Shawarma and Salmonella Enteritidis: Tracing a 2020 Foodborne Outbreak in Ain Al-Basha, Jordan

This study investigated a severe foodborne outbreak in Ain Al-Basha, Jordan, linked to a fast-food restaurant offering chicken shawarma meals. The outbreak highlighted systemic lapses in food safety, particularly in handling and preparing poultry products, underscoring the need for immediate public health intervention.

Outbreak data collected by rapid response teams from the Jordan Ministry of Health (MOH), were analyzed. A case was defined as any individual who visited healthcare centers within the Al-Balqa Governorate between July 27 and August 2, 2020, presenting with two or more of the following symptoms: fever, diarrhea, vomiting, abdominal pain, or headache. Descriptive statistics were used to summarize demographic, clinical, and exposure characteristics.

A total of 472 confirmed cases were identified, with a mean (standard deviation [SD]) age of 20.8 (13.4) years. The most frequently reported symptoms were fever (98.3%), abdominal pain (96.8%) and vomiting (96.0%). Most cases reported consuming chicken shawarma (86.0%), garlic sauce (83.1%), or French fries (79.9%). Of the 56 stool specimens tested, 100% tested positive for Salmonella enteritidis. Food samples revealed Enterococcus faecalis and Campylobacter spp. contamination in marinated raw chicken, indicating cross-contamination and improper cooking. Salmonella enteritidis was not detected in food items.

This outbreak underscores critical gaps in food safety practices related to shawarma preparation in Jordan. These findings call for stronger regulations, regular inspections, and focused public education on safe food handling, particularly for vulnerable populations. Timely action to enforce stricter protocols is vital to prevent further outbreaks and protect public health.