Undercooked Liver Pate Food Poisoning: Campylobacter Infections Rise

Serving undercooked chicken or duck liver pâté or parfait has been a trend among both haute cuisine chefs and amateur foodies for some time now. But public health officials in the United Kingdom say this may cause hundreds of people to fall ill with food poisoning.

Eating undercooked poultry liver pâté or parfait at weddings and other functions in hotels, clubs, restaurants and other banquet venues has been identified as the cause of nearly all food poisoning cases across the UK this year.

Figures from the Health Protection Agency (HPA) reveal that this food practice was the cause of 90% of all cases of campylobacter outbreaks in 2011.

Campylobacter is the most common cause of bacterial food poisoning in the UK, with more than 60,000 cases recorded in England and Wales in 2010, 2.4 million in the United States and 300,000 in Canada. It is also the most common cause of food poisoning worldwide, affecting thousands of people in developing countries.

Symptoms of campylobacteriosis—food poisoning by campylobacter—include diarrhea, stomach pains and cramps, fever and a general feeling of illness. As the infection is self-limiting, it eventually goes away and most people are sick for only a few days.

Generally, medicines are not needed to treat the illness, except for rehydration and replacement of electrolytes lost from frequent stools.

Usually, the infection is mild but it can be fatal in infants, very young children, the elderly and in people with acquired immune deficiency syndrome (HIV/AIDS), autoimmune diseases, or those drugs to suppress their immune systems.

Undercooked poultry livers

Investigating food poisoning outbreaks across the UK for this year, the HPA found that this was linked to pâté or parfait made from poultry livers that were not cooked thoroughly.

Poultry liver carries a particularly high risk for campylobacter infection. Unlike other poultry meat where bacteria is found only at the surface, campylobacter can be found all over the livers, which may remain sources of infection if not cooked enough.

The Food Standards Agency (FSA) has since reissued a reminder to chefs and caterers to cook poultry livers thoroughly to ensure that campylobacter is killed. It issued this advisory twice last year, as outbreaks were rising.
“The increase in outbreaks which are due to the consumption of chicken liver pâté has been steadily increasing over the last few years,” said Dr. Christine Little, an expert in gastrointestinal infections at the HPA.

“Not only is this dish popular in food recipe magazines, it is being served in a variety of different catering venues.”

Illness occurs when livers are only cooked until they are pink—and undercooking is not enough to kill the bacteria, she said.

“Both the public and the catering industry need to be aware that undercooking this product can result in food poisoning,” she added.

The FSA also advised chefs and caterers to follow good food hygiene practices when handling and cooking poultry livers, to avoid contaminating other foods with campylobacter.

Rising trend
The HPA analyzed 18 outbreaks of campylobacter across the UK in 2011. In all, 443 people fell ill and one had to be hospitalized. Of the 18 outbreaks, 14 occurred in catering venues and 13 of these were linked to chicken or duck liver pâté.

In all 13 cases, the livers used to make the parfait or pâté were undercooked, allowing the liver to remain pink in the center.

Seven cases occurred in wedding receptions at hotels, banquet venues or public houses and six were associated with catering at other functions such as hotels, clubs and restaurants.

In 2008, there were just three outbreaks linked to undercooked chicken liver pâté, but that rose to nine in 2009 and 14 in 2010.