Foodborne Disease of Undetermined Etiology among Patrons of a Local Eatery, Bibiani Township, Western Region of Ghana-2018

  • Water or foodborne
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Background: Foodborne diseases (FBD) remain a major health security threat; particularly in resource-limited settings where capacity to identify their etiology for adequate control is limited. On July 12, 2018, the Western Regional Health Directorate received notification of suspected FBD outbreak in Bibiani. Patrons of a particular eatery in Bibiani Township reported to a clinic with gastrointestinal symptoms. We investigated to determine the magnitude, etiology and source of the outbreak and implement control and preventive measures.
Methods: We conducted a retrospective cohort study. We interviewed patrons of the eatery and reviewed medical records of case-patients for data on demographics and clinical information. A FBD was defined as any person in Bibiani with abdominal cramp and or diarrhea and vomiting on or after July 11, 2018 and had eaten from the eatery. We conducted active case-finding, descriptive data analysis and calculated food specific attack rate ratios (ARR) and their corresponding 95% confidence intervals (CI). We inspected the production facilities and cultured stool specimens from case-patients and food handlers for enteropathogenic bacteria; nasopharyngeal specimens from food handlers were tested for enterotoxin-producing Staphylococcus aureus.
Results: Of 56 case-patients identified, 62.5% (35/56) were females; median age was 22 years (IQR: 15-30 years). Overall attack rate was 45.9% (56/122) with no fatality. Sex specific attack rates were 47.3% (35/74) and 43.7% (21/48) for females and males respectively. Compared to those who ate other food items patrons who ate stew were more likely to develop FBD (ARR=3.8; CI=1.97-7.33). No leftover food was available for testing. All clinical specimens tested negative for enteropathogenic bacteria and enterotoxin-producing Staphylococcusaureus.
Conclusions: A point source FBD outbreak of undetermined etiology occurred among patrons of an eatery in Bibiani. The most probable vehicle of transmission was contaminated stew. Prompt case management, community education and training of food handlers on food hygiene were control and preventive measures.

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