During the time period of the outbreak, April 18 to April 30, 2002, over 7,000 people ate at the Western Sizzlin’ restaurant in Spruce Pine, North Carolina. The Health Department in the Toe River Health District handled over 900 telephone calls and conducted 621 surveys of people who ate at the restaurant. There were 369 reported illnesses that may have been linked to the outbreak. Of those with symptoms, there were 39 lab-confirmed cases of Salmonella infection.
On Friday, April 26, 2002, the Health Director and one of the Environmental Health (EH) personnel from the Mitchell County HD inspected the restaurant. Deficiencies were noted. On Monday, the EH team collected food samples from an individual patron who had taken food home. The food collected for sampling included: hamburger steak with gravy; fried chicken; hamburger steak without gravy; and ham (which was under the hamburger steak without gravy). These specimens were sent to the State Laboratory for Public health (SLPH) for analysis. The Health Director, EH Supervisor and Regional EH Supervisor visited the restaurant and asked the manager to voluntarily close the restaurant pending the results of the epidemiological study. The manager, Darren King, closed his restaurant around 3:00 or 4:00 p.m. on Monday, April 27, 2002.
On Tuesday, EH obtained the following samples from the restaurant: 1) water from the tap in the kitchen; 2) water from the waitress service station; 3) leftover prepared mashed potatoes and gravy from the restaurant and 4) unopened packages of dried mashed potatoes and gravy. These were also sent to the SLPH. On Wednesday (May 1, 2002), samples of ice from the bottom of the large ice chest in the kitchen area were obtained. The restaurant was toured by EH from Mitchell County HD and Pam Jenkins from the State HD
Two asymptomatic employees of the restaurant were found to be infected with Salmonella. Lengthy interviews with the two employees were conducted. Both individuals ate at the restaurant. It could not be determined whether they got their infection from eating at the restaurant or infected the food at the restaurant. The serotypes of cultures from the two asymptomatic restaurant workers were identified as Salmonella heidelberg. The following are the results of the food samples sent to the SLPH:
Hamburger steak with gravy – Positive for S. heidelberg
Hamburger steak without gravy – Negative
Fried Chicken – Positive for S heidelberg
Ham – Positive for S. heidelberg
Applicator stick marked “gravy” – Positive for S. heidelberg
Obviously, a number of different foods served by the restaurant, and various cooking utensils and surfaces, were found to be contaminated with the Salmonella strain associated with the outbreak.
A review of the health department records indicates that management at Western Sizzlin’ was not particularly helpful in the handling of the investigation. Management denied its employees were sick, but a number of individual members described themselves with nausea and upset stomachs. Additionally, it also appears that foodmakers were allowed to return to work despite the possibility that they could still be shedding Salmonella.
It has been my experience in outbreak litigation that, when all the dust settles and discovery is done, juries will tend always to believe the unbiased reports of the investigating health department employees. Here, the health department report paints a bleak picture of Western Sizzlin’s practices as being the cause of so many unnecessary illnesses. (See, Toe River Health Department Records)