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Foodborne disease outbreak in a resource-limited setting: a tale of missed opportunities and implications for response.

Ameme DK, Abdulai M, Adjei EY, Afari EA, Nyarko KM, Asante D, Kye-Duodu G, Abbas M, Sackey S, Wurapa F - Pan Afr Med J (2016)

Bottom Line: Laboratory diagnostic capacity was also weak.A point source FBD outbreak linked to probable contaminated "waakye" and or "shitor" occurred.Missed opportunities for definitive diagnosis highlighted the need for strengthening local response capacity.

View Article: PubMed Central - PubMed

Affiliation: Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana.

ABSTRACT

Introduction: Foodborne diseases (FBD) have emerged as a major public health problem worldwide. Though the global burden of FBD is currently unknown, foodborne diarrhoeal diseases kill 1.9 million children globally every year. On 25th September 2014, health authorities in Eastern Region of Ghana were alerted of a suspected FBD outbreak involving patrons of a community food joint. We investigated to determine the magnitude, source and implement control and preventive measures.

Methods: A retrospective cohort study was conducted. We reviewed medical records for data on demographics and clinical features. A suspected foodborne disease was any person in the affected community with abdominal pain, vomiting and or diarrhea between 25(th) and 30(th) September 2014 and had eaten from the food joint. We conducted active case search, descriptive data analysis and calculated food specific attack rate ratios (ARR) and their corresponding 95% confidence intervals.

Results: Of 43 case-patients, 44.2% (19/43) were males; median age was 19 years (interquartile range: 17-24 years). Overall attack rate was 43.4% (43/99) with no fatality. Case counts rose sharply for four hours to a peak and fell to baseline levels after 12 hours. Compared to those who ate other food items, patrons who ate "waakye" and "shitor" were more likely to develop foodborne disease [ARR = 4.1 (95% CI = 1.09-15.63)]. Food samples and specimens from case-patients were unavailable for testing. Laboratory diagnostic capacity was also weak.

Conclusion: A point source FBD outbreak linked to probable contaminated "waakye" and or "shitor" occurred. Missed opportunities for definitive diagnosis highlighted the need for strengthening local response capacity.

No MeSH data available.


Related in: MedlinePlus

Incubation period of foodborne disease in Adeiso, September 2014
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Figure 0003: Incubation period of foodborne disease in Adeiso, September 2014

Mentions: A total of 43 case-patients were identified of whom 44.2% (19/43) were males. The overall attack rate was 43.4% (43/99) with no fatality. Sex specific attack rates were 55.8% (24/43) and 33.9% (19/56) for females and males respectively. The median age of the case-patients was 19 years (IQR: 17-24 years). The most affected age group was 10-19 followed by 20-29 (Figure 1). More males were affected in the most affected age groups (10-19) and (20-19). The index case was a 34 year old male Senior High School teacher in the affected community who presented to the District Health Centre on the 25th of September 2014 with abdominal pain, vomiting and watery diarrhea approximately 3-4 hours after eating food purchased from the popular food joint. He had not consumed any other meal that day. There was no fever. He was detained, managed and discharged the following morning. He was stable on the 29th September 2014; vomiting and diarrhea had ceased but he complained of some residual abdominal pain for which he was seeking care at a private clinic. The epidemic curve of the outbreak shows a point source. One case occurred on the 24th September 2014 at 14:00 hours followed by a second on the 25thSeptember 2014 at 02:00 hours. The number of cases rose sharply to a peak at 17:00 hours on the 25thSeptember and declined with the last case recorded on Friday 26th September at 05:00 hours (Figure 2). The incubation period of the outbreak ranged from 4 hours to 9.5 hours (Figure 3). The median incubation period was 5 hours. Patrons who consumed food in the early hours of the day had relatively longer incubation period of 8 hours and beyond compared to those who ate late from the food joint. Majority 69.77% (30/43) of the case-patients were clustered around the vicinity of the food joint (Figure 4). Some households had more than one case patient.


Foodborne disease outbreak in a resource-limited setting: a tale of missed opportunities and implications for response.

Ameme DK, Abdulai M, Adjei EY, Afari EA, Nyarko KM, Asante D, Kye-Duodu G, Abbas M, Sackey S, Wurapa F - Pan Afr Med J (2016)

Incubation period of foodborne disease in Adeiso, September 2014
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4862777&req=5

Figure 0003: Incubation period of foodborne disease in Adeiso, September 2014
Mentions: A total of 43 case-patients were identified of whom 44.2% (19/43) were males. The overall attack rate was 43.4% (43/99) with no fatality. Sex specific attack rates were 55.8% (24/43) and 33.9% (19/56) for females and males respectively. The median age of the case-patients was 19 years (IQR: 17-24 years). The most affected age group was 10-19 followed by 20-29 (Figure 1). More males were affected in the most affected age groups (10-19) and (20-19). The index case was a 34 year old male Senior High School teacher in the affected community who presented to the District Health Centre on the 25th of September 2014 with abdominal pain, vomiting and watery diarrhea approximately 3-4 hours after eating food purchased from the popular food joint. He had not consumed any other meal that day. There was no fever. He was detained, managed and discharged the following morning. He was stable on the 29th September 2014; vomiting and diarrhea had ceased but he complained of some residual abdominal pain for which he was seeking care at a private clinic. The epidemic curve of the outbreak shows a point source. One case occurred on the 24th September 2014 at 14:00 hours followed by a second on the 25thSeptember 2014 at 02:00 hours. The number of cases rose sharply to a peak at 17:00 hours on the 25thSeptember and declined with the last case recorded on Friday 26th September at 05:00 hours (Figure 2). The incubation period of the outbreak ranged from 4 hours to 9.5 hours (Figure 3). The median incubation period was 5 hours. Patrons who consumed food in the early hours of the day had relatively longer incubation period of 8 hours and beyond compared to those who ate late from the food joint. Majority 69.77% (30/43) of the case-patients were clustered around the vicinity of the food joint (Figure 4). Some households had more than one case patient.

Bottom Line: Laboratory diagnostic capacity was also weak.A point source FBD outbreak linked to probable contaminated "waakye" and or "shitor" occurred.Missed opportunities for definitive diagnosis highlighted the need for strengthening local response capacity.

View Article: PubMed Central - PubMed

Affiliation: Ghana Field Epidemiology and Laboratory Training Programme (GFELTP), School of Public Health, University of Ghana, Accra, Ghana.

ABSTRACT

Introduction: Foodborne diseases (FBD) have emerged as a major public health problem worldwide. Though the global burden of FBD is currently unknown, foodborne diarrhoeal diseases kill 1.9 million children globally every year. On 25th September 2014, health authorities in Eastern Region of Ghana were alerted of a suspected FBD outbreak involving patrons of a community food joint. We investigated to determine the magnitude, source and implement control and preventive measures.

Methods: A retrospective cohort study was conducted. We reviewed medical records for data on demographics and clinical features. A suspected foodborne disease was any person in the affected community with abdominal pain, vomiting and or diarrhea between 25(th) and 30(th) September 2014 and had eaten from the food joint. We conducted active case search, descriptive data analysis and calculated food specific attack rate ratios (ARR) and their corresponding 95% confidence intervals.

Results: Of 43 case-patients, 44.2% (19/43) were males; median age was 19 years (interquartile range: 17-24 years). Overall attack rate was 43.4% (43/99) with no fatality. Case counts rose sharply for four hours to a peak and fell to baseline levels after 12 hours. Compared to those who ate other food items, patrons who ate "waakye" and "shitor" were more likely to develop foodborne disease [ARR = 4.1 (95% CI = 1.09-15.63)]. Food samples and specimens from case-patients were unavailable for testing. Laboratory diagnostic capacity was also weak.

Conclusion: A point source FBD outbreak linked to probable contaminated "waakye" and or "shitor" occurred. Missed opportunities for definitive diagnosis highlighted the need for strengthening local response capacity.

No MeSH data available.


Related in: MedlinePlus