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Outbreak investigation of foodborne Illness in Village Bachal Soomro, District Tharparkar Sindh Pakistan; December; 2020: A Retrospective Cohort Study
ABSTRACT
Background:
On 3rd December 2020, District health authorities reported 15 suspected cases of gastroenteritis including 4 deaths from village Bachal Soomro after attending mourning ceremony.
Objective:
FELTP Fellows investigated the suspected outbreak with the objectives to determine magnitude of outbreak and to evaluate associated risk factors.
Methods:
A retrospective cohort study was conducted on 3rd December at Village Bachal Soomro, complete cohort was traced back and a pretested structured questionnaire was adopted to get demographic, clinical and risk factor information. A case was defined as “any individual who attended mourning ceremony at Village Bachal-Soomro on 3rd December 2020 presented with any of the symptom i.e loose Motions, abdominal pain/cramps & drowsiness”. Descriptive analysis followed by multiple logistic regression was done. Different blood, stool, oropharyngeal swabs, drinking water and milk samples were sent for microbiological and chemical investigation.
Results:
Out of 61 Participants, median age was 23 years (range 1-70 years) with 52% were males. The overall attack rate was 72% whilst the most affected age group was 10-19 years with an attack rate of 85%. Majority of the cases presented with loose motion (77%) followed by abdominal Pain (72%) vomiting (70%), body ache (48%), Drowsiness (16%) and fever (7%). Among all food items dessert had highest food specific attack rate of 90%. Among all risk factors, consumption of dessert (aOR: 61.3; CI=6.1-613.1), water (aOR: 23.9; CI=2.0-276.7) and Buffalo Milk (aOR: 7.9; 95%C-I=1.22-51.8) were found significantly associated. Distribution of cases shows common point source that probably due to a single source of pathogen.
Conclusions:
Dessert was prepared 10 to 12 hours prior to meal intake so outbreak was probably caused by dessert prepared by contaminated milk and water, with enterotoxins of Staphylococcus aureus. Community awareness on personal hygiene, proper storage/preservation of food items and provision of safe drinking water suggested.
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