Presence of Enterotoxin Following Wedding Celebration at Tulakan Sub-Village, Wonogiri District, Central Java Province, 2016 - A Food Poisoning Outbreak Investigation

  • Water or foodborne
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On May 30, 2016, Wonogiri District Health Office (DHO) received a report of 34 suspected food poisoning cases from Girimarto Public Health Center (PHC). The cases were treated by village midwife with the following signs and symptoms: dizziness, nausea, diarrhea, and vomiting after attending wedding celebration on 26th May 2016. Investigation was conducted to ensure the presence of outbreak and figure out the cause and source of infection.

We used active case finding to find additional cases among wedding guests. We interviewed the attendance and food handler. Specimen from leftover food were sent for laboratory examination. 1:1 unmatched case control study was conducted to identify risk factors. A case was defined as attendance of wedding celebration on 26 May 2016 and experienced following signs and symptoms: dizziness, nausea, heartburn, vomiting, and/or diarrhea. Controls were people who attend celebration without any symptoms. Data was collected through interviews using standard questionnaire. Risk factor was analyzed using chi-square.

Total 54 cases were identified. Majority of the cases experiencing diarrhea (46.3%), heartburn (46.3%), and nausea (13.9%). Over 54 cases, 52% were men and 64.7% were 41-50 years old. The incubation period varied from 5.5 to 20 hours with mean 11 hours. People who ate beef stew are more likely to have the disease (OR = 34; 95%CI=8.708-185.67). Result of laboratory tests showed the presence of Enterotoxigenic Escherichia coli (ETEC). Contamination of ETEC was potentially from improper raw beef which was cooked and consumed.

There was food poisoning outbreak in Tulakan sub-village on May 26-27, 2016. It was caused by consuming beef contaminated with ETEC. DHO should conduct health promotion activities on food safety to the community.

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