Sick employees spread norovirus at an Indiana Subway restaurant, apparently returning to work even when they were ill and contagious.
The Star Press, citing a report it obtained from the state health department, revealed that the information was discovered by the Blackford County Health Department during an investigation of the outbreak. The information was not publicly shared despite that about 90 people fell ill with gastrointestinal symptoms on or after January 5th. Of those sickened, three were hospitalized, two were treated in emergency rooms, and three were treated at physician offices.
Of the six stool samples retrieved from Subway employees and analyzed at the state health department laboratory, all six tested positive for Norovirus, according to a February 7th report by Stephanie English, health department epidemiologist to physician, Lori Skidmore, the Blackford County health officer, “The Blackford County Health Department identified sick employees who reported working while symptomatic,” English wrote. “Four Subway employees were sick with nausea, diarrhea and/or vomiting on Saturday, January 7. Most employees self-reported to co-workers that employees worked while sick,” English added, said The Star Press. “Subway was a contributing factor to the spread of Norovirus in Blackford County,” the report concluded.
The state’s investigation confirmed the outbreak took place from January 5 – 8 and that 75 people who were ill were questioned; 72 said they ate at the Subway restaurant and no other common sources were identified. Five patrons also tested positive for norovirus, said The Star Press.
In a February interview, Linda Briles, a county health department environmental health specialist, told The Star Press that tests revealed that more than one Subway employee was infected with Norovirus; however, she did not indicate that those employees were working while ill and did not report Subway was a contributing factor to the outbreak. She did allude to the virus potentially having been spread by a patron who may not have washed his/her hands and then touched a restaurant surface.
An Indiana administrative code regulating food workers with diagnosed illnesses has been in place since 2000, although not enforced there until 2008, that states that food employees diagnosed with Salmonella, shiga toxin-producing E. coli, shigella, hepatitis A, or norovirus must be excluded from the food establishment, said The Star Press. Briles told The Star Press in February that Subway was following the illness code, “They (Subway employees) have to agree to report those symptoms. “She (the manager) handed me a blank one (form) they all had to sign.” The county health department visited Subway on January 7th, according to the state health department’s report.
The report stated that, “Local management had learned about the reported illnesses through Facebook. It was learned later the employee on duty at the time of the interview was working while ill, which was neither reported to the health department at the time of the inspection nor reported to the local manager,” according to The Star Press.
This is not the first time Subway restaurants have been at the center of a food borne illness outbreak. In 2011, we wrote that following a 2010 Shigella outbreak linked to an Illinois Subway restaurant, 74 people filed a lawsuit after suffering from the serious illness. The Subway Shigella outbreak, according to our last report, was linked to the Lombard, Illinois Subway and caused at least 13 hospitalizations. The Shigella bacteria involved were Shigella sonnei, which can be lethal. The DuPage County Health Department never found the source of the Shigella, and conceded it may never be able to.
In 2010, we wrote that a final report issued by the state Department of Public Health in Illinois said the source of a different outbreak; this time, Salmonella, was linked to a number of Illinois Subway restaurants and likely originated with Sysco Central Illinois Inc. In all, 109 cases of Salmonella were confirmed in that outbreak and another 90 so-called “probable” cases took place from late April to June of that year; 28 people were hospitalized and 12 of Subway’s food handlers tested positive for the dangerous Salmonella pathogen. At least one lawsuit was filed, others have been threatened, and more are expected in the outbreak that affected 47 restaurants in 28 counties, and involved the rare, sometimes deadly, Salmonella Hvittingfoss pathogen.