(Delmarvanow.com) -- Health officials continue to investigate what caused a food poisoning outbreak among attendees at a Chincoteague festival in September.
At least 150 people from eight states reported becoming ill after eating at the Sept. 30 Chincoteague Chili Chowder Cook Off, which 2,000 or more attended.
More than 20 cultures from different laboratories in Virginia and Maryland, together with additional samples the local health district sent to a state laboratory, tested positive for the bacteria Salmonella, Dr. David Matson, Eastern Shore Health District director, said last week.
The source of the contamination has not been identified publicly by health officials.
Most of the samples tested were submitted by doctors who saw people who were ill.
Another 200 people who filled out a health department survey said they did not become ill after attending the event.
A health department official said this week the Eastern Shore Health District is still collecting and analyzing data and conducting interviews.
"It is our standard practice to continually review our policies and procedures to ensure we are doing everything possible to protect public health," Jon Richardson, senior environmental health manager for the Eastern Shore Health District, wrote in an Oct. 19 email.
The Virginia Department of Health is the agency responsible for seeing that food is safely prepared and handled at festivals that are regulated, he said.
Temporary food vendors — ones who are not restaurants that already have a permit to prepare and serve food — have to get a permit from the health department to participate in such festivals.
Along with paying a $40 fee, they fill out an application that requires them to describe each food item they plan to serve, along with whether it is purchased raw or cooked, prepared on- or off-site; how it will be transported; what type of hot- and cold-holding equipment will be used at the festival; what kind of cooking or reheating equipment will be used and what the final cooked temperature of the food is.
The fee is waived for certain groups, such as churches and schools.
The three-page form also requires information about what type of overhead covering the permittee will use where the food is being prepared and served; handwashing and toilet facilities; water and electricity source, dishwashing method; trash removal and other items.
Health department personnel inspect vendors at festivals "at frequencies prescribed by Virginia Department of Health regulations and policy using a risk-based approach," Richardson said.
"It is our intent at these types of events to ensure that food is properly prepared and that adequate measures are taken to ensure all food served is properly handled," he said.
Still, those measures apparently were not enough to prevent tainted food from being served at the Chincoteague festival.
Once the investigation is complete, the agency will discuss "whether there are measures that can be taken to minimize future risks of food-borne outbreaks at these types of events," Richardson said.
One additional lab result had been received by the agency as of last Monday, with most of the remaining results expected by early next week.
The additional result showed the same strain of Salmonella as was found in previous samples tested, Matson said.
Health officials have scheduled a meeting for Monday, when they likely will have "all or sufficient lab information" to give the public more information about the outbreak, Matson said.
The Chincoteague Volunteer Fire Company sponsors the popular annual cookoff, and a spokeswoman said it still plans to hold the event next fall.
"There is no one to blame. These things happen and unfortunately it just happened here," said spokeswoman Denise Bowden.
Entrants have to have a permit from the health department, and health inspectors come the day of the event, she said.
"We will take every possible measure to keep this from happening again," Bowden said, adding, "My advice is to make sure hot food always has a thermometer in it and cold food is iced."
Bowden said the fire company members "are so thankful that this didn't get worse and although it was just awful for those who experienced it, it could have been far, far worse."
Chincoteague also is the location of several other annual food festivals, including the Seafood Festival in spring and the Oyster Festival in fall.
The Chincoteague Chamber of Commerce sponsors those events, along with the Easter Decoy and Art Festival, where food also is sold.
The Chamber has to submit paperwork ahead of time explaining the offerings of each booth at the festivals — including the type of food, along with where and how it will be prepared and served, which distributor or seafood dealer the food item comes from, and the like, according to Chamber Director Evelyn Shotwell.
Then, on the day of the festival, one or two health inspectors arrive before the gates open, "and we typically have about an hourlong walk-through inspection of each food tent," she said.
If something at a booth is not in compliance, it usually can be corrected on the spot. Festival officials then have to sign all the paperwork and are given a certificate to display at the event, showing it has been inspected, Shotwell said.