Food poisoning outbreak caused by Salmonella Enteritidis in 2 funeral rites at Song District, Phrae Province, Thailand, 2017

Abstract

Background: In August 6, 2017 at 10.30 a.m., the food poisoning outbreak occurred in two funeral ceremonies simultaneously, was notified to SRRT of Song District, Phrae Province. It had been investigated to confirm the diagnosis and outbreak, describe the epidemiology, and disease control during August 6–8, 2017.
Methods: Descriptive epidemiology and retrospective cohort study were conducted among the funeral ceremonies guests. The case definition was the person who ate the foods served of the ceremonies whom had the major symptoms that consist of diarrhea and/or abdominal pain with at least one of the minor symptoms that consist of fever, nausea, vomiting, headache, and dizziness during August 5–8, 2017.
Results: There were 160 patients which the attack rate was 60.84%. Male to female ratio was 1 : 1.4. Most of them were 61-70 years (25.63%). The patients distributed into 5 villages of Bannoon Sub-district and started the symptoms from 02.00 a.m. to 02.00 p.m. of August 6, 2017. The epidemic curve presents a point common source and the average incubation period is 22 hours 25 minutes. The symptoms were fever (80.63%), abdominal pain (71.25%), diarrhea (54.38%), headache (34.38%), nausea (26.88%), vomiting (22.50%), and dizziness (18.13%). The RR of eating shrimp paste sauce is 3.01 ( p < 0.0001) whereas the Relative Risk (RR) of eating omelet with Acacia leaves is 1.46 (p = 0.0010). Laboratory results showed that Salmonella Enteritidis were found in the stool culture and the shrimp paste sauce whereas Salmonella Mbandaka was found in the omelet with Acacia leaves and Escherichia coli were found in many kinds of samples. Discussion and
Conclusions: We confirmed the food poisoning outbreak caused by Salmonella Enteritidis in Village No. 2 and Village No. 11 Bannoon Sub-district, Song District, Phrae Province during August 6–8, 2017 that shrimp paste sauce and omelet with Acacia leaves were the point common sources. Because the food maker collected vegetables together, the pathogen could spread from Acacia leaves to shrimp paste sauce. Salmonella Mbandaka found in the omelet with Acacia leaves might be explained the insufficient heat during culinary. Finding of Escherichia coli also showed poor sanitation of the cooking place.