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Hospitality operations

A detailed guide to food poisoning for restaurants

This resource is a must read for all restaurant managers. Prevent your customers from getting sick by learning what causes food poisoning.


When food isn't prepared properly, your customers can get very sick. Odds are you drill this into your kitchen staff from day one, because most restaurants are sticklers about enforcing proper food safety. 

But in 2017 alone, plenty of high profile restaurants have been in the news for food poisoning allegations, which shows there's still a lack of proper training in this area. While food can become contaminated during farming, harvesting and shipment, which is outside your restaurant’s control, many cases can also happen because of behavior inside your venue.

It’s up to you and your staff to familiarize yourselves with the most common causes of food poisoning, so you can take preventative action.


Watch the online allergies course on Typsy.com for all you need to know about food allergies and how to handle them in your hospitality venue.

Allergies training at typsy.com


With that in mind, let's take a look at the top 14 types of foodborne illnesses. We've also included some handy resources at the end that can be used to further educate your staff.

The most common causes of food poisoning in restaurants.png

Campylobacter


Campylobacter is a type of bacteria that causes gastroenteritis. Food is contaminated when it comes into contact with animal faeces. It's generally found in raw meat and chicken, and occurs if contaminated foods are left out at room temperature or undercooked.

Symptoms

Symptoms will start occurring two to five days after a customer eats the contaminated food, and include:

  • Diarrhea
  • Fever
  • Abdominal cramps
  • Vomiting

Prevention

Staff should wash their hands after handling raw meat, especially chicken. Uncooked poultry should also not be stored near raw ingredients like vegetables. If someone in your kitchen has become ill with Campylobacter, they should avoid coming to work until their symptoms have been gone for at least 48 hours.



Botulism

Botulism poisoning is very rare, but it's important to be aware of because it is a life-threatening illness. It causes paralysis, and patients who are not immediately treated have a high risk of death. 

It's most commonly caused by improperly canning or preserving food, though it can also be caused by storing baked potatoes at room temperature, and not storing garlic or herb infused oils in the refrigerator.

Symptoms

Symptoms occur 12 to 72 hours after eating contaminated food, and include:

  • Double or blurred vision
  • Difficulty swallowing
  • Drooping eyelids
  • Slurred speech
  • A thick feeling tongue
  • Dry mouth
  • Muscle weakness

Prevention

Botulism rarely occurs in restaurants, but outbreaks have happened. One of the most significant occurred in 1977, when a Mexican Restaurant in Michigan called Trini and Carmen's served hot sauce that caused 58 people to become sick (the jalapeños were home-canned). As recently as May this year, a gas station in California caused a botulism outbreak, which was traced back to its canned nacho cheese sauce. It resulted in one death.

If your restaurant cans its own produce, the CDC recommends following these safe canning guidelines



Clostridium perfringens (C. perfringens)


In the US alone, C. perfringens causes nearly 1 million cases of food poisoning every year. This type of bacteria is found in beef, chicken, gravies and pre-cooked meals like casseroles, and usually occurs when foods are prepared in large quantities and kept warm for a long time before serving.

Symptoms

Symptoms occur within six to 24 hours, and include:

  • Diarrhea
  • Abdominal cramps
  • Nausea

Prevention

In order to avoid spreading C. perfringens, food must be kept at 140ºF (60ºC) or higher after cooking to prevent the growth of the bacterium, and meat should be served within two hours of cooking.



Escherichia coli (E. coli)


E. coli is a bacterium that is found in animal intestines, which means it can be spread to meat during slaughter. Humans will most commonly get this illness when ground beef isn't properly cooked, but E. coli can also be spread when an infected person doesn't wash their hands and then touches food.

Symptoms

Symptoms of an intestinal infection usually occur one to eight days after eating contaminated food, and include:

  • Diarrhea
  • Abdominal cramps
  • Loss of appetite
  • Nausea
  • Fever
  • Fatigue
  • Kidney failure (in severe cases)

Prevention

You probably heard about Chipotle's E. coli outbreak in 2015. A total of 55 people were infected across 11 US states, and the Mexican restaurant chain was forced to close 2,000 stores in February 2016 to retrain its staff. It's still suffering the negative effects of this health scare today – customers are scared to return and sales have yet to recover. 

The company has acknowledged that its reliance on fresh meat and produce (unusual for a franchise with so many employees) opened it up to this crisis.

Prevent this from happening to your venue by ensuring staff cook beef until it’s at least 160ºF (71ºC). There should be no pink showing anywhere in the meat. Carefully wash raw produce, and store raw meats separately from vegetables and fruits. Surfaces and utensils should be thoroughly sanitized after coming into contact with raw meat.



Giardiasis (Beaver Fever) 


Giardiasis is normally spread through contaminated water rather than food, because heat kills the parasites, so it’s more common in developing countries where sanitation is poor. However, there have been a number of reported outbreaks in restaurants and cafeterias in countries like the US and Australia.

It can be spread if someone has the parasite and doesn’t wash their hands before handling food, or if a restaurant serves uncooked meat or raw produce that has been contaminated.

Symptoms

Symptoms tend to occur one to two weeks after exposure, and include:

  • Fatigue
  • Nausea
  • Diarrhea
  • Vomiting
  • Abdominal pain
  • Loss of appetite
  • Weight loss

Prevention

Prevent it by ensuring your restaurant’s water supply is clean, and that your staff wash their hands and fresh produce before preparing any meals.  



Hepatitis A


Hepatitis A is one of the milder hepatitis viruses, and many people who are infected with it fully recover, but it can have serious long-term health effects on the liver, and it’s highly contagious. It’s generally spread through person-to-person contact rather than through food, but foodborne outbreaks have been increasing.

In 2003, for example, over 650 people were infected with Hepatitis A after eating or being in contact with someone who had eaten raw and undercooked green onions at Chi-Chi’s Restaurant in Pennsylvania.

The outbreak was traced back to the farms where the onions were grown and harvested, but if the restaurant had cooked the onions thoroughly and to order, they might have prevented it. The consequences weren’t small – the restaurant chain was hit with a multi-million dollar lawsuit and closed its 65 US stores soon after.

Within your venue, the virus can be spread if a food handler is sick, or if an asymptomatic person doesn’t wash their hands before touching food (it’s worth noting that the virus is usually spread during the first two weeks of someone’s illness, when they will be unaware they’re sick). It most commonly survives in shellfish, salads, deli meats, fruit, dairy products and vegetables.

Symptoms

Symptoms can be flu-like, and usually occur 14 to 28 days after being infected. They include:

  • Muscle aches
  • Headache
  • Loss of appetite
  • Abdominal cramps
  • Fever
  • Weakness and fatigue

Prevention

Hepatitis A can be prevented by, again, ensuring staff properly wash their hands, and that they are cooking food to the correct temperature (185ºF or 85ºC).

Your venue should also ensure it’s sourcing items like shellfish from approved suppliers.

Staff diagnosed with Hepatitis A should be excluded from shifts, and should wait at least 24 hours after their symptoms have disappeared before returning to work. Depending on local regulations, they might also require a release form from a medical practitioner. 



Listeria


Listeria is most commonly found in raw vegetables, processed meats and milk products. This bacterium is especially dangerous for pregnant women (they are 20 times more likely to become infected than other adults) because it can cause serious illnesses in their unborn children and miscarriages. 

The most high-risk foods include ready-to-eat seafood (sushi, oysters, mussels), pre-packaged fruit and vegetable salads, deli meats (pâté, ham, salami, diced chicken, hot dogs), soft cheeses (brie, ricotta, feta, camembert) and milk products made from unpasteurized milk.

Symptoms

Symptoms can occur anywhere from three to 70 days after exposure and include:

  • Fever
  • A stiff neck
  • Aches and pains
  • Confusion
  • Exhaustion
  • Vomiting
  • Diarrhea

Prevention

To prevent spreading this bacteria, your staff should wash their hands between handling raw foods and ready-to-eat foods, wash all raw fruit and vegetables, and avoid reusing utensils that have been used for raw foods unless they have been washed first.

It’s also important that food be stored correctly – avoid getting liquids from raw foods on other foods, monitor use-by dates, don’t use unpasteurized cheese products, place cooked food in the refrigerator within an hour of cooking if not being served, and keep refrigerators clean and below 41°F (5°C).
 



Norovirus


Norovirus is the second most common virus after the common cold, and the leading cause of gastroenteritis. It’s very contagious, and can be spread from person to person, by eating contaminated food, or by drinking contaminated water. An alarming 70% of outbreaks occur because of restaurants with careless sick leave policies.

Let’s draw on another example from good old Chipotle, which suffered a norovirus outbreak in Virginia just last month. The company confirmed that the illness spread because managers required staff to work even when they were sick. 

Symptoms

Symptoms normally start 24 to 48 hours after infection, and include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Abdominal cramps
  • Headaches
  • Fever

Prevention

Food service workers who have norovirus should not be allowed to work and should wait at least 48 hours after their symptoms go away before coming back to the kitchen. A written release from a medical practitioner might also be necessary, depending on the regulations in your area. 

Restaurant managers who are reckless about this, or who force sick staff to work if they can’t find someone else to cover their shift, are risking customer welfare, the wellbeing of staff, and the reputation of the venue.
 



Rotavirus 


Rotavirus is a gastrointestinal virus that generally affects toddlers and young children. However, it can be spread by food workers who have been caring for sick kids and don’t wash their hands before touching food, surfaces or utensils. These adults can also become infected themselves, though usually with a milder case of the virus.

Symptoms

Symptoms show up 24 to 72 hours after infection, and include:

  • Nausea
  • Fever
  • Vomiting
  • Diarrhea

Prevention

As a precaution, infected staff members should wait at least 48 hours after their symptoms disappear before coming back to work.



Salmonella


Salmonella is another bacteria that can lead to gastroenteritis. It’s usually spread through contaminated eggs, milk, meat, poultry, custards, sauces, tofu and raw vegetables. 

Symptoms

Symptoms occur six to 72 hours after exposure and include:

  • Diarrhea
  • Abdominal cramps
  • Fever
  • Vomiting
  • Headache

Prevention

To prevent it, ill food handlers should avoid coming to work until their symptoms have been gone for 48 hours. Meat should be cooked to reach an internal temperature of 160°F (71°C), and precautions should be taken when storing and preparing meals containing raw or incompletely cooked eggs (like mayonnaise and French toast).

Salmonella is one of the more common types of food poisoning because it can be found in so many different types of food, and it can have serious consequences for negligent restaurants.

In 2015, 28 people became sick after eating at South Bank Surf Club in Brisbane. The source was traced back to a large batch of raw-egg-based aioli that was kept on kitchen benches for up to three hours before being refrigerated, and was then served for up to seven days afterwards. The restaurant was fined $37,000 for something that could have been easily prevented with the right food handling procedures.



Scombroid poisoning


Scombroid poisoning happens when fish from the Scombridae family aren’t refrigerated properly. Scombridae fish such as tuna, mackerel and bonitos contain a chemical called histamine, which increases to toxic levels during decomposition. 

Other non-scombroid fish with dark meat, such as mahi-mahi, sardines, marlin, abalone and amberjack, can also be culprits. It can't be detected through taste.

While it isn’t known as a fatal illness and symptoms will usually clear up within 24 hours, it can be dangerous – a mother and daughter from Australia died after suffering from scombroid poisoning while travelling overseas in Bali. They ate grilled mahi mahi in the hotel restaurant and died within hours.

There are approximately 280 cases every year in Australia, and 100 cases in the US.

Symptoms

Symptoms occur very quickly (about 30 minutes to an hour after poisoning), and include:

  • Flushing/sweating
  • Tingling or burning in the mouth
  • Nausea
  • Dizziness
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Headache
  • A rash (on the face or body)

Prevention

To avoid scombroid poisoning, fresh fish should be refrigerated immediately after being caught, and stored at 41°F or 5°C until served. Restaurants should not accept fish deliveries that appear discolored or dried out, or that have a bad odor.

While histamine-producing bacteria is destroyed during cooking, the histamine itself will remain in the fish. That means that leftover cooked or canned fish is at risk of recontamination if it isn’t refrigerated as soon as possible.

The US FDA requires fish to have a histamine level of less than 50 mg/kg. A level of 200 mg/kg is considered hazardous.

 



Shingella 


Shigella bacteria cause a contagious disease that is usually spread by ill food workers. It’s found in foods that involve a lot of handling, like cold salads and sandwiches, and raw vegetables that have been contaminated during harvest, like tomatoes and lettuce.

Symptoms

Symptoms occur one to three days after exposure and include:

  • Diarrhea
  • Fever
  • Abdominal cramps
  • Dehydration
  • Vomiting
  • Chills

Prevention

Infected food workers shouldn’t come to work until their symptoms have been gone for at least 48 hours. A Subway restaurant in Illinois ignored this rule by allowing two sick employees to prepare and serve food to customers, and the resulting outbreak affected 328 people. The chain was then forced to handle lawsuits for more than two years afterwards. Again, a proper sick leave policy would have easily prevented this.



Staphylococcus aureus (Staph)


Staphylococcus is a type of bacteria found on the skin and in the noses of many healthy people. Unfortunately, it can make toxins that cause food poisoning, which means people can infect others if they don’t wash their hands properly before touching food, equipment and surfaces. That’s why it’s most commonly found in uncooked foods that require a lot of handling like salads, pastries, desserts and sandwiches.

Symptoms

Symptoms occur one to six hours after exposure, and include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Abdominal cramps
  • Fever

Prevention

Staph can be prevented by ensuring workers aren’t preparing food if they are sick (particularly with a nose or eye infection), or if they have wounds or skin infections on their hands.

Foods should also be stored at the correct temperature after cooking, and not left at room temperature where the toxins can thrive. Juices from meats should not be allowed to touch other foods.



Vibrio vulnificus


Vibrio vulnificus is a bacterium that lives in warm seawater. Food poisoning from this is rare, but it usually occurs when customers eat contaminated seafood like oysters and shellfish.

In high-risk individuals (like people with cancer or liver disease), it can enter the bloodstream and be extremely dangerous – even fatal.

Symptoms

Symptoms in healthy people occur one to seven days after exposure, and include:

  • Diarrhea
  • Vomiting
  • Abdominal camps

Symptoms in high-risk people differ, and include:

  • Fever and chills
  • Septic shock
  • Skin lesions

Prevention

This type of food poisoning can be prevented by thoroughly cooking oysters, and avoiding cross-contamination between cooked seafood and other foods with raw seafood. It’s also important to make sure your venue is purchasing seafood from approved suppliers.



Other resources

Watch the online course on Allergies at typsy.com.

For advice about the best temperature measuring equipment, we recommend visiting Testo

For information about obtaining HACCP related certifications (a food safety and risk assessment plan), we recommend visiting HACCP Australia, the FDA if you live in the US, or the Food Standards Agency if you live in the UK. ServSafe is also terrific for food handling, food management and allergen certifications. 

Watch the online course: Principles of HACCP at typsy.com.

For an overview of every bacteria, parasite, virus and allergen that can lead to food poisoning, go to the Food Safety or CDC websites. 

For fantastic articles, fact sheets and posters about food safety education, visit the Australian Institute of Food Safety

And download great educational posters about food health over at National Food Safety Month.

 

For more advice about owning and managing a restaurant, subscribe to our newsletter and join our community!

 

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