Two die, 11 ill after eating at Taipei restaurant

Health officials said they are considering all possibilities, while the city mayor said they have not ruled out the possibility of a malicious act of poisoning

Two people who dined at a restaurant in Taipei’s Far Eastern Xinyi A13 Department Store last week have died, while four are in intensive care, the Taipei Department of Health said yesterday.

All of the outlets of Malaysian vegetarian restaurant franchise Polam Kopitiam have been ordered to close pending an investigation after 11 people became ill due to suspected food poisoning, city officials told a news conference in Taipei.

The first fatality, a 39-year-old man who ate at the restaurant on Friday last week, died of kidney failure two days later at the city’s Mackay Memorial Hospital.

A 66-year-old man who dined at the venue on Tuesday last week died of multiple organ failure at Shin Kong Wu Ho-Su Memorial Hospital at 11:35am yesterday, becoming the second fatality from the mystery illness.

Tri-Service General Hospital yesterday reported that a 53year-old woman who ate at the restaurant on Friday last week is receiving critical care for acidosis, septic shock and liver failure, department Commissioner Chen Yen-yuan (陳彥元) said.

Every customer of the restaurant who fell ill had consumed flat noodle dishes and showed symptoms within 12 hours of eating, he said.

Their condition progressed rapidly, with an acute decline in liver function, fulminant hepatitis, liver failure and septic shock, Chen said.

Taipei Mayor Chiang Wan-an (蔣萬安) said on the sidelines of a separate event that health officials on Sunday were alerted by their New Taipei City counterparts of a suspected food poisoning incident after one of the ill diners received treatment at a hospital there.

That person was the first to die in connection to the case.

The Taipei Department of Health immediately inspected the venue to collect samples and ordered improvements to be made to sanitation standards, Chiang said.

The Taipei City Government on Tuesday ordered the restaurant’s Xinyi District (信義) venue to close and has since extended the order to other branches of the chain, all of which are in the city, he said.

However, investigators did not discover any of the bacteria commonly associated with food poisoning in the food samples, he said.

When asked to comment on whether the restaurant’s food could have been deliberately tampered with, Chiang said the possibility of the poisoning being the result of a malicious act has not been ruled out.

The Food and Drug Administration (FDA), the Centers for Disease Control and law enforcement officials are involved in the investigation and every possibility is being explored, he said.

Meanwhile, the Taipei District Prosecutors’ Office said it had seized surveillance footage and collected evidence at the restaurant’s premises early yesterday with the help of police and health officials.

It has assigned a special prosecutor to oversee the investigation.

On Tuesday evening, FDA personnel and Taipei City Government officials collected additional samples of food that have a high risk of contamination from the restaurant, FDA Director-General Wu Shou-mei (吳秀梅) said.

Testing of the samples — which included vegetables, mushrooms, herbs and sauces — would take at least two weeks to complete, as microbial cultures must be grown to perform the procedure, she said.

Although the restaurant passed an inspection two years ago, Taipei officials found multiple code breaches, including cockroach droppings, improperly stored kitchen knives and missing employee health records, she said.

Last night, the Ministry of Health and Welfare held a meeting with specialists, who suggested that pathogens such as bongkrekic acid could be involved, but Taiwan needs to acquire the standard substance for testing it, Deputy Minister of Health and Welfare Victor Wang (王必勝) said.

The experts would not rule out any possibilities, and forensic autopsies would be performed today, he said.

Medical professionals yesterday said that suspected food poisoning deaths revolving around a restaurant at Far Eastern Department Store Xinyi A13 Store in Taipei could have been caused by one of several types of bacterium.

Ho Mei-shang (何美鄉), an epidemiologist at Academia Sinica’s Institute of Biomedical Sciences, wrote on Facebook that the death of a 39-year-old customer of the restaurant suggests the toxin involved was either “highly potent or present in massive large quantities.”

People who ate at the restaurant showed symptoms within hours of consuming the food, suggesting that the poisoning resulted from contamination by a toxin and not infection of the digestive system, Ho said.

The substance that tainted the food could be toxin from poisonous mushrooms or one of two bacterium, Bacillus cereus or Clostridium

botulinum, if reports of liver failure being a shared symptom are true, she said.

The bacterium thrive in temperatures above 25°C and in starchy environments, with the people affected reportedly having consumed pho or cellophane noodles, she said.

Poor food preparation procedures, such as leaving noodles at room temperature for too long could allow bacterial cultures to form, Ho said, adding that cooking does not reliably neutralize their toxins.

The government is advised to keep in mind that deliberate poisoning can also be a possible explanation for the incident, she said, adding that national security agencies would have to be involved to deal with sabotage by mass poisoning.

Lee Chien-chang (李建璋), a doctor of emergency medicine at National Taiwan University Hospital, said that B cereus is a possible culprit for the poisoning.

Its spores and secreted toxins can survive being stir-fried and have caused several documented cases of poisoning, dubbed fried rice syndrome, Lee said.

B cereus poisoning is also difficult to detect, as traces of the bacteria are excreted relatively quickly, he said.

Huang Chien-hsien (黃建賢), chief epidemiologist at Shin Kong Wu Ho-su Memorial Hospital in Taipei, which treated a 66-yearold who died of the alleged food poisoning yesterday, said that the person had gastroenteritis, so stool and blood tests were taken, but the common bacterial or viral pathogens that cause stomach flu were not found.

Staphylococcus aureus in food can multiply and produce toxins that can make people ill, but the patient’s symptoms onset was faster and the symptoms seem more serious than S aureus food poisoning, Huang said.

Asked about the possibility that Bongkrek acid was involved, he said past cases were mostly linked to cooked food that had been left at room temperature for too long.

However, the bacteria is not a specific part of routine inspections, so it is unclear whether it is involved in this week’s case, he said, adding that Food and Drug Administration testing would likely resolve the matter.