Investigation of a foodborne disease outbreak linked to a restaurant, City of Cape Town Metropolitan, Western Cape, South Africa, February 2024
1
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa
2
Communicable Disease Control and Outbreak Response, Western Cape Government, Department of Health and Wellness, Emergency and Clinical Services Support, Service Priorities Coordination, Cape Town, South Africa
3
City Health, Community Services and Health, Maitland, Cape Town, South Africa
4
Food Control Unit, City Health: Community Services and Health, Cape Town, South Africa
5
Centre for Enteric Diseases, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa
6
Facilities Infrastructure Management, Environmental Health and Climate Change, Western Cape Government, Department of Health and Wellness, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A414
ABSTRACT
BACKGROUND:
Foodborne diseases (FBD) remain an important global public health concern, causing an estimated 420 000 deaths and 33 million lost healthy life years annually. In South Africa, FBD outbreaks are classified as category 1 notifiable medical conditions, requiring immediate investigation to identify possible causes and implement corrective measures. This report summarises the epidemiological, clinical and environmental investigations, and subsequent public health response to a suspected FBD outbreak linked to a restaurant in the City of Cape Town Metropolitan area.
METHODS:
A descriptive cross-sectional study was conducted to characterise the outbreak and document the public health actions taken. Suspected cases were interviewed, and clinical specimens (stool or rectal swabs) were collected for laboratory testing. Environmental investigations included health inspections and assessments of the restaurant’s food safety practices. Bacteriological swabs (hands and surfaces), water samples (tap water and ice machine) and ready-to-eat food samples (raw and cooked) were collected to evaluate microbial contamination.
RESULTS:
Between 1–29 February 2024, 46 suspected cases were identified: 12 staff members and 34 patrons. The most common symptoms were diarrhoea (67%) and abdominal cramps (63%). Most affected individuals had consumed seafood (75%) or chicken (42%). Laboratory testing confirmed Shigella spp. or enteroinvasive Escherichia coli (EIEC) in 33 (67%) clinical specimens. Fifteen patrons required hospitalisation, with no fatalities. Environmental inspections revealed overstocked cold storage and poor stock rotation. Several food items did not meet microbiological standards for food: grilled chicken, prawn rissoles, cooked halloumi and mayonnaise sauce.
CONCLUSIONS:
Although the precise outbreak source could not be confirmed, evidence strongly suggested a foodborne origin involving contaminated food items or an infected food handler. Shigella spp./EIEC was considered the most probable causative agent. The outbreak was contained following temporary closure of the restaurant for decontamination, deep cleaning, staff refresher training and exclusion of symptomatic employees until full recovery.
Foodborne diseases (FBD) remain an important global public health concern, causing an estimated 420 000 deaths and 33 million lost healthy life years annually. In South Africa, FBD outbreaks are classified as category 1 notifiable medical conditions, requiring immediate investigation to identify possible causes and implement corrective measures. This report summarises the epidemiological, clinical and environmental investigations, and subsequent public health response to a suspected FBD outbreak linked to a restaurant in the City of Cape Town Metropolitan area.
METHODS:
A descriptive cross-sectional study was conducted to characterise the outbreak and document the public health actions taken. Suspected cases were interviewed, and clinical specimens (stool or rectal swabs) were collected for laboratory testing. Environmental investigations included health inspections and assessments of the restaurant’s food safety practices. Bacteriological swabs (hands and surfaces), water samples (tap water and ice machine) and ready-to-eat food samples (raw and cooked) were collected to evaluate microbial contamination.
RESULTS:
Between 1–29 February 2024, 46 suspected cases were identified: 12 staff members and 34 patrons. The most common symptoms were diarrhoea (67%) and abdominal cramps (63%). Most affected individuals had consumed seafood (75%) or chicken (42%). Laboratory testing confirmed Shigella spp. or enteroinvasive Escherichia coli (EIEC) in 33 (67%) clinical specimens. Fifteen patrons required hospitalisation, with no fatalities. Environmental inspections revealed overstocked cold storage and poor stock rotation. Several food items did not meet microbiological standards for food: grilled chicken, prawn rissoles, cooked halloumi and mayonnaise sauce.
CONCLUSIONS:
Although the precise outbreak source could not be confirmed, evidence strongly suggested a foodborne origin involving contaminated food items or an infected food handler. Shigella spp./EIEC was considered the most probable causative agent. The outbreak was contained following temporary closure of the restaurant for decontamination, deep cleaning, staff refresher training and exclusion of symptomatic employees until full recovery.
| eISSN: | 2654-1459 |
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