Saudi Arabia is a country where there is inflow of large number of people about 10 million Muslims throughout the year and specifically during Hajj seasons where around two million pilgrims performing their Hajj in a short time and at a relatively confined area. At the same time, chances of transmission and dissemination of Bacteria are very high especially during the summer months and Hajj season. On August 30,2017, the food safety in the department of the ministry of health in the Saudi Arabia received the notification about potential outbreak of foodborne illnesses. The Field Epidemiology in Saudi Arabia and public health department officials investigated to identify the source and prevent additional illnesses.
Methodology
A case-control study was done to defined as illness with onset between (data1) and (date 2). We used a standardized questionnaire to collect information on symptoms, time of illness onset, and food history. Main objective of the study were to confirm the outbreak and identify it extend among the pilgrims. To specify the main cause of food poisoning. To propose preventive recommendations to avoid such incidents in the future.
Results
We identified 30 cases: 15(50%) were males 15 cases (50%) were female. among 517 Emirates pilgrims. Cases most commonly reported symptoms of abdominal pain and diarrhea. The epidemiological curve shows the first symptoms of onset to appear at 3:00 AM on Thursday 31/08/2017 the cases started from 3:00AM its gradually increased until the cases stop on Thursday 31/08/2017 at 9:00 PM and the peak was at 3:00 PM in the same day. The incubation period was 6-32 Hours with a mean 22 hours. To compare between the cases and control we collect data form 60 controls. The analysis using Chi2 test showed that Meat and Tomato sauce were statistically significant (P-Value=0.03 for Tomato sauce &0.04 for Meat) where other food items (Rice and Kubaah) were not statistically significant (P-Value=0.8 for Rice &0.1for Kubaah).
Conclusion
According to the clinical pictures and the incubation period, the most probably causative organism a Salmonella or E. coli, Salmonella infection are more linked to the Meat and Edam. Probably the delay of notification led to the negativity of the laboratory investigation. This study recommended to Improve the food transportation pathway and the way of storing food items. Finally, Restricted monitoring food providers, from the level of restaurants to food handling worker.