Foodborne gastroenteritis outbreak among patrons of a local eatery, Fijai, Western Region, Ghana-2018

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Foodborne diseases (FBD), a major global public health threat, though underreported are occasionally the cause of outbreaks in Ghana. On 29th June 2018, the Western Regional Health Directorate received report of suspected FBD outbreak in Fijai. Patrons of an eatery in Fijai reported to the community health centre with abdominal cramps, vomiting and diarrhoea. We investigated to characterize the outbreak and implement control and preventive mea- sures.
We conducted a retrospective cohort study. We defined FBD case-patient as any person at Fijai who ate from the eatery from 26-30 June, 2018 and presented with abdominal cramps, vomiting or diarrheoa. We conducted active case-finding, interviewed patrons of the eatery and reviewed medical records of patients for data on demographics and clinical information. Descriptive data analysis and food specific attack rate ratios (ARR) and their correspond- ing 95% confidence intervals (CI) were computed. We inspected the food production facilities and cultured stool specimens from patients and food handlers.
Of 45 case-patients, 68.8% (31/45) females were identified with overall attack rate of 48.9% (45/92) with no fatality. Sex specific attack rates were 65.5% (19/29) and 49.2% (31/63) for males and females respectively.
Median age of case-patients was 22 years, (interquartile range [IQR]: 15.5-32 years). Patrons who ate vegetables were 4.6 times more likely to develop FBD (ARR=4.6; 95% CI= 1.90-11.09) compared to those who ate other food items. No leftover food was available for testing. Generally the food production site was untidy. Vibrio parahaeymolyticus was isolated from stool specimen of 3 case-patients whose specimens were collected.
A point source FBD outbreak caused by Vibrio parahaemolyticus occurred among patrons of an eatery in Fijai. The most probable vehicle of transmission was contaminated vegetables. Prompt case management, community education and training of food handlers on food hygiene were control and preventive measures.

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