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Suspected food poisoning investigation

Food poisoning is an illness caused by eating contaminated food. It's not usually serious, and most people get better within a few days without treatment.

The symptoms of food poisoning usually begin within one to two days after eating contaminated food, although they may start at any point between a few hours and several weeks later. It is also important to note that the symptoms of food poisoning can be attributed to causes other than bacteria such as viruses and food intolerances.

The only way to confirm the presence of a food poisoning organism is by submitting a stool sample via your GP, if you think you have food poisoning you need to contact your GP to arrange testing.

If you suspect you have contracted food poisoning after eating at any commercial food business or outlet, you can let us know by completing the form below, we will monitor the information you provide and will contact you only if we really need to.

While you are symptomatic it is important to maintain high standards of personal hygiene and to avoid cooking food for others. If you work in healthcare, catering or with young or elderly clients and still have symptoms, the guidelines are to remain off work until you have passed a 48 hour period without any symptoms.

If it has been confirmed through laboratory testing that you have a positive result for a food poisoning organism you will be contacted by the department either in writing or by telephone in order for us to obtain more information in relation to your illness.

This form is available in Welsh - click on 'Cymraeg' in the top right corner of your screen.

Swansea Council is the data controller for the personal information you provide on this form. Your information will be used to provide you with the service that you have requested and will not be used for any other purpose. We will not share your data with any third parties without your explicit consent unless we are required or permitted to do so by law.

Data protection law describes the legal basis for our processing your data as necessary for the pursuit of our legitimate interests. For further information about how Swansea Council uses your personal data, including your rights as a data subject, please see our corporate privacy notice on our website.
Your details
1. Surname*
2. Forename(s)*
3. Date of birth*
4. Age*
5. Telephone*
6. Email (optional)
7. Address
  1. Building and street*
  3. Town or city (optional)
  4. County (optional)
  5. Postcode*
Further details
1. Employment / School details:*
2. Are you a food handler (as part of your employment)?*
  
  Yes
  
  No
3. If 'yes' please give details:
Food premises
1. Please give us details of the food premises/outlet you suspect may have been the cause of your food poisoning.
2. Premises name*
3. Premises address*
4. Date visited*
5. Time visited*
6. Food eaten at premises*
Onset date and time
1. (The date and time symptoms first started)
2. Date*
3. Time of day*
Symptoms
1. Vomiting*
  
  Yes
  
  No
2. Further details
  1. Duration
  2. Comments (optional)
3. Diarrhoea*
  
  Yes
  
  No
4. Further details
  1. Duration
  2. Comments (optional)
5. Blood present in stools*
  
  Yes
  
  No
6. Further details
  1. Duration
  2. Comments (optional)
7. Headaches*
  
  Yes
  
  No
8. Further details
  1. Duration
  2. Comments (optional)
9. Fever*
  
  Yes
  
  No
10. Further details
  1. Duration
  2. Comments (optional)
11. Temperature*
  
  Yes
  
  No
12. Further details
  1. Duration
  2. Comments (optional)
13. Abdominal pain*
  
  Yes
  
  No
14. Further details
  1. Duration
  2. Comments (optional)
15. Nausea*
  
  Yes
  
  No
16. Further details
  1. Duration
  2. Comments (optional)
17. Jaundice*
  
  Yes
  
  No
18. Further details
  1. Duration
  2. Comments (optional)
19. Other symptoms*
  
  Yes
  
  No
20. Further details
  1. Duration
  2. Comments (optional)
21. Has a faecal sample been submitted?*
  
  Yes
  
  No
22. When and where?
23. Were you admitted to hospital for treatment?*
  
  Yes
  
  No
24. When and where?
25. Have you contacted your GP?*
  
  Yes
  
  No
26. GP details
Were any other people affected? (Family, work, school)*
1. Yes
2. No
Person affected
1. Name and address
2. Relationship
3. Date of birth (optional)
4. Food eaten:
Person affected
1. Name and address (optional)
2. Relationship (optional)
3. Date of birth (optional)
4. Food eaten: (optional)
Person affected
1. Name and address (optional)
2. Relationship (optional)
3. Date of birth (optional)
4. Food eaten: (optional)
Person affected
1. Name and address (optional)
2. Relationship (optional)
3. Date of birth (optional)
4. Food eaten: (optional)
1. If you want to save this form, please ensure you have entered your email address above to receive the link in order to continue it later.