On April 8, 2001, the Henrico County Health Department (HCHD) received reports from numerous emergency rooms and clinics that an unusually high number of patients were ill with a gastrointestinal illness. Many patients said they had eaten pork sandwiches from a Richmond, Virginia-area Vietnamese delicatessen and bakery, Linh’s Bakery, before becoming ill.
HCHD investigators visited the restaurant that afternoon and advised the restaurant owner to stop selling pork sandwiches and to hold all sandwich ingredients for testing. HCHD investigators learned that a number of the sandwiches were made at one time, wrapped in deli-paper, and placed on the counter (at room temperature) for sale. The owner of the restaurant estimated that 150 of these sandwiches had been sold over a four day period.
By April 9, as many as 20 people were hospitalized in the Richmond area with symptoms of what was later determined to be Salmonella infection. Henrico County revoked the restaurant’s operating permit pending further investigation on April 10.
On April 18, HCHD and Virginia Department of Health (VDOH) investigators began testing food items used to make the pork sandwiches. An environmental investigation was conducted, and swabs were taken of all food preparation surfaces in the restaurant, both before and after a thorough cleaning of the restaurant.
Tests of the food items revealed that all opened sandwich ingredients were contaminated with Salmonella enteritidis. In addition, Salmonella enteritidis was found throughout the deli’s kitchen - on the sandwich preparation area, a large cutting board near the sandwich preparation area, and on several surfaces in the cake preparation area. Three of the four restaurant workers tested positive for S. enteritidis, although only two complained of any symptoms consistent with infection.
In its final report, VDOH concluded:
This large S. enteritidis outbreak was due to a contaminated egg or eggs used to make an uncooked sandwich spread…The preparation method of the sandwiches allowed ample opportunity for cross-contamination of all items on the sandwich preparation area. Therefore, eating any sandwich, even one that did not have the “butter,” was associated with illness. In addition, contamination spread to environmental surfaces, including the cake decorating area in the backroom…Cooked foods such as noodle dishes, rice dishes, skewered meats, and stuffed croissants were not associated with the illness.
Improper food holding temperatures allowed organisms to multiply. Improper temperatures occurred in the restaurant but also in many customers’ homes where sandwiches were kept at room temperature.
Nearly 250 people reported symptoms consistent with Salmonella infection after eating at Linh’s Bakery before the outbreak investigation was complete. Marler Clark represented several victims of the Salmonella outbreak. The claims were resolved in mid-2002.