Acute Gastroenteritis Outbreak in an International Meeting [ASEAN +3 FETN], Ministry of Public Health, 28 January 2013

Abstract

Participants from several countries reported gastrointestinal disturbance after attending the meeting of ASEAN+3 Field Epidemiology Training Network on January 28th, 2013. We conducted an investigation to verify outbreak, identify agent and source, and describe the mode of contamination. We collected data with a structured questionnaire comprised with clinical signs and onset and food items and consumed volume from the meeting. Samples were collected from participants, cooks and ingredients and tested for enteropathogenic bacteria at Thai-National Institute of Health (NIH). We used sanitation check list to survey food preparing site. Utensils swabs and cooks’ hands were tested with SI Medium, diet for detecting coliform bacteria. We found that 16 people who met case definition from 73 (92%) responded people (attack rate 22%). Lunch was the only meal all cases consumed. Onset of illnesses ranged from 5.5 – 44.5 hours after lunch. Chili paste consumption was strongly associated with illness (P-value = 0.016). This food item served with fresh vegetable. We isolated Aeromonas veronii biovar sobria from one of nine cases and leftover crab meat. Rectal swab cultures from food handlers were negative. This gastroenteritis outbreak might be caused by chili paste which contaminated by crabmeat through food processing. We recommended strengthen the education and monitoring of cooks for gathering banquet, use different containers for raw and cooked food.