An Epidemiological Study on an Outbreak of Gastroenteritis Linked to Dinner Served at a Senior High School in Accra
Background: An outbreak of gastroenteritis occurred in December 2019 after students of a Senior High School in Accra were served with kenkey and fish during their dinner. An investigation was conducted to characterize the affected people, the source of contamination, the etiologic food and agent. Methods: An epidemiological study was conducted with cases selected from the student population who were ill. Controls were selected from among students who also ate from the school canteen during dinner but were not ill. Food history of each case and control was taken to assess their exposure status. Epi Info 7 was used to analyze the data obtained from the outbreak. Attack rates and odds ratios were calculated to determine the risk of foodborne infection for each of the foods consumed by the population. The source of contamination of the foods was ascertained by conducting an environmental risk assessment at the school. Results: Data were obtained from 126 students, out of which 57 (45.2%) were cases and 69 (54.8%) were controls. The cases presented with symptoms such as diarrhea (85.96%), abdominal cramps (66.67%), vomiting (50.88%), headache (21.05%), fever (17.86%) and nausea (3.51%). The peak incubation period was 18 hours with a minimum and maximum incubation periods of 6 and 50 hours respectively. From the incubation period, duration of illness and the symptoms, non-typhoidal salmonellosis was suspected. Multivariate analysis indicated that the illness was associated with the consumption of the fried fish served, however this was statistically insignificant (AOR 3.1.00, P = 0.159). No stool, blood or food samples were available for organism isolation and confirmation of suspected etiologic agent. The environmental risk assessment indicated poor hand washing practices on the part of both the food handlers and students. Conclusion: The outbreak could probably be due to the consumption of the fried fish that might have been contaminated with Salmonella sp. as a result of poor hand washing practices in the school.
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