Foodborne Illness Outbreak Investigation in a High-Profile Sports Club

Sports Medicine - Open, Jun 2017

A foodborne illness outbreak involving an elite sports team was investigated by a public health unit in Sydney, Australia. An epidemiological association was established between gastrointestinal illness and the consumption of food supplied by an external caterer, with a lamb meal most strongly associated with illness. Genetically identical Salmonella isolates were identified from clinical specimens, residual food items, and an environmental swab taken from the catering premises. The training schedule and other club operations were significantly affected by this outbreak. Increased susceptibility due to regular shared activities and the potential for significant impact upon performance indicates that sports clubs must ensure that food suppliers comply with the highest standards of hygiene. Collaboration with public health authorities assists in source identification and prevention of further transmission.

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Foodborne Illness Outbreak Investigation in a High-Profile Sports Club

Cavanagh et al. Sports Medicine - Open Foodborne Illness Outbreak Investigation in a High-Profile Sports Club Kwendy Cavanagh 0 Travers Johnstone 0 Essi Huhtinen 0 Zeina Najjar 0 Peter Lorentzos 1 Craig Shadbolt 2 John Shields 2 Leena Gupta 0 Key Points 0 Sydney Local Health District Public Health Unit , King George V Building, Missenden Road, Camperdown, NSW 2050 , Australia 1 Sports team physician , Sydney , Australia 2 New South Wales (NSW) Food Authority, 6 Avenue of the Americas , Newington, NSW 2127 , Australia A foodborne illness outbreak involving an elite sports team was investigated by a public health unit in Sydney, Australia. An epidemiological association was established between gastrointestinal illness and the consumption of food supplied by an external caterer, with a lamb meal most strongly associated with illness. Genetically identical Salmonella isolates were identified from clinical specimens, residual food items, and an environmental swab taken from the catering premises. The training schedule and other club operations were significantly affected by this outbreak. Increased susceptibility due to regular shared activities and the potential for significant impact upon performance indicates that sports clubs must ensure that food suppliers comply with the highest standards of hygiene. Collaboration with public health authorities assists in source identification and prevention of further transmission. Public health; Communicable diseases; Sports; Disease outbreaks; Athletes; Salmonella; Foodborne illness Background An estimated 4.1 million cases of foodborne illness are reported in Australia each year, and outbreaks are common [ 1 ]. Despite the frequency of such outbreaks in the general population [ 1, 2 ], infectious disease outbreaks of any type in sporting teams are not frequently described in the literature [ 3–5 ]. The few reported outbreaks in sporting teams in Australia have mainly been caused by environmental pathogens, such as Cryptosporidium [ 6, 7 ] and Aeromonas hydrophila [ 8 ], rather than foodborne organisms. In Australia, only two published outbreaks relating to food and sports were identified on review; an outbreak of gastroenteritis amongst six persons associated with a team lunch [ 9 ] and a Staphylococcus aureus outbreak amongst 22 participants of an elite event [ 10 ]. Internationally, reports of gastroenteritis in sports teams have been linked to ice used in drinks [ 11 ], a football game [ 12 ], a rowing tournament [ 13 ] and more recently, an outbreak of Salmonella affecting a number of European ice hockey teams was linked to catering venues at the event [ 13 ]. However, such accounts are not numerous, suggesting that foodborne illness outbreaks in sporting teams are likely to be significantly underreported. Sports teams may be at increased risk of infectious diseases due to their close physical interactions, exposing them to both point-source and person-to-person transmission [ 3, 4, 12 ]. Teams may also be at risk of foodborne illness because of mass catering at training, events or functions. Furthermore, when food is prepared for specific dietary circumstances or needs of sportspersons, adherence to strict food safety principles is required. Large-scale sporting events will often have risk management plans which include food safety as a significant area for risk mitigation [ 14 ]. However, when catering is on a smaller, more routine scale, such plans or consideration of food safety may not be a particular priority. This report describes an outbreak of Salmonella amongst the team and staff of a professional sports club during training season, the challenges involved in the investigation, and practical implications for future prevention and management of similar incidents amongst sportspersons. Case Report In late 2014, a public health unit (PHU) in Sydney was notified by the doctor of a professional sports team of 33 players and staff at a sports club who had developed gastrointestinal symptoms within a 24-h period. In New South Wales (NSW), Australia, suspected foodborne illness outbreaks are notifiable to public health authorities under the NSW Public Health Act 2010 [ 15 ]. In line with NSW health guidelines [ 16 ], an outbreak investigation was initiated in conjunction with the NSW Food Authority (NSW FA), the lead food regulatory agency, to determine the cause and control any ongoing risk. The PHU conducted a retrospective cohort study, with the cohort being defined as all individuals who attended the sports club premises within a 72-h period surrounding the first reported onset of illness. A case was defined as a member of the cohort who developed gastrointestinal symptoms within the 7 days following their attendance at the club. A modified standard questionnaire [ 17 ] was used to collect details of any illness and of foods consumed. Ninety-one people attended the club during this period, forming the cohort; 76 of t (...truncated)


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Kwendy Cavanagh, Travers Johnstone, Essi Huhtinen, Zeina Najjar, Peter Lorentzos, Craig Shadbolt, John Shields, Leena Gupta. Foodborne Illness Outbreak Investigation in a High-Profile Sports Club, Sports Medicine - Open, 2017, pp. 24, Volume 3, Issue 1, DOI: 10.1186/s40798-017-0088-x