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Epidemiologic Investigation on an Outbreak of Salmonellosis in Yeongcheon-si, 2004  

Min, Young-Sun (Department of Preventive Medicine, College of Medicine, Dongguk University)
Lee, Hwan-Seok (Public Health & Sanitation Division, Gyeongsangbuk-do)
Lim, Hyun-Sul (Department of Preventive Medicine, College of Medicine, Dongguk University)
Publication Information
Journal of Preventive Medicine and Public Health / v.38, no.4, 2005 , pp. 457-464 More about this Journal
Abstract
Objectives : An outbreak of salmonellosis occurred among the student s and staff of D primary school in Yeongcheon-si, 2004. This investigation was carried out to prevent any recurrence of this outbreak and to study the infection source and transmission of the salmonellosis. Methods : The authors conducted a questionnaire survey among 1,205 students and staff members from D primary school about the ingestion of the school lunch and drinking water, and the manifestation of their symptoms. The author examined rectal swabs, the tap water and microorganism cultures, and we also investigated the dining facility and water supply facility. Results : The diarrheal cases were defined as the confirmed cases or the persons who had diarrhea more than one time with symptoms such as fever, vomiting and tenesmus. The diarrheal attack rate was 28.0%. Ingestion of fried bean curd with egg had a significantly high association with the diarrheal attack rate (p<0.05), and the relative risk of the fried bean curd with egg was 10.68 (95% CI=3.88-29.41), as was determined by logistic regression analysis. The bacterial counts in the tap water of the food preparation room and toilet (first floor) exceeded the maximum permissible counts. S. Enteritidis bacteria were only cultured from the fried bean curd with egg of all the supplied foods on September 3, 2004. Conclusions : The major cause of salmonellosis was presumed to be the contaminated bean curd via contaminated tap water due to a water leak of a school water pipe. This contaminated bean curd was under prepared, which allowed the S. Enteritidis to survive and multiply prior to its ingestion.
Keywords
Salmonellosis; Salmonella Enteritidis; Outbreaks; Bean curd; Food contamination;
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1 김정순. 한국인의 건강과 질병양상. 신광출판사; 2001, (536-540쪽)
2 Oh MD. Food borne illness - Salmonellosis, virbriosis, listeriosis. Korean J Med 1998; 55(4): 701-705 (Korean)
3 Roberts T. Salmonellosis control: estimated economic costs. Poult Sci 1988; 67(6): 936- 943   DOI   PUBMED   ScienceOn
4 Gast RK, Holt PS. Incubation of egg contents pools at an elevated temperature (42 degrees C) does not improve the rapid detection of Salmonella enteritidis phage type 14b. J Food Prot 2004; 67(8): 1751-1754   PUBMED
5 Matsui T, Suzuki S, Takahashi H, Ohyama T, Kobayashi J, Izumiya H, Watanabe H, Kasuga F, Kijima H, Shibata K, Okabe N. Salmonella enteritidis outbreak associated with a schoollunch dessert: cross-contamination and a long incubation period, Japan, 2001. Epidemiol Infect 2004; 132(5): 873-879   DOI   ScienceOn
6 Yoon TH, Lee YJ, Lee OJ, Lee EW, Kim H, Lee DC, Nam SH. Heterotrophic bacteria in terms of free chlorine residuals in water distribution systems. Kor J Env Hlth Soc 2002; 28(3): 9-18 (Korean)
7 Mattick KL, Bailey RA, Jorgensen F, Humphrey TJ. The prevalence and number of Salmonella in sausages and their destruction by frying, grilling or barbecuing. J Appl Microbiol 2002; 93(4): 541-547   DOI   ScienceOn
8 Muramatsu K, Nishizawa S. An outbreak of municipal water-associated food poisoning caused by Salmonella enteritidis. Kansenshogaku Zasshi. 1992; 66(6): 754-760   PUBMED
9 Schroeder CM, Naugle AL, Schlosser WD, Hogue AT, Angulo FJ, Rose JS, Ebel ED, Disney WT, Holt KG, Goldman DP. Estimate of illnesses from Salmonella enteritidis in eggs, United States, 2000. Emerg Infect Dis 2005; 11(1): 113-115   DOI   PUBMED
10 CDC. Multistate Outbreak of Escherichia coli O157:H7 Infections associated with eating ground beef-United States, June-July 2002. MMWR 2002; 51(29): 637-639
11 Lim HS, Bae GH. Epidemiologic investigation of an outbreak of Shigella sonnei among students in Bonghwa, 1999. Korean J Prev Med 2000; 33(1): 10-16 (Korean)
12 Threlfall EJ, Ward LR, Rowe B. Increasing incidence of resistance to trimethoprim and ciprofloxacin in epidemic Salmonella typhimurium DT104 in England and Wales. Euro Surveill 1997; 2(11): 81-84   PUBMED
13 Patrick ME, Adcock PM, Gomez TM, Altekruse SF, Holland BH, Tauxe RV, Swerdlow DL. Salmonella enteritidis infections, United States, 1985-1999. Emerg Infect Dis 2004; 10(1): 1-7
14 Bahk GJ, Roh WS. Estimates of cases and social economics costs of foodborne salmonellosis in Korea. J Fd Hyg Safety 1998; 13(3): 299-304 (Korean)
15 Ahmed R, Soule G, Demczuk WH, Clark C, Khakhria R, Ratnam S, Marshall S, Ng LK, Woodward DL, Johnson WM, Rodgers FG. Epidemiologic typing of Salmonella enterica serotype Enteritidis in a Canada-wide outbreak of gastroenteritis due to contaminated cheese. J Clin Microbiol 2000; 38(6): 2403-2406   PUBMED
16 Brooks GF, Butel JS, Morse SA. Jawetz, Melnick & Adelberg's Medical Microbiology, 22th ed. New York: McGraw Hill Companies; 2001. p. 225-228
17 Kim JR, Lee SW, Kim HB, Cha J, Lee KH, Bae KW. An epidemiologic investigation on the mode of transmission of the lethal salmonellosis outbreak in Hamyang county. Korean J Epidemiol 1999; 21(2): 185-194 (Korean)
18 Blaser MJ, Newman LS. A review of human salmonellosis: I. Infective dose. Rev Infect Dis 1982; 4(6): 1096-1106   DOI   PUBMED
19 Nakadai A, Kuroki T, Kato Y, Suzuki R, Yamai S, Yaginuma C, Shiotani R, Yamanouchi A, Hayashidani H. Prevalence of Salmonella spp. in pet reptiles in Japan. J Vet Med Sci 2005; 67(1): 97-101   DOI   ScienceOn
20 Lee HD, Chung WS, Gee CS. Characteristics of chlorine residual decay and water quality change in water distribution system. J KSWQ MAR 1998; 14(1): 79-86 (Korean)
21 KNIH. Infection of Enterohemorrhagic Escherichia coli. CDMR 2001; 12(9): 97-103 (Korean)
22 Mintz ED, Cartter ML, Hadler JL, Wassell JT, Zingeser JA, Tauxe RV. Dose-response effects in an outbreak of Salmonella enteritidis. Epidemiol Infect 1994; 112(1): 13-23   DOI   ScienceOn
23 Motarjemi Y, Kaferstein FK. Global estimation of foodborne diseases. World Health Stat Q 1997; 50(1-2): 5-11   PUBMED
24 al-Ahmadi KS, el Bushra HE, al-Zahrani AS. An outbreak of food poisoning associated with restaurant-made mayonnaise in Abha, Saudi Arabia. J Diarrhoeal Dis Res 1998; 16(3): 201- 204   PUBMED
25 Kim MK Lim HS, Jung C, Ha GY. An epidemiological survey on a Salmonella enteritidis outbreak in Kyongju, Korea. Korean J Epidemiol 1998; 20(2): 187-201 (Korean)
26 Chart H. Salmonella. In: Greenwood D, Slack RCB, Peutherer JF, Editors. Medical Microbiology. 16th ed. Burlington: Eslevier Science; 2002. p. 250-259
27 Gomez TM, Motarjemi Y, Miyagawa S, Kaferstein FK, Stohr K. Foodborne salmonellosis. World Health Stat Q 1997; 50(1-2): 81-89   PUBMED
28 Park MS, Kang YH, Lee SJ, Song CY, Lee BK. Characteristics of epidemic multidrugresistant Salmonella enterica serovar Typhimurium DT 104 strains first isolation in Korea. J Korean Infect Dis 2002; 34(1): 1-8 (Korean)   DOI   ScienceOn
29 식품의약품안전청. 집단식중독 발생 현황. 식품의약품안전청; 2004
30 Mazurek J, Holbert L, Parrish MK, Salehi E. Raw eggs-lessons learned from an outbreak of salmonella serotype enteritidis infections associated with meringue pie. J Public Health Manag Pract 2005; 11(3): 201-207   PUBMED
31 Kim SW. Water quality control technologies in the distribution system. J NERI 1999; 4(1): 1-18 (Korean)
32 Glynn JR, Palmer SR. Incubation period, severity of disease, and infecting dose: evidence from a Salmonella outbreak. Am J Epidemiol 1992; 136(11): 1369-1377   PUBMED
33 Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical Microbiology, 4th ed. Saint Louis: Mosby; 2002. p. 273-275