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Public Health - Seattle & King County

Foodborne illness complaints

It is estimated that up to 48 million people get a foodborne illness in the U.S. each year. Most illnesses are infections caused by viruses, bacteria, and parasites. Others are caused by harmful toxins or chemicals in food. For most, the precise cause is never determined because many people don't get sick enough to go to the doctor, and of those who do see a doctor, laboratory testing often isn't done. This makes it hard to keep accurate statistics on foodborne illness. An estimated 3,000 people a year die from food borne illness in the United States, and many others suffer long term effects. Food borne illness is most dangerous for the very young, the very old, and those whose immune systems are weak. Foodborne illness investigations are initiated in response to reports of suspected foodborne illnesses by citizens, health care professionals, and restaurants.

Surveillance for food borne illnesses is done through reportable conditions (e.g., enteric diseases including Shiga-toxin producing E. coli, Salmonella, Campylobacter, Listeria, Vibrio, typhoid fever) and through reports of possible foodborne illness complaints and outbreaks.

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Foodborne illness in King County

Purpose of surveillance:

  • To identify outbreaks
  • To identify and eliminate sources of transmission including contaminated food and water
  • To identify unsafe food preparation and handling practices, particularly in commercial food establishments

Foodborne illness in King County by year

Foodborne illness in King County by month

Local epidemiology:

Public Health received 588 foodborne illness (FBI) complaints in 2012. These are reports of possible foodborne illness associated with a vendor and reported by citizens, health care providers, and restaurants/food vendors. These reports are investigated to determine if they indicate a true foodborne illness. Of these, 54 (9.2%) resulted in an inspection of the food service establishment by Public Health's Environmental Health Division, and 28 (4.8%) were categorized as probable or confirmed foodborne complaints. To count as a probable foodborne complaint, there must either be evidence of food handling violations during an environmental investigation or strong epidemiologic evidence of an outbreak linked to the food source. In addition to meeting the definition for a probable complaint, confirmed complaints must also have laboratory confirmation of the suspected pathogen.

Sixteen of the 28 confirmed and probable FBI reports were parties where one or more persons tested positive for Vibrio parahaemolyticus or had a clinically compatible illness following consumption of raw shellfish. During these investigations, shellfish tags containing information on the origin of the product are retrieved from the vendor and implicated shellfish is traced back to the area where it was harvested. These areas are placed under restrictions for the duration of the high risk season for Vibrio (May-September).

Nationally, the most common foodborne illness pathogen is norovirus, which causes the sudden onset of diarrhea and vomiting (sometimes accompanied by muscle aches, chills, or fever) and typically resolves within 24 to 72 hours. Most cases of norovirus-related illness do not get reported. Norovirus-like illness accounted for 3 of the 28 confirmed and probable reports in 2012.

There were 4 probable and two confirmed cases of scombroid poisoning, an illness caused by the build-up of histamine in the meat of decomposing fish. Symptoms begin within minutes of ingestion and include flushing, dizziness, headache, palpitations, and mouth numbness and tingling. Four of the cases had consumed ahi tuna, one had mahi mahi, and one had consumed commercially canned albacore tuna.

Another notable FBI investigation in 2012 was an outbreak of Clostridium perfringens where over 200 people became ill following a catered picnic event in King County. C. perfringens bacteria multiply rapidly when cooked foods are cooled too slowly or reheated to insufficient temperatures to kill the bacteria. For this reason, outbreaks are often associated with large events where complex foods have been prepared in advance and must be reheated at the time of service. Both leftover food and stool from the ill attendees tested positive for the causal bacteria. The investigation of the caterer revealed evidence of temperature abuse including improper cooling, and insufficient hot and cold holding. The facility was closed temporarily to give time for staff to correct observed violations in food handling procedures.