Medical Report Blames Delayed Notification on The Fat Duck's Norovirus Outbreak

Back in February/March of 2009, 529 diners were served raw oysters at Heston Blumenthal's world-renowned restaurant The Fat Duck and fell ill with norovirus; last week Epidemiology and Infection published the results of an investigation. It's pretty damning, as "the size and duration of this outbreak exceed any other commercial restaurant-associated norovirus outbreaks in the published literature."

If you've followed this story at all, most of the journal article's findings aren't terribly new — see the 2009 medical report — but the journal article presents more details, specifically regarding the delayed response to the outbreak and staff working while sick.

Norovirus is a particularly nasty and highly contagious bug — it's supposedly the culprit for over 50% of the US's foodborne outbreaks, including those rampant on cruise ships. During a seven-week period in 2009, diner after diner got sick after eating at Blumenthal's three Michelin-starred and #5 restaurant in the world The Fat Duck. The restaurant had hired private consultants "in mid-February to review its food safety management system following complaints of illness" and it was voluntarily closed on February 22, 2009.

The Fat Duck took its time contacting health agencies: "The restaurant made no contact with either the local authority (LA) or Health Protection Agency (HPA) prior to the 24 February 2009. Sixty-six complaints of illness had been received by the restaurant by the time it had contacted the LA...." How long did the restaurant know? "The outbreak was reported to the [health authorities] 6 weeks after the putative index case." From the journal article:

This delay in reporting to the appropriate statutory authorities resulted in an ongoing risk of exposure to infection for diners. Had the reported illness in diners at the restaurant resulted in the public health authorities being notified earlier then investigations and appropriate interventions could have taken place sooner, potentially avoiding such a high number of cases over such a long period of time.

Back in 2010, Blumenthal told the Daily Mail: "Our staff training manual very clearly lays out a 48-hour return-to-work policy." The policy apparently wasn't followed, however, as the journal article found: "Of those staff reporting illness, six reported working while unwell... Nine reported returning to work prior to being asymptomatic for 48 h (against national guidance) and all without negative laboratory tests (against the restaurant's policy)."

And the restaurant made tracking down the cause of illness super-difficult, doing a deep-clean before contacting authorities: "A 'deep cleaning' exercise of the premises had been conducted immediately after closure and preceding notification of authorities, thus severely limiting the potential findings from environmental sampling as the environmental samples were taken 1 week after closure." Was this following the advice of the consultants? At best the "deep clean" delayed the investigation; at the worst this was a deliberate coverup.

Because the restaurant was closed for a week, there was no little-to-no food to test: "These samples were primarily frozen items such as stocks, sauces and purees. There was limited food to sample (no fresh products) as the restaurant had not prepared and served food since lunchtime on 22 February 2009, a period of more than 8 days." Following the trail, however, led to contaminated oysters and razor clams.

Bizarrely, no diners filed complaints with any health authorities until after the restaurant was closed. The article concludes:

It is hoped that lessons learned from this outbreak will help to inform future action by restaurateurs especially in early notification to public health authorities once an outbreak is suspected. It is also notable that diners may often choose to inform restaurants directly rather than their doctors or public health authorities. It is important that both diners and restaurants are provided with better information about whom to inform and when to inform once an outbreak of illness is suspected.

The restaurant ended up being closed for three weeks in total, and Blumenthal apologized and compensated diners who fell ill. Nevertheless, some of the affected diners filed lawsuits against the chef. Since the norovirus outbreak, Blumenthal has gone on to open a London restaurant called Dinner that serves modern takes on historic British dishes (hopefully using modern sanitation practices) and has recently written a cookbook, Heston Blumenthal at Home.

· A large foodborne outbreak of norovirus in diners at a restaurant in England between January and February 2009 [Epidemiology and Infection via Barfblog]
· All Heston Blumenthal Coverage on Eater [-E-]
· All The Fat Duck Coverage on Eater [-E-]