Restaurant was never named but should be: 33 sickened by Campylobacter in Cardiff, 2015

Knowing when to go public in an outbreak situation is challenging. But it’s better than silence.The most important conclusions from this Public Health Wales report are:

Buffet_CounterOn the 27th May 2015 the Shared Regulatory Services Communicable Disease Team (Cardiff)  identified two cases of Campylobacter (one in Cardiff and the other in the Vale of Glamorgan) that were linked to the same premises (Premises A) in Cardiff.

This triggered an immediate investigation and an Outbreak Control Team was subsequently convened, declaring a formal outbreak on 4th June 2015.

In total there were 33 cases meeting the case definition of which 11 were microbiologically confirmed as Campylobacter jejuni. No cases were hospitalised. 24 cases ate at Premises A on 17th May. Of the remaining cases, seven ate on 16th May and one on 18th May. The final case ate on 7th June.

Repeated environmental visits were undertaken and issues that could potentially lead to cross contamination were identified. Premises A voluntarily closed on 4th June to address these issues and reopened on 6th June.

Of the 33 cases, 31 participated in a case control study.  These all ate between the 16th and 18th May.  The study revealed that 100% (31) of included cases had eaten from the salad bar compared to 84.9% (45/53) controls (p=0.024). In addition, 30 of 31 cases (96.8%) had eaten pasta salad from the salad bar, compared with 22/50 controls  (44%) (odds ratio 38; 95% CI 5.3–1611). Adjustment for other exposures using logistic regression did not materially change the association with eating pasta salad. A similar but independent association with eating noodles from the salad bar was also identified but few of the cases (6/31) had consumed noodles.

Environmental investigation found areas of non compliance with statutory food hygiene regulations and confirmed that several poor food hygiene practices had been identified that potentially could result in pasta salad cross-contamination within the kitchen area.

It was therefore concluded that eating pasta salad from the salad bar between 16th and 18th May 2015 was significantly associated with acquiring Campylobacter infection in this outbreak, and that for the small number of individuals who ate noodles this may have been independently associated with acquiring Campylobacter infection. The identification of non-meat items (often salad) in Campylobacter outbreaks is a reoccurring theme.

IMG_7739Ensuring good food hygiene is always the sole responsibility of the Food Business Operator. Nevertheless, it is important to note that this outbreak identified several issues which have implications more widely.

These included:

  • Issues with the interpretation and implementation by the food business of the Food Standards Agency E. coli O157 Control of Cross Contamination Guidance (revised December 2014).
  • Issues relating to the Primary Authority’s response in outbreak situations (relevant to Food Business Operators with multiple outlets).

The specific points of concern are explained in the discussion section of this report. 

Related to these issues, investigations highlighted three matters which may have implications for other high throughput food businesses.  These were:

  • Not using physical separation as the primary control measure to prevent cross-contamination.
  • An over reliance on two-stage cleaning as a control measure which may fail during busy periods.
  • The need to design out (as much as possible) any potential for human error resulting in cross-contamination.

Following this outbreak, improvements with respect to these three matters have been implemented in Premises A and all other similar premises nationally that are under the same ownership.

The outbreak was declared over on 25th August 2015.


  1. There were 33 cases of Campylobacter associated with this outbreak. Eleven were microbiologically confirmed.
  2. This had the features of a point source outbreak. All but one case ate at Premises A on the weekend 16-18th May. The final confirmed case ate at the premises on 7th June.
  3. Epidemiological and environmental investigation identified cross-contamination of the pasta salad as the most likely source of the outbreak for the cases on 16-18th May. No source was identified for the case on 7th June.
  4. Environmental investigation found areas of non compliance with statutory Food Hygiene Regulations and confirmed that several poor food hygiene practices had been identified that potentially could result in pasta salad cross-contamination within the kitchen area.
  5. The interpretation and application of the December 2014 revised version of the Food Standards Agency E. coli O157 Control of Cross Contamination Guidance by the Food Business Operator of Premises A resulted in the business not using physical separation as the primary control measure to prevent cross-contamination. This and over reliance on two-stage cleaning as a control measure was potentially not effective in preventing cross-contamination. This guidance was then used by the Food Business Operator to defend such arrangements and structural layouts as being in line with the recommendation of this guidance.
  6. Implementation of some control measures in this outbreak were delayed by involvement of the Primary Authority.
  7. Being unable to interview food handlers involved in this outbreak at an early stage in a structured format away from Premises A hampered outbreak investigation and control.
  8. Issuing a proactive press release without naming the premises resulted in this decision becoming the media focus rather than the outbreak.


  1. The Food Standards Agency E. coli O157 Control of Cross Contamination Guidance (revised December 2014) should be reviewed in light of the issues identified in this outbreak.
  2. The Food Standards Agency should work with the Better Regulation Delivery Office to develop advice for Primary Authorities on providing timely and effective responses to outbreak investigations.
  3. Proactive follow-up for example via telephone of all confirmed Campylobacter cases in Wales should be routine practice by all Local Authorities. This supports early detection of outbreaks, the application of control measures to be timely and prompt hygiene advice to be given to cases.
  4. Local Authorities should ensure that they retain sufficient Environmental Health staff with Food Safety and Communicable Disease skills to be able to proactively follow up communicable disease cases and investigate suspected outbreaks.
  5. Although direct poultry contact or consumption is known to be the most common source for Campylobacter infection in humans, the Food Standards Agency Campylobacter Reduction Strategy should note for consideration that outbreaks in Wales have also been linked to non meat products such as salads. This could of course in some cases represent cross contamination but they may wish to consider looking at the body of evidence from such outbreaks across the United Kingdom to inform the Strategy going forward.
  6. The use of ‘Requests for Co-operation’ under health protection legislation should be considered early in outbreak investigations in order to effectively interview food handlers.
  7. In future outbreaks proactive media engagement without naming the premises should be avoided.


‘Vomiting, aching limbs hot flushes’ Gastro outbreak at Cardiff hotel

A hotel in Cardiff remains closed following an outbreak of gastroenteritis leaving 26 people feeling ill.

angel.hotel.cardiffThe Angel Hotel, in Castle Street, was closed this week following the outbreak.

Speaking to the BBCWales, teacher Kevin Waite from Gwaelod-y-Garth, Cardiff, fell ill at the hotel after attending a training event on Friday

He said: “I felt nauseous, I was having hot and cold flushes and my limbs were aching.

“I started vomiting on Sunday and this lasted through until Monday.

“The hotel looked plush, pleasant and clean. There was nothing to point to any problems.”

“I’m shocked and disappointed. But these bugs can happen for many reasons.”

Of course it was Wales: KFC suspends Cardiff staffer after Facebook post claims she laced meal with pubic hair

I nag my five daughters about being careful what they post on Facebook, probably the same way my parents nagged me to stop being such an asshole.

A message on Facebook’s “Spotted Cardiff” page alleged a worker sabotaged a customer’s meal in revenge for rudeness, Walesonline reports.

kfcSpotted Cardiff is a page for Facebook users who “need to get something off (their) chest?”

The anonymous post appears to target a group of females who had threatened a female staff member at the Cardiff Excelsior Road drive-through in the UK because she “needed to smile more”.

The post said: “After over hearing the way you spoke to my girl on the head set be picking pubes out your teeth for a week.”

A spokeswoman for KFC told Walesonline: “We have investigated this incident and although there was an altercation in the drive-through between the customers and a member of our team, we do not believe the food was contaminated in any way.

“We have the highest standards of food hygiene and do not tolerate even the suggestion of this kind of behavior, and therefore the employee was suspended as soon as the matter came to our attention.”

9 sickened; owner of Cardiff kebab shop jailed after E. coli outbreak

The owner of a Cardiff takeaway has, according to BBC News, been jailed for eight months following an outbreak of E. coli.

Diar Wali Ali admitted at Cardiff magistrates’ court to 23 food hygiene offences and was jailed on Monday.

In August 2011, nine customers fell ill with food poisoning after visiting the Adonis Kebab House in City Road, Roath.

The takeaway was closed for two weeks while inspections were carried adonis.kebab.takeawayout and the council was satisfied the risks had been removed.

Councillor Derek Morgan, chair of Cardiff council’s public protection committee, said people had a right to eat safe food and certain levels of hygiene.

“However, where poor hygiene practices and substandard conditions are found, we take immediate action to safeguard public health,” he said.

“I hope this case helps to show how seriously we take this commitment and demonstrate that, where appropriate, we will use the full force of the law to ensure food safety regulations are met.”

Welsh E. coli kebab toll rises to 13, calls increase for mandatory restaurant inspection disclosure

WalesOnline reports a further six people are being monitored by public health experts investigating an outbreak of deadly E.coli O157 in Cardiff.

The outbreak control team last night said the number of confirmed cases remained at seven – one person is still seriously ill in hospital after developing symptoms.

The Adonis Kebab House, City Road, which is at the heart of the outbreak, also remains closed more than a week after Cardiff council shut it as a “precautionary measure”.

Consumer Focus Wales last night urged people to check the hygiene scores of their local restaurants and takeaways following the outbreak.

The Adonis Kebab House had a hygiene rating of one (out of a possible five), but that score was only publicized online. A new law proposed by the Welsh Government will mean food businesses are required to display their rating.

Disclosure should be mandatory, otherwise, why bother.

Cardiff kebab house closed after E. coliO157 leaves 1 in hospital, 4 others sick

A city kebab house has been closed following an outbreak of E.coli in Cardiff, affecting five people, one of who has been hospitalised.

Two further cases are under investigation but the person taken to hospital was said to be recovering.

Dr Gwen Lowe, Consultant in Communicable Disease Control, Public Health Wales and chairwoman of the Multi-agency Outbreak Control Team, said the Adonis Kebab House, City Road, Cardiff, had been closed by Cardiff Council on August 11, while investigations were carried out. Dr Lowe said letters have been sent to GPs and out of hours services across South East Wales to alert them to the situation.

Don’t go to work if you’re sick – Cardiff pub edition

In April 2007, 135 patrons of the Ffynnon Wen pub in Cardiff, Wales, became sick with norovirus.

Public health types have just published a report, concluding that sick staff likely had returned to work too soon after being ill and were still infectious, unintentionally contaminating customers’ food.

Don’t go to work if you’re sick.

Simon Royal, one of the food poisoning victims, is not happy. He plans to sue Marston’s Inns and Taverns, the company that owns the Ffynnon Wen in Thornhill, Cardiff, and criticized local council for taking so long to publish a full report into the outbreak.

The official report has recommended the council does not take legal action against the pub or the manager because of “insufficient evidence collected during the investigation.”

Investigators discovered two staff members who had suffered from a stomach bug could have returned to work within 48 hours and before they were fully symptom-free, in contravention of the company’s fitness-to-work policy.

Policies are nice, but only if they are enforced.

Hygiene horrors in Cardiff, Wales takeout restaurants

Bill Marler’s going to London, and if he gets to Wales, beware the Cardiff takeaway.

The South Wales Echo reports that cockroaches, dirt, poor personal hygiene and congealed fat are just some of the shocking  details uncovered in health inspector reports on kebab shops and chippies in Caroline Street.

Hundreds of hungry revellers regularly use the street, widely known as Chip Alley (below), after nights out on the town.

But the most recent kitchen hygiene inspection reports, obtained under the Freedom of Information Act, show the street’s takeaways broke food safety regulations more than 70 times.