European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden.
Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases, National Public Health Organization (NPHO), Athens, Greece.
Foodborne Pathog Dis. 2023 Feb;20(2):41-46. doi: 10.1089/fpd.2022.0057. Epub 2023 Jan 31.
On May 28, 2021, several gastroenteritis cases were reported among students and staff of a high school on a Greek island. Lunches were delivered daily at the school by a catering company. We conducted a retrospective cohort study. Cases were defined as students or school staff presenting with diarrhea and abdominal pain between May 27 and 29, 2021. We used a self-administered questionnaire to collect the data. In the univariate analysis, we calculated food-specific attack rates (ARs), relative risks (RRs), and confidence intervals (95% CIs). Statistically significant variables ( < 0.05) were included in the multivariable model. Stool samples were collected from students on the same day of notification and were tested for bacteria, viruses, and parasites. The local food safety authority also inspected the school and the catering company premises. The food samples were sent to the reference laboratory for analysis. We received 129 responses from 174 students and staff members (response rate: 74%). Thirty cases were identified (AR, 23%). Of the 11 significant food items in the univariate analysis, the consumption of spaghetti with minced meat on May 27 (odds ratio 53.40, 95% CI: 3.9-736.1, 97% of cases exposed) was independently associated with the onset of gastroenteritis. was detected in two of the three students' stool samples. Six samples from spaghetti with minced meat were positive for and four of those also tested positive for . Environmental investigation revealed non-compliances concerning food personnel training and Hazard Analysis and Critical Control Points (HACCP) plan implementation in the food establishment. Timely investigation and samples collection allowed the identification of the probable source of the outbreak. Changes, regarding the reception and distribution of meals in the school, were applied. Recommendations were given to the catering establishment focusing on adequate personnel training and HACCP issues, especially regarding temperature/time controls during all production, handling, and distribution phases.
2021 年 5 月 28 日，希腊一岛屿上的一所高中报告了几例肠胃炎病例，这些病例发生在学生和教职员工中。学校的餐饮公司每天为学校提供午餐。我们进行了一项回顾性队列研究。病例定义为 2021 年 5 月 27 日至 29 日期间出现腹泻和腹痛的学生或学校工作人员。我们使用自填式问卷收集数据。在单变量分析中，我们计算了特定食物的攻击率（AR）、相对风险（RR）和置信区间（95%CI）。有统计学意义的变量（<0.05）被纳入多变量模型。在通知当天收集了学生的粪便样本，并检测了细菌、病毒和寄生虫。当地食品安全当局还检查了学校和餐饮公司的场所。食物样本被送到参考实验室进行分析。我们从 174 名学生和工作人员中收到了 129 份回复（回复率：74%）。确定了 30 例病例（AR23%）。在单变量分析中有 11 个有意义的食物项目，5 月 27 日食用肉末意大利面（比值比 53.40，95%CI：3.9-736.1，97%的病例暴露）与肠胃炎的发生独立相关。在 3 名学生的 2 份粪便样本中检测到。在 6 份肉末意大利面样本中检测到，其中 4 份也检测到阳性。环境调查显示，食品场所存在食品人员培训和危害分析及关键控制点（HACCP）计划实施方面的违规行为。及时的调查和样本采集有助于确定疫情的可能来源。对学校的膳食接收和分发进行了更改。向餐饮公司提出了建议，重点是加强人员培训和 HACCP 问题，特别是在所有生产、处理和分发阶段的温度/时间控制。
