On Monday 13th July 2009 About 103 persons attended lunch meal in a camp of soldiers in Madenah city. They started to complain of diarrhea, abdominal pain, fever, nausea, and vomiting, with some variations in symptoms and severity. All of them visited emergency departments in different hospitals madenah city,10 of them were admitted. An investigation was initiated to identify the source, mode of transmission and etiologic agent standing behind this outbreak.
Methodology
A retrospective cohort study was conducted. The data were collected by interview with all cases and non-cases to inquire about food items they had, symptoms they experienced, either hospitalized or not, the management they received and the laboratory results if available. Anyone of the attendees developed abdominal pain and one or more of the following symptoms (diarrhea, vomiting, fever) within two days of the lunch meal of mondy 13 July 2009 were considered as a case.
Results
A total of 103 individuals were contacted,72 developed gastroenteritis manifested by diarrhea (66%), abdominal pain (67%), fever (29.1%) and vomiting (16.5%). All were Saudis; (100%) males. The most probable implicated food items are Chicken and Rice from the restaurant. Regarding chicken (R.R=4.96) with 95% C.I=2.40 - 10.23. Regarding Rice (R.R=4.20) with 95% C.I =1.18 - 14.73. Stool analysis was done for cases and Salmonella was isolated from 4 cases and 2 workers of food handlers although Staphylococcus aureus was found with all workers.
Conclusion
The causative organism of this foodborne outbreak was salmonella spp and Staph aureus . The incriminated food items were probably O and rice. Asymptomatic carrier was possibly the source of organism. The carrier is most likely within the food handlers of the restaurant. Although the temperature of preparation is adequate to kill the organism but cross contamination after preparation could be the cause. The mode of transmission is probably by food handler.