Section 1: Introduction & Legislative Framework

1.1 Purpose

This procedure establishes a comprehensive framework for managing food poisoning incidents in South Africa[26][32]. It provides systematic guidance for identifying symptoms, recording details, notifying authorities, conducting investigations, and implementing corrective actions while ensuring victim-centered care and legal compliance[42][37].

1.2 Legislative Requirements

This procedure ensures compliance with the following South African legislation:

• National Health Act 61 of 2003: Requires food poisoning incidents to be reported to Environmental Health Practitioners within 24 hours when ≥2 cases occur[42][39]
• Foodstuffs, Cosmetics and Disinfectants Act 54 of 1972: Regulates food safety standards and prohibits sale of contaminated food[8][17]
• Occupational Health and Safety Act 85 of 1993: Mandates reporting of work-related incidents within 7 days[37][35]
• Compensation for Occupational Injuries and Diseases Act 130 of 1993: Provides compensation for work-related food poisoning[41][36]
• Consumer Protection Act 68 of 2008: Enables strict liability claims for unsafe food products[53][45]

1.3 South African Context

South Africa has experienced multiple food poisoning outbreaks affecting both formal and informal food traders[16][18]. Recent incidents have highlighted the need for systematic incident management procedures that protect public health while ensuring legal compliance and appropriate victim support[9][24].

Section 2: Scope & Application

2.1 Application

This procedure applies to:

• All employees, contractors, customers, and visitors
• Food poisoning incidents occurring on-site, off-site during work activities, or involving company-supplied food
• Suspected incidents involving formal and informal food traders
• Cases where individuals or representatives need to manage the incident process

2.2 Victim-Centered Approach

This procedure prioritizes keeping the victim or their representative in control of the process while ensuring appropriate professional support and legal compliance[26][32]. The victim maintains decision-making authority regarding medical treatment, disclosure, and legal action.

Section 3: Definitions & Symptoms Recognition

3.1 Key Definitions

• Food Poisoning Incident: Illness caused by consuming contaminated food or beverages, potentially affecting multiple persons[44][49]
• Environmental Health Practitioner (EHP): Professional authorized to investigate food safety incidents under the National Health Act[6][15]
• Victim: Person experiencing food poisoning symptoms (may be represented by another person)
• Outbreak: Two or more persons with similar symptoms linked to a common food source[44][52]

3.2 Common Symptoms

Food poisoning symptoms typically include[43][46][48]:

• Nausea and vomiting
• Diarrhea (may be bloody)
• Abdominal cramps and pain
• Fever and chills
• Loss of appetite
• Lethargy and general malaise
• Muscle aches

3.3 Severe Symptoms Requiring Immediate Medical Attention

Seek urgent medical care if experiencing[43][46]:

• Bloody diarrhea
• High fever (>38.9°C/102°F)
• Signs of severe dehydration
• Persistent vomiting preventing fluid retention
• Diarrhea lasting more than 3 days
• Neurological symptoms (blurred vision, muscle weakness)

Section 4: Incident Management Procedure

4.1 Step 1: Immediate Response & Medical Care

1. Seek immediate medical attention if experiencing severe symptoms
2. Maintain hydration with clean water or oral rehydration solutions
3. Preserve any remaining suspected food and packaging
4. Document symptoms, onset time, and progression

4.2 Step 2: Detailed Recording

Complete comprehensive incident documentation including[44][49]:

• Personal details and contact information
• Detailed symptom description and timeline
• Complete food consumption history (72+ hours prior to onset)
• Purchase locations, receipts, and establishment details
• Names of others who consumed similar food
• Medical treatment received and specimens collected

4.3 Step 3: Notification Requirements

Notify the following within specified timeframes:

• Environmental Health Practitioner (Local Municipality): Within 24 hours for suspected outbreaks (≥2 cases)[42][26]
• Employer/Supervisor: Immediately if work-related[37][35]
• Medical Facility: For clinical evaluation and specimen collection[47][44]
• Food Poison Centre: Call 0861 555 777 for reporting[39]

4.4 Step 4: Evidence Preservation

• Refrigerate suspected food samples and maintain chain of custody
• Collect clinical specimens (stool, vomit) as directed by medical professionals[47]
• Photograph food, packaging, and receipt evidence
• Document environmental conditions at food source

4.5 Step 5: Investigation & Contact Tracing

Coordinate with Environmental Health Practitioners to[44][49]:

• Identify additional cases through active case finding
• Conduct site visits to suspected food sources
• Interview cases and non-cases (controls)
• Perform food supply chain traceback
• Collect environmental samples from food premises

4.6 Step 6: Immediate Control Measures

• Remove suspected food items from sale/consumption
• Issue internal and public health alerts as appropriate
• Consider voluntary product recall in consultation with authorities[15]
• Implement additional hygiene measures at affected establishments

4.7 Step 7: Investigation Report

Compile comprehensive report including:

• Case description and epidemiological analysis
• Laboratory results and pathogen identification
• Root cause analysis and contributing factors
• Recommendations for prevention
• Legal compliance status

4.8 Step 8: Corrective Action Assignment & Tracking

Implement systematic corrective action management:

• Assign specific responsible persons for each corrective action
• Set realistic due dates based on action complexity
• Track progress using status indicators (Open/In Progress/Closed)
• Escalate overdue items after 7 days
• Require evidence of completion before closure

4.9 Step 9: Victim Communication & Support

Maintain victim-centered communication throughout:

• Provide incident reference number and 24/7 contact information
• Send progress updates at least every 48 hours during active investigation
• Share investigation findings and medical reports (subject to confidentiality)
• Assist with compensation claims under Consumer Protection Act or COID[29][53]
• Respect victim's privacy and decision-making autonomy

4.10 Step 10: Close-out & Review

• Verify effectiveness of all corrective actions
• Process compensation claims where applicable[29][41]
• Conduct lessons learned debrief with all stakeholders
• Update risk assessments and food safety training programs
• Archive all records for minimum 5 years

Section 5: Roles & Responsibilities

Section 6: Records Management & Review

6.1 Mandatory Records (Retain 5+ Years)

• Food poisoning incident forms and case line-lists
• Medical reports and laboratory results
• Sample chain-of-custody documentation
• Investigation reports and corrective action registers
• Regulatory notifications and correspondence
• COID claim files and compensation records
• Victim communication logs and consent forms

6.2 Key Performance Indicators

• Time to notification (target: <24 hours for outbreaks)
• Investigation completion time (target: <14 days)
• Corrective action closure rate (target: >95% within due date)
• Victim satisfaction with communication process
• Laboratory confirmation rate for suspected cases

6.3 Review Schedule

• Annual procedure review or after significant incidents
• Quarterly KPI assessment and trending analysis
• Continuous improvement based on lessons learned
• External audit compliance verification