More than 220 people are part of an outbreak in Hong Kong linked to sandwiches.

The Centre for Health Protection (CHP) of the Department of Health reported 229 people were sick and 45 needed hospital treatment after eating the implicated sandwiches. It was previously reported that 27 people were sick and five needed hospital treatment.

The CHP has identified 96 clusters of suspected food poisoning. Among them, stool specimens from 12 sick people and one food sample tested positive for Salmonella. All those affected are now in stable condition.

The Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department (FEHD), previously said that while following up on suspected food poisoning involving sandwiches, it was found they were produced by an unlicensed food factory in Hong Kong.

Multiple clusters of illness identified
The latest seven identified clusters involved four males and 10 females aged 8 to 49. They developed gastroenteritis symptoms including abdominal pain, vomiting, diarrhea and fever about five to 50 hours after consuming the sandwiches. Among them, 11 sought medical consultation and one required hospitalization.

One day earlier, the CHP identified 26 more clusters of suspected food poisoning related to the sandwiches. These clusters involved 22 men and 39 women aged 2 to 67. They developed gastroenteritis symptoms about three to 57 hours after eating the sandwiches. Among them, 49 sought medical consultation and 12 required hospitalization.

Another 26 more clusters involved 24 males and 37 females aged 2 to 61. They developed gastroenteritis symptoms about three to 86 hours after consuming sandwiches. Fifty-two of them sought medical consultation and 17 had hospital treatment.

On May 25, 26 more clusters of suspected food poisoning were reported. They involved 25 males and 40 females aged 1 to 64. They developed gastroenteritis symptoms about two to 30 hours after eating the sandwiches. Among them, 54 sought medical consultation and 15 needed hospitalization.

“Prolonged storage of food at room temperature may allow pathogens to grow and produce toxins. Members of the public should avoid consuming cooked or ready-to-eat food that has been kept at room temperature for several hours,” said a CHP spokesman.

Action by CFS
The CFS has been inspecting retail outlets and tracing distribution of the affected product. All the premises concerned had stopped sale of it based on the CFS’ advice.

Two sandwich samples from the Tsuen Wan retail outlet of the sandwich firm concerned were found to contain Salmonella.

A CFS spokesman said so far all the reported cases had bought the sandwiches before the investigation and preventive and control measures were started.

“So far, the CFS, according to the information provided by the manufacturer, has investigated a total of 12 premises including the food factory that sold the product, and all of them had stopped sale of the affected product according to the CFS’ advice,” according to the statement. “The CFS has also provided health education on food safety and hygiene to the person-in-charge and staff concerned, and requested them to carry out a thorough cleaning and disinfection.

“Moreover, the manufacturer was suspected of operating an unlicensed food factory. Prosecution had been instituted against the person-in-charge of the premises by the FEHD earlier.”

The spokesman urged the public not to consume any batches or types of the product concerned and told any traders to stop using or selling the affected items.

Under regulations, the maximum penalty for operating an unlicensed food factory is a fine of HK$50,000 (U.S. $6,500) and up to six months’ imprisonment upon conviction.

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