Category Archives: Illness

USA – Foodborne Illness Outbreaks at Retail Food Establishments — National Environmental Assessment Reporting System, 25 State and Local Health Departments, 2017–2019



Problem/Condition: Each year, state and local public health departments report hundreds of foodborne illness outbreaks associated with retail food establishments (e.g., restaurants or caterers) to CDC. Typically, investigations involve epidemiology, laboratory, and environmental health components. Health departments voluntarily report epidemiologic and laboratory data from their foodborne illness outbreak investigations to CDC through the National Outbreak Reporting System (NORS); however, minimal environmental health data from outbreak investigations are reported to NORS. This report summarizes environmental health data collected during outbreak investigations and reported to the National Environmental Assessment Reporting System (NEARS).

Period Covered: 2017–2019.

Description of System: In 2014, CDC launched NEARS to complement NORS surveillance and to use these data to enhance prevention efforts. State and local health departments voluntarily enter data from their foodborne illness outbreak investigations of retail food establishments into NEARS. These data include characteristics of foodborne illness outbreaks (e.g., etiologic agent and factors contributing to the outbreak), characteristics of establishments with outbreaks (e.g., number of meals served daily), and food safety policies in these establishments (e.g., ill worker policy requirements). NEARS is the only available data source that collects environmental characteristics of retail establishments with foodborne illness outbreaks.

Results: During 2017–2019, a total of 800 foodborne illness outbreaks associated with 875 retail food establishments were reported to NEARS by 25 state and local health departments. Among outbreaks with a confirmed or suspected agent (555 of 800 [69.4%]), the most common pathogens were norovirus and Salmonella, accounting for 47.0% and 18.6% of outbreaks, respectively. Contributing factors were identified in 62.5% of outbreaks. Approximately 40% of outbreaks with identified contributing factors had at least one reported factor associated with food contamination by an ill or infectious food worker. Investigators conducted an interview with an establishment manager in 679 (84.9%) outbreaks. Of the 725 managers interviewed, most (91.7%) said their establishment had a policy requiring food workers to notify their manager when they were ill, and 66.0% also said these policies were written. Only 23.0% said their policy listed all five illness symptoms workers needed to notify managers about (i.e., vomiting, diarrhea, jaundice, sore throat with fever, and lesion with pus). Most (85.5%) said that their establishment had a policy restricting or excluding ill workers from working, and 62.4% said these policies were written. Only 17.8% said their policy listed all five illness symptoms that would require restriction or exclusion from work. Only 16.1% of establishments with outbreaks had policies addressing all four components relating to ill or infectious workers (i.e., policy requires workers to notify a manager when they are ill, policy specifies all five illness symptoms workers need to notify managers about, policy restricts or excludes ill workers from working, and policy specifies all five illness symptoms requiring restriction or exclusion from work).

Interpretation: Norovirus was the most commonly identified cause of outbreaks reported to NEARS, and contamination of food by ill or infectious food workers contributed to approximately 40% of outbreaks with identified contributing factors. These findings are consistent with findings from other national outbreak data sets and highlight the role of ill workers in foodborne illness outbreaks. Although a majority of managers reported their establishment had an ill worker policy, often these policies were missing components intended to reduce foodborne illness risk. Contamination of food by ill or infectious food workers is an important cause of outbreaks; therefore, the content and enforcement of existing policies might need to be re-examined and refined.

Public Health Action: Retail food establishments can reduce viral foodborne illness outbreaks by protecting food from contamination through proper hand hygiene and excluding ill or infectious workers from working. Development and implementation of policies that prevent contamination of food by workers are important to foodborne outbreak reduction. NEARS data can help identify gaps in food safety policies and practices, particularly those concerning ill workers. Future analyses of stratified data linking specific outbreak agents and foods with outbreak contributing factors can help guide the development of effective prevention approaches by describing how establishments’ characteristics and food safety policies and practices relate to foodborne illness outbreaks.

Singapore – Suspension of Nosh Cuisine Pte Ltd’s food business operations – Gastroenteritis Investigation


The Ministry of Health (MOH), the Singapore Food Agency (SFA), and the Early Childhood Development Agency (ECDA) are investigating three incidents of gastroenteritis reported at MindChamps preschools (MindChamps Preschool @ Bishan, MindChampsPreschool@ Changi Airport and MindChampsPreschool@ Tanglin).

As of 12pm, 30 May 2023, a total of 89 persons (79 children and 10 staff) reported gastroenteritis symptoms after consuming food prepared by Nosh Cuisine Pte Ltd between 17 May and 29 May 2023. Six were hospitalised and are in stable condition. The rest had either sought outpatient treatment, self-medicated, or recovered without treatment.

USA – Now over 50 with Salmonella linked to Los Amigos Taqueria in Brighton

Food Poison Journal

According to press reports, more than 50 confirmed cases of salmonella have now been linked to Los Amigos Taqueria’s Brighton restaurant, state health officials confirmed Friday.

The chain’s Brighton outpost was one of two ordered closed last week after health inspectors flagged multiple issues at each restaurant; the West Roxbury Los Amigos Taqueria also shut its doors temporarily.

As of Friday, there were 56 lab-confirmed salmonella cases among people who had eaten at the Brighton Los Amigos Taqueria before becoming ill, the Massachusetts Department of Public Health said. Of those cases, 37 are among Boston residents.

State health officials continue to receive additional reports of lab-confirmed and undiagnosed illnesses linked to the restaurant, according to DPH.

Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

USA – Health officials confirm an outbreak of Salmonella infections linked to Boston Restaurants

Food Safety News

Laboratory testing has shown that dozens of people have Salmonella infections linked to two Mexican restaurants in Boston.

There are now 45 confirmed patients, up from 33 earlier this week, according to the Massachusetts Department of Public Health.

Patients report eating at Los Amigos Mexican Grill taquerias in Brighton Center and West Roxbury. Of the 45 confirmed patients, 29 are from Boston. Additional illnesses have been reported but have not yet been confirmed with lab tests.

The two restaurants have been closed by authorities who have cited health code violations. The Los Amigos Mexican Grill taquerias in Brighton Center and West Roxbury have also had their permits to operate temporarily suspended.

USA – Norovirus outbreak linked to California restaurant sickens nearly 100

Food Safety News


A norovirus outbreak originating from a California restaurant has sickened about 100 people, according to the San Luis Obispo County Public Health Department.

Jessie Burmester, an epidemiologist from the health department, told KSBY news that 97 cases have been confirmed in connection with the outbreak earlier this month. While Burmester did not disclose the name of the restaurant involved, she revealed that the investigations consistently pointed to the same establishment.

“Our primary objective during investigations is to identify a common source or exposure point,” Burmester said. “Thus far, all individuals reporting illness have consistently provided the name of the restaurant.”

USA – Papa Murphy’s Cookie Dough Salmonella Outbreak

Food Poison Journal

Oregon Department of Health links 4 residents to Papa Murphy’s Cookie Dough Salmonella Outbreak

Food Poison Journal

Washington Department of Health reports 6 with Salmonella linked to Papa Murphy’s Cooking Dough

Food Poison Journal

Idaho Public Health weighs in on Papa Murphy’s Salmonella Outbreak

USA – FDA – Core Outbreak Table Investigations of Foodborne Illness Outbreaks


What’s New

  • An outbreak of Salmonella Enteritidis (ref # 1156) linked to raw cookie dough has been added to the table. On 05/23/2023, FDA issued an Outbreak Advisory. Additionally, traceback, an onsite inspection, and sample collection and analysis have been initiated.
  • An outbreak of Cyclospora cayetanensis (ref # 1155) in a not yet identified product has been added to the table. Traceback has been initiated.
  • For the investigation of illnesses with a suspect vehicle of Morel mushrooms (ref # 1152), the FDA issued an advisory on 5/19/2023.
Ref Pathogen
Cause of
Linked to

(if any)

5/24/2023 1156 Salmonella
Raw Cookie Dough See
5/24/2023 1155 Cyclospora
Not Yet
19 Active
4/26/2023 1152 Not Yet Identified Morel Mushroom
See Advisory Active
3/29/2023 1141 Salmonella Infantis Raw Flour See
3/1/2023 1143 Hepatitis A Virus Frozen Organic
2/15/2023 1123 Listeria
Not Yet

USA – Salmonella Outbreaks Linked to Backyard Poultry


Public health officials are investigating multistate outbreaks of Salmonella linked to contact with backyard poultry. Any backyard poultry can carry Salmonella germs that can make you sick. Always take steps to stay healthy around your flock.

Fast Facts
  • Illnesses: 104
  • Hospitalizations: 19
  • Deaths: 0
  • States: 31
  • Investigation status: Active
Backyard Poultry and Salmonella

Backyard poultry, like chickens and ducks, can carry Salmonella germs even if they look healthy and clean. These germs can easily spread to anything in the areas where the poultry live and roam.

You can get sick from touching your backyard poultry or anything in their environment and then touching your mouth or food and swallowing Salmonella germs.

What Backyard Flock Owners Should Do
  • Wash your hands
    • Always wash your hands with soap and water immediately after touching backyard poultry, their eggs, or anything in the area where they live and roam.
    • Use hand sanitizer if soap and water are not readily available. Consider keeping hand sanitizer at your coop.
  • Be safe around backyard flocks
    • Don’t kiss or snuggle backyard poultry, and don’t eat or drink around them. This can spread Salmonella germs to your mouth and make you sick.
    • Keep your backyard flock and supplies you use to care for them (like feed containers and shoes you wear in the coop) outside of the house. You should also clean the supplies outside the house.
  • Supervise kids around flocks
    • Always supervise children around backyard poultry and make sure they wash their hands properly afterward.
    • Don’t let children younger than 5 years touch chicks, ducklings, or other backyard poultry. Young children are more likely to get sick from germs like Salmonella.
  • Handle eggs safely
    • Collect eggs often. Eggs that sit in the nest can become dirty or break.
    • Throw away cracked eggs. Germs on the shell can more easily enter the egg through a cracked shell.
    • Rub off dirt on eggs with fine sandpaper, a brush, or a cloth. Don’t wash eggs because colder water can pull germs into the egg.
    • Refrigerate eggs to keep them fresh and slow the growth of germs.
    • Cook eggs until both the yolk and white are firm, and cook egg dishes to an internal temperature of 160°F to kill all germs.

Call your healthcare provider right away if you have any of these severe symptoms:

  • Diarrhea and a fever higher than 102°F
  • Diarrhea for more than 3 days that is not improving
  • Bloody diarrhea
  • So much vomiting that you cannot keep liquids down
  • Signs of dehydration, such as:
    • Not peeing much
    • Dry mouth and throat
    • Feeling dizzy when standing up

UK – 50 sick in Cryptosporidium outbreak linked to farm

Food Safety News

water contamination

Fifty cases of Cryptosporidium have been traced to a farm on an island off the south coast of England.

The UK Health Security Agency (UKHSA)’s South East branch has tried to contact people who visited Hazelgrove Farm from April to the start of May on the Isle of Wight.

People are thought to have become sick after coming into contact with animals. The farm halted animal petting activity in early May.

No ongoing risk
Dr. Anand Fernandes, the health protection consultant for UKHSA South East, said there is no ongoing risk to the public associated with the farm.

Research – Salmonella Outbreak Linked to Raw Cookie Dough


Papa Murphy’s Chocolate Chip Cookie Dough

Fast Facts
  • Illnesses: 18
  • Hospitalizations: 2
  • Deaths: 0
  • States: 6
  • Recall: No
  • Investigation status: Active
Contaminated Food

Papa Murphy’s raw cookie dough:

  • Chocolate chip cookie dough
  • S’mores bars dough

Nine sick people reported eating raw cookie dough from Papa Murphy’s Take ‘N’ Bake Pizza in the week before they got sick. Based on this information, Papa Murphy’s has temporarily stopped selling their raw chocolate chip cookie dough and raw S’mores bars dough.

At least two sick people did not eat at Papa Murphy’s. Investigators are working to identify the contaminated ingredient in the raw cookie dough.

What You Should Do
  • Check your refrigerator and freezer for Papa Murphy’s chocolate chip cookie dough or S’mores bars dough.
    • Throw the dough away, even if you didn’t get sick after eating some of it.
    • Wash items and surfaces that may have touched the dough using hot soapy water or a dishwasher.
  • Always follow cookie dough baking instructions in the recipe or on the package label.
    • Papa Murphy’s chocolate chip cookie dough and S’mores bars dough are not meant to be eaten raw.
    • Most raw cookie dough is made with unpasteurized eggs or raw flour and can have germs like Salmonella and E. coli.
    • Some other companies make edible cookie dough that does not have to be baked. These products are made with heat-treated flour and pasteurized eggs or no eggs. Read the label carefully to make sure the dough is meant to be eaten without baking or cooking.
  • Call a healthcare provider if you have any of these severe Salmonella symptoms:
    • Diarrhea and a fever higher than 102°F
    • Diarrhea for more than 3 days that is not improving
    • Bloody diarrhea
    • So much vomiting that you cannot keep liquids down
    • Signs of dehydration, such as:
      • Not peeing much
      • Dry mouth and throat
      • Feeling dizzy when standing up
Symptoms of Salmonella
  • Most people infected with Salmonella experience diarrhea, fever, and stomach cramps.
    • Symptoms usually start 6 hours to 6 days after swallowing the bacteria.
    • Most people recover without treatment after 4 to 7 days.
  • Some people—especially children younger than 5 years, adults 65 years and older, and people with weakened immune systems—may experience more severe illnesses that require medical treatment or hospitalization.
  • For more information about Salmonella, see the Salmonella Questions and Answers page.