KUALA LUMPUR (THE STAR/ASIA NEWS NETWORK) - Eateries in the city should not hire foreigners to prepare food, said Malaysian Federal Territories Minister Tengku Adnan Tengku Mansor, amid a spike in typhoid cases in the Malaysian capital.

He said he had requested the ministry's licensing division to meet with food operators and conduct random spotchecks on cleanliness and the hiring of foreigners in the kitchen.

"I have said it before, if there are too many foreigners in the kitchen, it will bring problems," he said at the Parliament lobby on Tuesday (Oct 20).

Datuk Seri Tengku Adnan said he was happy with the food operators at Kuala Lumpur's Jalan Alor as they had given their commitment that only locals would be allowed to be food outlet operators.

"It is all right to hire foreigners as cleaners and waiters but all my statements get twisted," he said.

"When I talk about rats, people get angry. When I talk about the homeless, they get angry. When I talk about how soup kitchens should take care of cleanliness, people are still angry with me."

He said the Kuala Lumpur City Hall would cooperate with the Health Ministry to monitor and find a solution to the problem.

It comes as Deputy Health Minister Hilmi Yahya said illegal immigrants working as food handlers in Kuala Lumpur were being looked at as the possible cause for the rise in typhoid cases.

The disease, which is more commonly seen in rural areas, has seen a spike in the city, with 32 cases reported since August.

As it tries to zero in on the source of the spike, the Health Ministry has said it will shut down eateries that do not meet food safety and hygiene standards.

It is also warning the public to stay away from dirty eateries.

Disease Control division director Chong Chee Kheong said the ministry was investigating the source of the outbreak in several areas in Kuala Lumpur to determine whether it was from a single or multiple source.

"We will check the travel and food history of those infected and make an analysis on where the source is," he said.

Dr Chong said it would be a very targeted investigation.

"If the infected person had taken food from certain areas in Kuala Lumpur, those areas will be investigated and rated and if the food taken was from another state, those places will also be checked," he said.

"If they are not clean, we are going to close them down," he said in an interview after the launch of the Health Ministry's Fourth Dietetic and Nutrition conference.

On Monday, the ministry issued a typhoid outbreak alert following 32 cases of typhoid reported in Cheras, Titiwangsa, Kepong and Lembah Pantai since August.

Dr Chong said typhoid was endemic in Malaysia and it was related to contaminated food and drinks due to poor hygiene and cleanliness, he said.

Between 200 to 300 cases were reported each year nationwide, he said.

Typhoid fever is caused by the bacteria Salmonella typhi and is spread by eating food or water contaminated with excreta from an infected person.

The symptoms include abdominal pain, fever, headache and fatigue.

Dr Chong said that the alert was given because people did not expect a typhoid outbreak to occur in Kuala Lumpur, associating it more with rural areas where hygiene levels were low.

"Consumers must be particular about the places they eat. It need not be expensive places but clean places," he said.

Dr Chong said the investigation into the source of typhoid cases would take time as the patients involved ate different foods in different locations over three weeks and investigators had to take samples from all the different places.

He said that they also had to take stool samples from food operators and food handlers who were not always at their premises at the time of sample collection.

When patients were asymptomatic, they had to take more than one sample and from everyone working in the shop, he said.