Outbreak Investigation of Food Poisoning among Child Development Centers in Yasothon Province, Thailand, 1st - 5th October 2014

Abstract

Background: On 1^st October 2014, The Surveillance Rapid Team (SRRT) of Yasothon Provincials Health Office was notified a cluster of food poisoning receiving the treatment in Saimoon Hospital. Outbreak investigate was conducted immediately, aiming to confirm diagnosis and outbreak, to identify source and risk factor of the outbreak and to implement outbreak control measure.
Methods: Descriptive and Retrospective Cohort study was conducted. We interviewed and performed active case finding in Child Development Centers. A case was defined as any student or teacher in Child Development Centers who had one or more of nausea vomiting, diarrhea, abdominal pain during 30^th August – 1^st October 2014. Environmental survey of cooking as well as rectal swab of case and food handlers, and food cultures were assessed. Characteristic data using descriptive statistics, risk factor using multiple logistic regression, were presented with Adjusted Odds Ratio [OR_adj] and 95%CI [OR_adj].
Results: Total 88 cases were met case definition and attack rate was 63.6%, 52.3% were men, median age was 4 years (min 3, max 68). The case distributed in four Child Development Centers. Twenty four cases were admit in the Hospital. The majority of the clinical presentation was nausea vomiting, fatigue and abdomen pain 83.0%, 56.8% and 51.1%, respectively. Lod Chong Dessert in Coconut Milk was suspected source of this outbreak (ORadj 50.7, 95% CI 10.9 - 235.7), milk was protective factor of this outbreak (ORadj 0.04, 95% CI 0.01 - 0.24). Staphylococcus aureus (1:120X10⁶) and Bacillus cereus (1:690,000) were found from sample of Lod Chong Dessert in Coconut Milk.
Discussions and Conclusions: This outbreak was caused by Staphylococcus aureus. The investigation suggested that contaminated Lod Chong Dessert in Coconut Milk was a source of the outbreak because of unhygienic cooking process. The control measure included manufacture stopped and health education about food sanitation. To prevent outbreak in the future, health education about food sanitation, provider and responsible man should carry on food safety for food manufacturers in community.