An investigation of food poisoning from chemical contamination in noodles, Nang Rong District, Buriram Province, June 2020

Abstract

Background: On 2 June 2020, Office of Disease Prevention and Control region 9, Nakhon Ratchasima was notified that there were 13 food poisoning patients admitted at Nang Rong Hospital, Buriram since 30 May 2010, all cases had history of eating noodles with suspected pesticide contamination. Office of Disease Prevention and Control region 9, Nang Rong Hospital and Nong Sanam Subdistrict Hospital, jointly conducted the investigation to confirm the diagnosis and identify the cause of illness.
Methods: The study was a descriptive study. The medical records of patients at Nang Rong Hospital were reviewed. Active case finding was done for more additional patients at Nong Wihan Sub-District Health Promoting Hospital, during 29–30 May 2020. The cooks and related persons from the noodle restaurant were interviewed, and the restaurant were explored. Six stool samples were collected and tested at Nang Rong Hospital. Total 12 suspected food samples were collected, 5 of them were tested for Bacillus cereus, and Staphylococcus aureus, and other 7 samples were tested for organophosphate and carbamate at the laboratory of Regional Medical Sciences Center 9, Nakhon Ratchasima.
Results: There were 15 patients (12 females and 3 males) with median age of 24 years. Thirteen of them were workers in the same factory. All cases got sick on 30 May 2020, with 30 minutes–2.30 hours hospitalization after eating noodles. The most common symptoms were nausea and vomiting (100%), dizziness (77%), abdominal pain (31%) and diarrhea (29%) accordingly, with no severe cases. None of pathogens were found in stool samples. Four suspected food samples were tested positive for carbamate (carbofuran) insecticide. The remaining food was contaminated with suspected gravel, abate sand or furadan flakes in the chilies, which used for seasoning. According to the interviews, the cooks confirmed that there were no chemicals stored or used in this restaurant. Where the food storage can be accessed by other outsiders, we assumed that chilies was contaminated by intention.
Conclusions: This outbreak was caused by eating noodles with carbamate contaminated chili. We suggested that food storage should be able to prevent from pests and other chemical, including regularly checking food’s abnormalities before serving.