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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Background:
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.

Methods:
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.

Results:
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.

Conclusion:
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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