive for
C1. welchii. The investigation revealed that the temperature of prepared food on the hot plate ready for
service was inadequate. Appropriate advice was given.
A further instance involving three persons who were ill after consuming meat pies was also the result of
improper temperature control. One was positive for Salmonella enteritidus. Pies used were cooked the day
prior to being eaten and then cooled and refrigerated. They were warmed the following day before being
placed in the hot plate pending purchase. The temperature in the hot plate was below the statutory
requirement. Suitable advice was given.
Two outbreaks of C1. welchii followed one another at a restaurant. The vehicle of infection was the
sauce used as a base for curried dishes. Adequate refrigerated space was not available, and the practice of
cooking the sauce on the day prior to use, and thereafter leaving it in the kitchen temperature to cool,
induced the growth of the C1. welchii organism. Late night and early morning visits were made to the
premises (which remained open all night), to ensure that instructions regarding temperature control were
being followed.
Some eleven days after the occurrence, information was received of five persons who consumed a meal
of chicken curry at office premises in Westminster. The meal was supplied by caterers from premises
outside Westminster. Salmonella enteritidus was isolated from a specimen of one of those affected. The
symptoms described, the ingestion onset period, together with the identification of the salmonella organism
in an associated outbreak (which occurred outside Westminster) where chicken curry was also prepared by
the same caterers, pointed to this organism being the causative agent, and the curry the vehicle of infection.
A family of six were ill shortly after their return from a holiday abroad where they did their own
catering. Meals were obtained from a variety of sources. There was evidence that one of the children had
been ill while on holiday. The mother and three of the four children were all excreting a salmonella
typhimurium organism. No conclusion could be reached but the infection was obviously incurred abroad.
Four persons were ill after consuming pizzas. One was admitted to hospital with a suspected salmonella
infection. The pizzas were manufactured at premises outside Westminster and an investigation by
the local authority concerned did not disclose any possible cause of the infection.
Two outbreaks occurred following social functions involving 24 persons. None of the food remained
from either of the suspected meals. At both functions oysters were consumed by most of those who were ill
and while this was considered as the possible vehicle of infection insufficient evidence was available to reach
a conclusion in either case.