This paper is in the following e-collection/theme issue:

EMPHNET 7th Regional Conference 2021: “Towards Public Health Resilience in the EMR: Breaking Barriers” (62)

Published on in Vol 8, No 1 (2022): Jan-Dec

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/36627, first published .
Outbreak Investigation of a Foodborne Illness in Village Bachal Soomro, District Tharparkar, Sindh, Pakistan (December 2020): Retrospective Cohort Study

Outbreak Investigation of a Foodborne Illness in Village Bachal Soomro, District Tharparkar, Sindh, Pakistan (December 2020): Retrospective Cohort Study

Outbreak Investigation of a Foodborne Illness in Village Bachal Soomro, District Tharparkar, Sindh, Pakistan (December 2020): Retrospective Cohort Study

Authors of this article:

Kashif Qureshi1 ;   Mudassar Hussain1 ;   Naveed Masood1 ;   Muhammad Ali Gadehi2 ;   Saeed Ahmed Bhurt2 ;   Mirza Zeeshan Baig3 ;   Aneel Kumar4 ;   Aurangzeb Sand5 ;   Nosheen Ashraf6 ;   Mumtaz Ali Khan6 ;   Aamer Ikram6 ;   Muhammed Juman Bahoto7
Article Authors Cited by Tweetations Metrics

    Abstract

    1Provincial Disease Surveillance and Response Unit at Directorate General Health Services Sindh, Hyderabad, Pakistan

    2Field Epidemiology and Laboratory Training Program Pakistan, Hyderabad, Pakistan

    3Field Epidemiology and Laboratory Training Program Pakistan, Islamabad, Pakistan

    4Department of Health Sindh, Mitthi, Pakistan

    5Department of Health Sindh, Nagarparkar, Pakistan

    6National Institute of Health Pakistan, Islamabad, Pakistan

    7Department of Health, Government of Sindh, Hyderabad, Pakistan

    Corresponding Author:

    Kashif Qureshi, MBBS

    Provincial Disease Surveillance and Response Unit at Directorate General Health Services Sindh

    Old Wahdat Colony

    Hyderabad, 71000

    Pakistan

    Phone: 92 3322925218

    Email: kashifqureshidoc@gmail.com


    Background: On December 3, 2020, district health authorities reported 15 suspected cases of gastroenteritis, including 4 deaths, from Village Bachal Soomro after a mourning ceremony.

    Objective: Field Epidemiology and Laboratory Training Program (FELTP) fellows investigated the suspected outbreak, with the objective to determine the magnitude of the outbreak and to evaluate associated risk factors.

    Methods: A retrospective cohort study was conducted on December 3, 2020, at Village Bachal Soomro. The complete cohort was traced back, and a pretested structured questionnaire was adopted to obtain demographic, clinical, and risk factor information. A case was defined as “any individual who attended the mourning ceremony at Village Bachal Soomro on December 3, 2020, and presented with any of the following symptoms: diarrhea, abdominal pain/cramps, and drowsiness.” Descriptive analysis followed by multiple logistic regression was performed. Different blood, stool, oropharyngeal swab, drinking water, and milk samples were sent for microbiological and chemical investigation.

    Results: Of 61 participants, 32 (52%) were males and the median age was 23 years (range 1-70 years). The overall attack rate was 72%, while the most affected age group was 10-19 years, with an attack rate of 85%. The majority of cases presented with diarrhea (47/61, 77%), followed by abdominal pain (44/61, 72%), vomiting (43/61, 70%), body ache (29/61, 48%), drowsiness (10/61, 16%), and fever (4/61, 7%). Among all food items, dessert had the highest food-specific attack rate of 90%. Among all risk factors, consumption of dessert (adjusted odds ratio [aOR] 61.3, 95% CI 6.1-613.1), water (aOR 23.9, 95% CI 2.0-276.7), and buffalo milk (aOR 7.9, 95% CI 1.22-51.8) were found to be significantly associated with the attack. Distribution of cases showed a common point source that was probably due to a single pathogen source.

    Conclusions: Dessert was prepared 10-12 hours prior to meal intake, so the outbreak was probably caused by dessert prepared with contaminated milk and water, with enterotoxins of Staphylococcus aureus. Community awareness of personal hygiene, proper storage/preservation of food items, and provision of safe drinking water are suggested.

    iproc 2022;8(1):e36627

    doi:10.2196/36627

    Keywords

    foodborne illness; outbreak investigation; retrospective cohort study 

    Edited by Y Khader; This is a non–peer-reviewed article. submitted 19.01.22; accepted 19.01.22; published 11.02.22

    Copyright

    ©Kashif Qureshi, Mudassar Hussain, Naveed Masood, Muhammad Ali Gadehi, Saeed Ahmed Bhurt, Mirza Zeeshan Baig, Aneel Kumar, Aurangzeb Sand, Nosheen Ashraf, Mumtaz Ali Khan, Aamer Ikram, Muhammed Juman Bahoto. Originally published in Iproceedings (https://www.iproc.org), 11.02.2022.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.