Food-borne salmonella outbreak at a bank cafeteria: an investigation in an Arab country in transition.

Symptoms of gastroenteritis compatible with a food-borne outbreak started appearing among employees at the central headquarters of a “Bank” located in Beirut, Lebanon, on the evening of Monday 17 May 2004. Earlier on that day, many employees had had lunch at the bank cafeteria. All of those with signs and symptoms had eaten the main dish of chicken noodles au gratin served at the cafeteria on that day. The chicken noodle dish had been brought from the kitchen of a local catering company in 2 large serving containers. This catering company has an excellent reputation in Beirut and had been serving the Bank for more than a year with no previous problems reported. Public health officers alerted to the outbreak went to the caterer on May 18 in line with legal regulations. Based on the mandate of an obsolete law they were supposed to “destroy” the remains of the “poisoned” food items. This kind of policy usually renders all evidence-based epidemiological investigations impossible. Fortunately, a portion of leftovers of the chicken noodles had been hidden by the caterers from the public health food inspectors, in anticipation of potential court action. Those leftovers were sent on 18 May to the Central Laboratory, the government reference laboratory in Beirut. On 19 May, testing of the remains of the incriminated dish demonstrated the presence of S. enterica Serovar Enteritidis, thus confirming the contamination of the dish.