Pho Tam Salmonella Outbreak LawsuitsIn early March 2015 Central District Health Department (CDHD) staff learned of three individuals who were laboratory confirmed with Salmonella serotype Schwarzengrund. They did not know each other and lived in separate households. CDHD interviewed each person and determined that the only common exposure shared by all three patients was food they had purchased and consumed at Pho Tam Restaurant located at 1098 Orchard Street in Boise, Idaho. Meal dates for the three individuals occurred on February 23, February 24 and February 28. CDHD notified the Idaho Department of Health and Welfare (IDHW) who assigned Outbreak ID# 2015-024 to the investigation. Investigators would soon learn of two more patients diagnosed with Salmonella Schwarzengrund who had dined at Pho Tam in the week before symptom onset. Genetic testing by Pulsed Field Gel Electrophoresis (PFGE) confirmed that all five Pho Tam patrons who were laboratory confirmed with Salmonella Schwarzengrund were infected with an indistinguishable genetic strain of the bacteria. This strain was assigned PulseNet pattern identification number JM6X01.0230.
After determining there was an association between Salmonella illnesses and Pho Tam, CDHD sanitarian, Lori Badigian, conducted an on-site inspection at the restaurant on March 11. During the inspection she noted numerous critical food safety violations. These included
· Bare hand contact, improper glove use;
· Foods such as lettuce and rice noodles were held at improper temperatures;
· No sanitizer in the kitchen and prep surfaces were not being sanitized;
· Raw meat was improperly stored above vegetables in the prep unit; and,
· Food items were not date marked as required.
Long Doan, the owner of Pho Tam, said no employees had been ill. Ms. Badigian collected various food samples (rice noodles, lettuce, sprouts and basil) and environmental swabs for laboratory testing. None of the samples tested positive for Salmonella at the IDHW Bureau of Laboratories (BOL).
On March 23 the owner of Pho Tam voluntarily closed the restaurant for a day. On April 3 CDPH staff went to the restaurant to provide employees with stool collection kits. Stool samples were collected and analyzed at the IDHW BOL. None of the samples tested positive for Salmonella. On April 7 CDHD employees, Lori Badigian and Tammie McCarter conducted an onsite training session with Pho Tam staff. Educational materials were provided, including instructions written in Vietnamese.
During an April 9 inspection Lori Badigian again noted improper storage of raw meat above vegetables. She learned that the restaurant did not use a thermometer to check cook temperatures. There was no sanitizer in the kitchen. In her opinion the owner of Pho Tam was not able to demonstrate basic knowledge of food safety practices. The license to operate Pho Tam was immediately suspended. On April 17 the owners of Pho Tam informed Lori Badigian that the restaurant would remain closed until a complete renovation was finished. On April 24, 2015 CDHD sent a letter reminding Mr. Doan that before the restaurant could reopen, all plans for renovation would need approval by health department staff. The restaurant has now reopened.
In summary, an outbreak of Salmonella Schwarzengrund occurred among dining patrons of Pho Tam. Meal dates ranged from February 23, 2015 to March 12, 2015. Five individuals were laboratory confirmed with Salmonella Schwarzengrund, PFGE strain JM6X01.0230. Food and environmental samples were negative for Salmonella as were stool specimens collected from Pho Tam employees. However, evidence of poor food safety practices observed over several weeks leaves little doubt that food prepared at Pho Tam was responsible for the outbreak.
Marler Clark represented 2 of the 5 individuals who were laboratory confirmed with the strain of Salmonella Schwarzengrund, achieving settlements covering medical expenses, wage loss, and non-economic losses.