Foodborne Outbreak Investigation in Elementary School Students in Bantul, Yogyakarta, 2023
DOI:
https://doi.org/10.30597/mkmi.v20i3.34464Keywords:
Elementary school, foodborne, outbreak , SalmonellaAbstract
Bantul District Health Office received notification that 75 students in elementary school were sick with symptoms of nausea, vomiting, and dizziness after they consumed snacks from the school canteen. An epidemiological investigation was conducted to confirm the outbreak, identify additional cases, determine risk factors and causes, and recommend preventive measures. This investigation conducted active case finding followed by a retrospective cohort study. Individuals who experience one or more symptoms, such as nausea, vomiting, diarrhea, stomach pain, dizziness, fever, and malaise after consuming snacks were defined as cases. Data was collected through direct interviews with students, teachers, staff, and food sellers. Samples of food and vomit were collected and sent to the health laboratory. Data were analyzed using chi-square and multiple binomial regression. There were 150 cases. Most cases were found in the female group (53.22%), 9-year-old group (55.32%), and third-grade students (65%). Dizziness (66.67%), vomiting (56.67%), and nausea (46%) were the most common symptoms. The epidemic curve was a common source, with incubation periods ranging from one to 26 hours. Meatballs were associated with the increased risk of becoming a case in this outbreak (aRR = 1.49; 95% CI = 1.22-1.81). The causative agent was suspected to be Salmonella spp, but the laboratory analysis results were inconclusive due to contamination. Potential risk factors were large storage in the refrigerator, insufficient reheating, and cross-contamination. Improvements in food safety monitoring for schools and food handlers, along with appropriate sampling by healthcare facilities, are required to control outbreaks.
References
1. Lee H, Yoon Y. Etiological Agents Implicated in Foodborne Illness World Wide. Food Science of Animal Resource. 2021;41(1):1–7. https://doi.org/10.5851/kosfa.2020.e75
2. Heredia N, García S. Animals as Sources of Food-Borne Pathogens: A Review. Animal Nutrition. 2018;4(3):250–255. https://doi.org/10.1016/j.aninu.2018.04.006
3. WHO. Who Estimates of the Global Burden of Foodborne Diseases. Encycl Parasitol. 2005;1068–1069. https://www.who.int/publications/i/item/9789241565165
4. WHO. Investigating Foodborne Disease Outbreaks-Stage One Booklet: Strength-ening surveillance of and Response to Foodborne Diseases. 2017. Geneva: World Health Organization; 1–96. https://apps.who.int/iris/bitstream/handle/10665/259475/9789241513234-eng.pdf?sequence=1
5. BPOM RI. Laporan Tahunan Badan Pengawas Obat dan Makanan Tahun 2023. Jakarta: Badan Pengawas Obat dan Makanan Republik Indonesia; 2023.
6. Arisanti RR, Indriani C, Wilopo SA. Kontribusi Agen dan Faktor Penyebab Kejadian Luar Biasa Keracunan Pangan di Indonesia: Kajian Sistematis. Berita Kedokteran Masyarakat. 2018;34(3):99-106. https://doi.org/10.22146/bkm.33852
7. Dinkes DIY. Profil Kesehatan D.I.Yogyakarta Tahun 2022. Daerah Istimewa Yogyakarta; 2023. https://dinkes.jogjaprov.go.id/download/index?keyword=profil+kesehatan
8. Tao D, Zhang D, Hu R, Rundensteiner E, Feng H. Epidemiological Data Mining for Assisting with Foodborne Outbreak Investigation. Foods. 2023;12(20):1–18. https://doi.org/10.3390/foods12203825
9. StataCorp. Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC.; 2021.
10. Chris Baylis MU, Davies HJ and A. The Enterobacteriaceae and Their Significance to the Food Industry. ILSI Europe Report Series; 2011: 11–12. https://ilsi.eu/publication/the-enterobacteriaceae-and-their-significance-to-the-food-industry/
11. Ehuwa O, Jaiswal AK, Jaiswal S. Salmonella, Food Safety and Food Handling Practices. Foods. 2021;10(5):1–16. https://doi.org/10.3390/foods10050907
12. Turgeon P, Ng V, Murray R, Nesbitt A. Forecasting the Incidence of Salmonellosis in Seniors in Canada: A Trend Analysis and the Potential Impact of the Demographic Shift. PLoS One. 2018;13(11):1–10. https://doi.org/10.1371/journal.pone.0208124
13. Rahman HS, Mahmoud BM, Othman HH. A Review of History, Definition, Classification, Source, Transmission, and Pathogenesis of Salmonella: A Model for Human Infection. Journal of Zankoy Sulaimani. 2018;20(3-4):11–19. https://www.diva-portal.org/smash/record.jsf?pid=diva2%3A1274460&dswid=-3517
14. Zain R, Hidanah S, Damayanti R, Warsito SH. Detection of Salmonella sp. on Bulk Meatballs and Packaged Meatballs at Sepanjang Market, Sidoarjo. Journal of Applied Veterinary Science and Technology. 2021;2(2):31-36. https://doi.org/10.20473/javest.V2.I2.2021.31-36
15. Sohail MN, Rathnamma D, Priya SC, Isloor S, Naryanaswamy HD, Ruban SW, et al. Salmonella from Farm to Table: Isolation, Characterization, and Antimicrobial Resistance of Salmonella from Commercial Broiler Supply Chain and Its Environment. Biomed Research Intenational. 2021;2021: 1-12. https://doi.org/10.1155/2021/3987111
16. Firmansyah M. Edible Coating Application on Chicken Meatballs. Edufortech. 2020; 5(2):128–135. https://doi.org/10.17509/edufortech.v5i2.28815
17. Mahbub MA, Pramono YB, Mulyani S. Pengaruh Edible Coating dengan Konsentrasi Berbeda terhadap Tekstur, Warna, dan Kekenyalan Bakso Sapi. Animal Agriculture Journal. 2012;1(2):177–185. https://ejournal3.undip.ac.id/index.php/aaj/article/view/1254
18. Silva C, Calva E, Maloy S. One Health and Food-Borne Disease: Salmonella Transmission between Humans, Animals, and Plants. Microbiology Spectrum. 2014;2(1). https://doi.org/10.1128/microbiolspec.oh-0020-2013
19. WHO. Foodborne Disease Outbreaks: Guidelines for Investigation and Control. World Health Organization; 2008. https://apps.who.int/iris/handle/10665/43771
20. FoodSafety.gov. 4 Steps to Food Safety. :1–5. https://www.foodsafety.gov/keep-food-safe/4-steps-to-food-safety
21. Li T, Zou Q, Chen C, Li Q, Luo S, Li Z, et al. A Foodborne Outbreak Linked to Bacillus Cereus at Two Middle Schools in a Rural Area of Chongqing, China, 2021. PLoS One. 2023;18(10 October):1–11. https://doi.org/10.1371/journal.pone.0293114
22. Fekadu Y, Kinde MZ, Dagnaw GG, Dessalegn B, Dejene H, Gessese AT. Knowledge, Attitude, and Practices on Food Safety among Food Handlers Working in Public Food Service Establishments in Lemi Kura Subcity, Addis Ababa, Ethiopia. Biomed Res Int. 2024;2024(1):1-14. https://doi.org/10.1155/2024/2675894
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