November 10, 2018
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Donated catered meal sickens hospital staff after Hurricane Harvey

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A donated catered meal seems to be the cause of a foodborne outbreak of Staphylococcus aureus that sickened dozens of staff members last year at a hospital in Houston after Hurricane Harvey, according to findings published in Infection Control and Hospital Epidemiology.

Fifty staff members — but no patients — suffered acute gastrointestinal symptoms after eating a meal that included pork sausage, pulled pork, brisket, chicken and yogurt, according to Lucila Marquez, MD, MPH, assistant professor of pediatrics at Baylor College of Medicine and associate medical director of infection control and prevention at Texas Children’s Hospital, and colleagues.

Experts warned that flooding caused by Harvey could put storm victims at a higher risk for infection, but Marquez and colleagues said exposure to flood water was not associated with illness in the patients involved in the outbreak. They noted that S. aureus is one of 31 known causes of foodborne illness and outbreaks.

According to their report, on Sept. 1, 2017, a catered meal was donated and served to staff of the unnamed hospital. After infection control staff were notified of several cases of gastrointestinal illness among staff who ate the meal, the Harris County Department of Health was notified about the suspected outbreak, leftover food was secured and samples were taken from the pork sausage, pulled pork, brisket and chicken for testing.

catering trays 
Staff at hospital in Houston were sickened in an outbreak of Staphylococcus aureus linked to a donated catered meal.
Source: Adobe Stock.

Of the 191 staff who were working when the catered meal was delivered, 48% (n = 92) reported eating some of the meal, according to Marquez and colleagues. Within 14 hours, 54% (n = 50) of those who consumed the meal reported acute onset of gastrointestinal symptoms. All recovered within 24 hours.

Leftovers were tested for S. aureus, shigatoxin-producing Escherichia coli, and Bacillus cereus —pathogens with a short incubation period, Marquez and colleagues noted. Brisket and chicken tested negative for any pathogen, but portions of pulled pork and pork sausage tested positive for S. aureus. Based on a questionnaire completed by staff members, Marquez and colleagues calculated a 1.47 relative risk for illness from eating pork sausage (95% CI, 1.06-2.04) and a 1.45 relative risk for illness from eating yogurt (95% CI, 1.05-2.01), although no yogurt samples were available for testing.

They said the disruption in public health services in the wake of the storm prevented the health department from immediately investigating the catering business that delivered the meal.

“Emergency preparedness for institutions such as hospitals involves securing stockpiles of water and nonperishable food. However, after such disasters, volunteers often donate supplies, water, and catered meals, especially for first responders and hospitals,” Marquez and colleagues wrote. “Institutions should be cautious when accepting donations of catered meals and should consider whether safe food handling practices have been followed because foodborne outbreaks can impact the delivery of needed services after natural disasters.” – by Marley Ghizzone

Disclosures: The authors report no relevant financial disclosures.