Update on suspected food poisoning cases involving Taiwan sandwiches
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     The Centre for Health Protection (CHP) of the Department of Health (DH) and the Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department (FEHD) today (August 10) provided an update on the suspected food poisoning cases related to the consumption of sandwiches of "Hung Rui Chen" (Horng Ryen Jen) (in case of any problem with the transliteration, the name in Chinese shall prevail) of Taiwan, and again urged the public to maintain personal, food and environmental hygiene to prevent food-borne diseases.

     As of today, the CHP had identified a total of 31 clusters affecting 88 persons. These clusters were reported to CHP from July 28 to August 8 from various sources, namely public hospitals (seven clusters), private hospitals (seven clusters), a private doctor (one cluster), referrals from the CFS (13 clusters) and enquiries to the CHP (three clusters).

     The 88 affected persons comprised 33 males and 55 females aged 1 to 79. The size of the clusters varied from two to seven persons. They presented with diarrhoea (87 persons), abdominal pain (83 persons), fever (57 persons) and vomiting (32 persons) about three to 71 hours after consuming the incriminated sandwiches from July 24 to 30.

     Thirteen affected persons required hospitalisation and all had been discharged. However, one of them was readmitted to hospital due to persistent fever and diarrhoea. Fourteen patients had attended the Accident and Emergency Departments of public hospitals without hospitalisation and 41 had consulted private doctors/out-patient clinics/Chinese medicine practitioners for treatment while 20 did not seek medical attention.

     All the reported cases bought and consumed the sandwiches before investigation and control measures instituted by the CFS, and no additional cases have been reported after the control measures were implemented.

     Among the 88 affected persons, a total of 16 stool specimens were collected from the patients and 12 of them tested positive for Group D Salmonella. Laboratory investigation on nine of the Group D Salmonella isolates by the CHP's Public Health Laboratory Services Branch showed that all were Salmonella Enteritidis with identical genotyping patterns. Stool specimens taken from three other affected persons tested negative and laboratory results of stool specimens for one patient are pending.

     The affected persons purchased the sandwiches through various channels from July 24 to 29, namely an exhibition booth in Lok Fu Plaza (11 clusters*); the website "Peachy Sweet" (five clusters); city'super in Harbour City, Tsim Sha Tsui (five clusters); Taiwan Taoyuan International Airport (two clusters); Eight Tea Eight restaurant at 10 Yuen Long Tai Cheung Street (two clusters); PIAGO in Telford Plaza, Kowloon Bay (two clusters); APITA in Cityplaza, Taikoo Shing (one cluster); an exhibition booth in Chung On Commercial Complex, Ma On Shan (one cluster); an exhibition booth at 2/F of Tsuen Fung Centre Shopping Arcade, Tsuen Wan (one cluster); Foodies Corner at 4/F of Block 3, Camel Paint Building, Kwun Tong (one cluster)*; and an instant mobile messaging application (one cluster).

(* One cluster purchased sandwiches from both sources.)

     The nine patients with an identical strain were from eight clusters that had purchased sandwiches from five retailers, namely city'super in Harbour City (four patients), an exhibition booth in Lok Fu Plaza (two patients), the "Peachy Sweet" website (one patient), APITA in Cityplaza (one patient) and Eight Tea Eight restaurant (one patient). Investigation by the CFS showed that five retailers imported the sandwiches from three different importers. Places of purchase and importers are detailed in the attachment.

     The epidemiological and laboratory findings have so far suggested a common-source Salmonella food poisoning outbreak caused by the same brand of sandwiches.

     In general, Salmonella is commonly found in intestines of animals (especially poultry) and eggs, and the usual source of food poisoning by such agents are inadequately cooked meat, meat and poultry products, raw eggs and egg products.

     As the sandwiches were prepackaged food imported by different importers, the affected persons purchased them via different channels and nine of the Group D Salmonella isolates were Salmonella Enteritidis with identical genotyping patterns, the site of bacterial contamination is likely to have occurred before entering Hong Kong. Subsequent prolonged and improper storage of the sandwiches may provide favourable conditions for the bacteria to grow and thus aggravate the level of contamination. The CFS has passed the above information to the relevant authorities of the place of origin to assist their further investigation.

     Prolonged storage of food at room temperature may allow pathogens to grow and produce toxins. Members of the public should avoid consuming cooked or ready-to-eat food, including sandwiches, that has been kept at room temperature for several hours. For more information on microbiological risks of sandwiches, members of the public may visit the thematic website of the CFS (www.cfs.gov.hk/english/whatsnew/whatsnew_fst/whatsnew_fst_Mirco_Sandwichs.html).

Ends/Monday, August 10, 2015
Issued at HKT 16:16

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