The sandwich producer at the center of a Listeria outbreak that has killed five people in England has been given permission to restart activity.

The Good Food Chain voluntarily ceased production June 5 and withdrew all products that remained within date parameters. A total of 43 hospital operations across England were supplied with the company’s pre-packed sandwiches and salads. The University Caterers Organization (TUCO) also revealed the firm supplied a few of its members.

The Food Standards Agency (FSA) said following testing and verification by Stafford Borough Council, The Good Food Chain is no longer involved in the investigation into the outbreak source.

Nine hospital patients developed Listeria infections in England between April 20 and June 2. Five deaths were reported at hospitals in Manchester, Liverpool, Leicester and Nottingham. Sandwiches containing chicken are the suspected outbreak source.

“We are deeply saddened to learn that one of our patients has died from the strain of Listeria being investigated by Public Health England,” said Carolyn Fox, chief nurse at University Hospitals of Leicester NHS Trust. “As soon as we were made aware of the outbreak we immediately removed all traces of the sandwiches that may have been connected with the original supplier and have stopped using the supplier.”

Good Food Chain says it may not resume production
The Good Food Chain welcomed the news it was no longer part of the investigation, but its officials said they have not yet made a decision about whether it is viable to restart. So, production remains suspended.

If it does restart, more food safety measures will be in place and the local authority will carry out monitoring and oversight of the company for the next three months, with further supervision determined by inspection findings. The business will have to reapply for accreditation before it can directly supply the National Health Service again.

Measures include a deep-cleaning process. Environmental swab tests will have to be conducted to determine whether the site is clear of potential sources of any type of Listeria monocytogenes, including the outbreak strain. The Stafford Borough Council will do additional product sampling, environmental testing and more incoming supply verification.

Other Listeria cases not part of outbreak
Colin Sullivan, chief operating officer at the FSA, said the company will be monitored to ensure public health protection.

“This is a complex investigation, but we have worked to swiftly identify and remove from the food chain the products linked to these hospital cases. Our investigations are now focused on wher the outbreak strain originated from and subject to strict verification and ongoing monitoring by Stafford Borough Council, The Good Food Chain company is now able to restart production,” he said.

Public Health England (PHE) has analyzed 29 samples from people with listeriosis within the time frame the incident is thought to have occurred. Twenty are not linked to the outbreak and separate investigations are ongoing for these patients with continued analysis of all samples sent to National Infection Service laboratories.

“Public Health England is carrying out a thorough genomic analysis of all listeriosis cases reported in England and can confirm that so far, there are no further cases linked to this outbreak across the UK,” said Nick Phin of the National Infection Service at PHE. “Our investigations continue and the public should be reassured that the risk to the public continues to be low.”

Raw material from Ireland
The outbreak strain of Listeria was identified in meat produced by North Country Cooked Meats used by The Good Food Chain. The firm and their distributor North Country Quality Foods, voluntarily stopped distribution on June 3 and withdrew all ready-to-eat items.

Products supplied by North Country Quality Foods to other businesses have not led to any known infections to date. North Country Cooked Meats and North Country Quality Foods remains closed.

The investigation is examining the supply chain of North Country Cooked Meats and looking at previous findings of Listeria, including those within permitted legal limits. Further testing of products and the environment is also being done to see if a match to the outbreak strain can be found.

Listeria monocytogenes has been detected at 190 colony forming units per gram in pre-packed sandwiches with raw material from Ireland. Distribution included St. Helena and the Environmental Health Section in the country contacted the importer who sourced products from North Country Cooked Meats. This firm has been advised to retain the products such as canned pork roll and chopped pork until investigations have been completed in England.

Secretary of State for Health and Social Care Matt Hancock previously called for a review of hospital food and said government would work with the Hospital Caterers Association in this area.

Information about Listeria infection
Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause serious and sometimes life-threatening infections. Anyone who has eaten any of the implicated products and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about the possible exposure to Listeria.

Also, anyone who has eaten any of the products should monitor themselves for symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop.

Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses.

Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn or even stillbirth.

By Joe Whitworth