An outbreak of food poisoning at one of the temple fairs in NongMi Sub-district, Kut Chum District, Yasothon Province, Thailand, 2st–7th October 2016

Abstract

Background: On 2 October 2016, 10:20 a.m., the Surveillance and Rapid Response Team (SRRT) of NongMi Subdistrict was notified a cluster of food poisoning receiving the treatment in NongMi Sub-district Health Promoting Hospital. The NongMi Sub-district SRRT had investigated and control the outbreak along with the Kut Chum District SRRT and the Yasothon Province SRRT during October 2-7, 2016. This study aiming to confirm diagnosis and outbreak, to identify source and risk factor and to implement outbreak control measure.
Methods: Case-control study was conducted. We reviewed medical records of the patients in hospital, interviewed and performed active case finding people who attended the making-merit ceremony at the temple. Environmental survey, rectal swab of cases and food handlers, and food cultures were done. Identified risks factors using Multiple logistic regression analysis.
Results: There were 115 patients; 35 male and 80 female, the median age was 51 years old (min 3, max 89). Thirtyseven patients (32.17%) were admitted in hospital, no dead case. On 1 October 2016 during 11.00-12.00 a.m. , many people came to made merit at the temple and had lunch together. An median incubation period was 22 hours (min 4, max 32). The most occurred symptom was diarrhea (94.78%), abdominal pain (85.22%), fever (75.65%) and nausea (51.30%). The risk factors were Fried Vermicelli Noodle with Pork ( ORadj 4.41, 95% CI 1.74– 11.19) and Gnocchi in Coconut Cream ( ORadj 4.03, 95% CI 2.13–7.61) . The result of culture of food, Salmonella spp. and Staphylococcus aureus were in pork, and S. aureus was found in Gnocchi in Coconut Cream. The pork was bought from the market, which the sick pig was carved to sale. The cooking areas was put on the ground, utensils were share with raw pork and other foods. Measures of disease prevention and control were health education for food sanitation, occupational health in local people together with local cattlemen. Discussions and
Conclusions: The Fried Vermicelli with Pork contaminated with Salmonella spp. might be caused of the common source outbreak of food poisoning. Unhygienic keeping fresh food and cooking process might took the contamination. Sub-District Administration Organization and other department that related should be aware about food sanitation and food safety. Livestock agency should be educating about dangers of eating meat of sick animals and law enforce with the transgressor.