Anatomy of a Foodborne Illness Complaint, Part 4: Outbreak


It’s unsettling to think that food served from a restaurant can lead to hundreds of people getting ill and possibly dying, but it happens more often then we would like to admit. It can be the result of untrained or sick employees, serving contaminated products or an overall lack of respect for food safety. A restaurant’s involvement in an outbreak can be devastating.

It often starts with 1 or 2 phone calls from sick customers. This doesn’t seem too alarming since complaints occasionally come from customers, but nothing ever resulted in a confirmed foodborne illness. However, in an outbreak, there could be more calls coming into the health department at the same time. The health department takes calls directly from sick customers as well as any confirmed cases identified in clinics and hospitals. A restaurant owner or manager may think he or she has only a couple of disgruntled customers, but in reality it could be 3 times that number and growing.


The health department has people dedicated to tracking down where sick individuals became ill. This is called epidemiology. As investigators gain more information and piece together the histories of the sick individuals, they can begin to pinpoint where the outbreak occurred. If through the course of the investigation a particular restaurant keeps popping up in multiple cases, they will start an investigation of that business. Epidemiology works closely with environmental health inspectors who are out in the restaurants every day doing routine inspections. But this time, the inspection will be a little different. They will focus more specifically on the food items they have already identified in the epidemiology investigation and the questions we outlined in the previous blog post, Anatomy of a Foodborne Illness Complaint, Part 3: Confirmed Cases.

What Should Restaurants Do?

Let’s get back to the restaurant that already received those 2 early complaints. Now it has ballooned to 10 complaints over the next couple of days. If a restaurant manager used a Foodborne Illness Report for each case to gain information on each complaint, the restaurant can do its own investigation. Look for common food items that all the sick people ate. This can be very difficult to find, because it may not be a specific food at all. There could be a sick employee handling food, an employee working the grill who doesn’t wash his hands often enough, or equipment not holding food at proper temperatures. If a link is found with a particular food, pull the product until it can be investigated thoroughly. At this point, making more people sick doesn’t help anyone and could increase liability.

Call the Health Department

This may be a hard call to make. There is a certain level of trust that needs to exist between restaurants and the local health department for a facility to make that call. The health department not only has an obligation to protect public health, but it also has an interest in helping a restaurant mitigate a crisis such as this. Health department inspectors are the experts in this area and they can help. They may be working on similar outbreaks and these cases could be linked to them. The health department may rule out the restaurant as the cause. It’s always important to cooperate with them as much as possible. Recently, a restaurant recorded 20 cases of foodborne illness that it decided not to report to the health department. This didn’t go over very well and started the discussion on whether or not restaurants should by law report any suspected foodborne illness cases to the health department.

Damage Control

Hopefully, with the cause identified and prevented from causing anymore illness, it’s time to pick up the pieces. There are different severities of outbreaks based on numbers of sick people and how ill they become. In the case of norovirus, it may be over by the time the cause is found and most of the cases probably were sick for only 24 hours. However, if it’s E. coli O157H7 exposed to kids, they most likely will still be in the hospital fighting for their lives. The liability and costs of those 2 scenarios probably differ by the millions of dollars. At this point, lawyers will be involved and lawsuits may be filed. Even though the lawyer is trying to limit liability, if there are sick people still in the hospital, they will need help with treatment and medical bills. Without admitting fault, the restaurant can still provide this help while everything else gets worked out. This will go a long way in building trust in the community. The sick people were their customers, after all.

Moving Forward after an Outbreak

Most restaurants don’t understand how damaging serving contaminated food can be. The CEO of Jack in the Box during the E. coli outbreak in the 1990s, Robert Nugent, couldn’t believe the product served in Jack in the Box restaurants every day could kill anyone. It killed 4 children. Today, Jack in the Box is bigger than ever. How did it recover from this PR nightmare? Nugent had a plan. Luckily, the company had enough insurance, but it also put controls in place to make sure this didn’t happen again. Restaurants shouldn’t wait until an outbreak occurs to clean up their act. Most don’t have the resources to recover like Jack in the Box. Don’t wait until it’s too late.

For additional information on the Jack in the Box outbreak, I highly recommend reading Poisoned by Jeff Benedict. It should be required reading for all restaurant owners and managers. Please contact me with any further questions you may have on this topic:

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