By: Candess Zona-Mendola

After a three-month investigation into an outbreak that left 149 children and 6 adults sick, the Florida Department of Health released a report this week linking the illnesses to a state-contracted South Florida catering company, Healthy Children Catering. Of those stricken with illness, 17 required hospitalization. The children’s ages range from 1 year to 10 years old. The schools and daycares involved include: Ave Marie Friends Preparatory School in Lauderhill, Florida, Kidstown Early Learning Center in Fort Lauderdale, Florida, and several unnamed Miami-Dade county schools. Both known schools have changed caterers.

The children that became ill on November 7, 2016 became ill less than three hours after lunchtime. For some children, the Lauderhill Fire Rescue Department rushed them to the hospital directly from their daycares. Initially, the fire department suspected a gas leak was the cause of illness. When inspections showed there was no link, food poisoning was concluded and the Florida Department of Health was contacted.

The Report

In its report this week, the agency identified that 117 children in 8 separate Miami-Dade county daycares and 32 children at 2 separate Broward County daycares were involved in the outbreak. All of the children reported ill were found to have ingested food made by Healthy Children Catering from their daycare centers. The agency represents that the students are believes to have been exposed to Staphylococcus aureus (Staph) due to mistakes by the catering company in its food preparation. The ham and turkey served is considered the most likely culprit.

The Florida Department of Health conducted a thorough inspection of Healthy Children Catering’s premises and kitchens. This inspection found that the caterer’s preparation of the food items lacked proper temperature monitoring and controls. On November 9, 2016, after 5 visits to the premises, the Florida Department of Health in conjunction with the Florida Department of Business and Professional Regulation ordered the caterer cease and desist food sales. The stop order includes sales of its rice and beans, pork products, turkey and ham sandwiches, and vegetables for improper preparation temperatures. This failure to ensure proper temperatures of food is a classic food safety violation that promotes the growth of dangerous bacteria – like Staph. The report confirmed that the:

“[r]esults from this investigation suggest this outbreak likely resulted from consumption of ham and turkey contaminated with S. aureus delivered by the catering company. S. aureus levels in the ham exceeded those (10 CFU/gram of food) typically known to cause illness. In addition, violations found at the catering company during the environmental assessment (improperly preparing and monitoring time and temperature controls for the food) resulted in an environment that is conducive to S. aureus multiplication and toxin production.”

Investigation

On or about November 7, 2016, the Florida Department of Health received reports of a large number of sick children from several daycare centers in South Florida. Within the same day, the Florida Department of Health commenced investigation. They quickly were able to collect samples of leftover food from a random sampling of daycare centers located in Broward and Miami-Dade counties. The samples were provided to the state’s Bureau of Public Health Laboratories for pathogenic testing. Bureau of Public Health Laboratories in Jacksonville tested ham, turkey, mixed vegetables, black eyed peas and dinner rolls from two Miami-Dade County daycares. Staph was found in the turkey and ham samples. All other samples were negative for both Staph and Bacillus cereus.

Those who were ill exhibited symptoms of nausea, vomiting, diarrhea, and exhausting within hours after eating lunch at the daycares. The quick onset lead investigators to interview the daycares, which lead to the discovery of a common catering company.

During the 5 inspections of Health Children Catering’s premises, the Florida agencies found more than just improper cooking temperatures. The agencies identified the following “high priority” violations in its report, among other intermediate and basic violations.

  • Chlorine sanitizer used to sanitize clean in place equipment not at proper minimum strength.
  • Dented/rusted cans present.
  • Employee began working with food, handling clean equipment or utensils, or touching unwrapped single-service items without first washing hands. Observed employee handling soiled equipment, and began preparing food without washing hands.
  • Raw sewage on ground of establishment.
  • Condensation or other drainage not disposed of according to law. Observed condensation dripping over food prep table in kitchen area.

This list is not exhaustive. For the full report, you can visit here.

State Contracts and Healthy Children Catering

Healthy Children Catering, through its parent-company Montoya Holdings, Inc., is a South Florida-bases company who is contracted through the state of Florida to provide meals to daycares in accordance with federal program for low-income students. This program works in conjunction with Florida Department of Health’s Child Care Food Program to provide daycare centers with reimbursement for meals and snacks provided by state contracted catering companies. When questioned about their involvement in the outbreak, Healthy Children Catering was a bit hostile and shooed out the media. The company’s only comment was, “We have had very good inspections.”

The company remains open and still provides catering services to other South Florida daycares.

What is Staphylococcus aureus?

The report is clear that Staphylococcal food poisoning (SFP) from the bacterium Staphylococcus aureus (Staph) is the cause of this outbreak. People become sick with Staph after eating food that has been contaminated. Food can become compromised from cross-contamination, lack of proper heating, and food sitting out too long. According to the Centers for Disease Control and Prevention, “People who carry Staph can contaminate food if they don’t wash their hands before touching it. It can grow in salty foods like ham, and as it multiplies in food it produces toxins that are resistant to heat and cannot be destroyed by cooking” This is why foods that are not cooked prior to eating, like pastries and sandwiches, are most likely to cause Staph food poisoning. Usually, food that is contaminated with Staph looks, smells, and tastes fine.

Symptoms of a Staph infection show up quickly, usually within 30 minutes to 6 hours. Typical symptoms are vomiting, nausea, diarrhea, and stomach cramps. In most cases, the recovery time is relatively short, usually 1 to 2 days. Supportive care, like drinking plenty of fluids and getting plenty of rest, is generally all that is needed. However, in more severe cases, especially in young children, victims may require hospitalization. The children involved in this outbreak appear to have recovered within a few days, according to the agency report.

With proper care, staph is preventable. There are a few simple ways to help reduce the risk of Staph food poisoning. For instance, handwashing is a great way to prevent cross-contamination of Staph from hands onto food. Also, by heating food to its optimum cooking temperature and keeping cooked foods at the proper holding temperature, the growth of Staph can be reduced. Chilling cold foods to 40 degrees Fahrenheit or below can also reduce growth. According to the Florida Department of Health Report, “S. aureus contamination and subsequent intoxication can be prevented by appropriate handwashing prior to handling of foods, ensuring clean food preparation, storage, and equipment surfaces. Additionally, “potentially hazardous” prepared foods should be immediately stored at either below 40°F or maintained in hot holding above 140° F to prevent growth of S. aureus. Findings from these investigations emphasize the importance of adhering to food safety regulations. Caterers serving young children should be aware of the risks associated with improper food handling and storage. Safe food preparation in lunch programs, particularly child care centers, is essential.”

 

Sources:

http://www.sun-sentinel.com/local/broward/lauderhill/fl-sb-sick-preschoolers-20170302-story.html

https://www.myfloridalicense.com/inspectionDates.asp?licid=5922139

https://www.cdc.gov/hai/organisms/staph.html