India Epidemic Intelligence Services Officer, National Centre for Disease Control, New Delhi, India.
Assistant Director, Division of Epidemiology, National Centre for Disease Control, New Delhi, India.
Indian J Public Health. 2021 Jan;65(Supplement):S18-S22. doi: 10.4103/ijph.IJPH_1045_20.
A suspected food-poisoning outbreak occurred in a residential school in Mirzapur, India, in February, 2017.
We investigated the outbreak to find out the epidemiology and to identify the risk factors.
A descriptive study followed by retrospective-cohort study was done to investigate the outbreak. Cases (defined as ≥3 or more loose stools in 24 h, abdominal pain, or vomiting with onset between February 1 and 4, 2017) were searched by reviewing sick/patient registers from school and nearby health facilities. Cases were also searched through active surveillance by visiting school hostels. Stool samples were sent for microbiological testing. Food sources and food handlers were also assessed.
Among 468 students, 204 cases were identified (44% attack rate) without any mortality. The median age was found to be 14 years (range: 10-18 years) and 59% were male. Relative risk with consumption of curd, apple, and panjiri (sweetened wheat flour) was found to be 15.4, 2.5, and 3.7, respectively. All these three food items were served as prasad, a religious offering. Only consumption of sweetened curd (adjusted odds ratio = 36.1, 95% confidence interval = 12.1-107.8) was significantly associated with gastroenteritis. No microorganism was isolated from two tested stool samples. Curd from the vendor was prepared from nonpasteurized milk. There were no illnesses among food-handlers.
This outbreak of acute gastroenteritis in a residential school was associated with consumption of curd, likely contaminated with preformed toxins. We recommend implementation of the food safety and standards authority of India regulations.
2017 年 2 月，印度米尔扎布尔的一所寄宿学校发生一起疑似食物中毒暴发事件。
我们对此次暴发进行了调查，以了解其流行病学特征并确定危险因素。
采用描述性研究和回顾性队列研究相结合的方法对暴发进行调查。病例（定义为 2017 年 2 月 1 日至 4 日期间出现≥3 次稀便、腹痛或呕吐，且发病时间在该时间段内）通过查阅学校和附近医疗机构的就诊/患病登记本进行搜索。还通过主动监测访问学校宿舍寻找病例。采集粪便样本进行微生物学检测。同时评估食物来源和食物处理人员。
在 468 名学生中，共发现 204 例病例（发病率为 44%），无死亡病例。中位年龄为 14 岁（范围：10-18 岁），男性占 59%。与食用凝乳、苹果和潘杰里（加糖的小麦粉）相关的相对危险度分别为 15.4、2.5 和 3.7。这三种食物均作为宗教供品（prasad）供应。仅食用加糖凝乳（校正比值比=36.1，95%置信区间=12.1-107.8）与肠胃炎显著相关。从两份检测粪便样本中均未分离出微生物。供应商提供的凝乳是由未经巴氏消毒的牛奶制成的。食物处理人员未出现任何疾病。
这起寄宿学校发生的急性肠胃炎暴发与食用凝乳有关，可能是由预先形成的毒素污染所致。我们建议实施印度食品安全和标准局的相关规定。
