Hong Kong’s Centre for Health Protection (CHP) has finished an epidemiological investigation into two food poisoning clusters affecting passengers on Cathay Pacific Airways flights from Kathmandu, Nepal, to Hong Kong.
The primary focus was flight CX640, which arrived in Hong Kong on January 8 and 9, where 43 passengers experienced food poisoning symptoms. The affected travelers included 22 men and 21 women, ranging in age from 11 to 75 years old.
Passengers reported symptoms characteristic of food poisoning, including vomiting, nausea, abdominal pain, and diarrhea. The symptoms emerged rapidly, occurring 10 to 60 minutes after consuming in-flight meals.
Despite the widespread outbreak, no passengers required hospitalization. Stool samples from two patients tested positive for Staphylococcus aureus, a bacterial pathogen that can cause food-related illnesses.
The investigation was extensive, with health protection staff conducting interviews with 120 passengers using multiple communication methods, including face-to-face meetings, telephone calls, emails, and a dedicated hotline. The comprehensive approach allowed for detailed data collection and analysis.
Epidemiological analysis pinpointed the beetroot salad as the most likely source of contamination. All 43 affected passengers had consumed in-flight food and had not eaten other meals before boarding. A case-control study statistically linked the beetroot salad to the illness outbreak.
Investigators collected two food samples from undistributed batches served on the flights. Interestingly, these samples did not exceed food safety standards for Staphylococcus aureus, adding complexity to the investigation.
Detailed examination of the food preparation facility revealed potential contamination risks. The investigation found that the beetroot salad preparation involved multiple manual handling steps, which could increase the likelihood of bacterial transmission. This exclusive food supplier had been providing beetroot salad for Cathay Pacific flights from Kathmandu to Hong Kong since the beginning of January.
In response to the findings, CHP instructed the vendor to discontinue supplying the beetroot salad. Following this intervention, no additional food poisoning incidents were reported on related flights.
CHP provided specific recommendations to prevent future contamination. These included minimizing manual food handling, utilizing utensils to reduce direct hand contact with ingredients, and implementing strict hand hygiene guidelines during food preparation, particularly for processes without subsequent heating steps.
Commenting on this article, the nation’s leading Staphylococcus aureus lawyer said,
“This investigation shows the importance of following rigorous food safety protocols in the airline catering industry and demonstrates the critical role that epidemiological research plays in identifying and mitigating potential health risks.”
