2019년 충남지역 고등학교에서 발생한 다병원체에 의한 집단식중독의 역학적 분석
Epidemiological Analysis of a Food Poisoning Outbreak Caused by Multiple Pathogens in a High School in Chungnam Korea, 2019
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Objectives: This study was performed in order to report the epidemiological features of a food poisoning outbreak caused by multiple pathogens in a high school in Chungcheongnam-do Province, Korea in April 2019 and to suggest measures to prevent a similar incidence. Methods: A total of 39 patients with diarrhea were examined. Environmental samples were obtained from 6 food handlers, 4 food utensils, 72 preserved foods served during the food poisoning outbreak, 9 door handles, 10 drinking water samples from water dispensers, and 6 ground water samples from water taps. These analyzed to detect viruses and bacteria. Results: Among the 39 patients, 21 cases (53.8%) of enteroaggregative E. coli (EAEC), 7 cases of Staphylococcus aureus (17.9%), and 17 cases of norovirus (43.6%) were positive, and in 16 of the cases a co-infection with at least one other pathogen were observed. EAEC was assumed to be transmitted from contaminated drinking water because it was also detected in the water sample from a water dispenser in the dormitory. Staphylococcus aureus was isolated only in the fecal samples of patients, meaning it was not possible to trace its origin. The genotype of norovirus detected in the drinking water and ground water was consistent with that isolated from patients, and it was determined that the norovirus infection originated from the school's water environment. Conclusions: These findings indicate that a lack of environmental hygiene management related to school meals caused the food poisoning incident. In particular, a lack of management of drinking water, water supply, and personal hygiene should be pointed out. This should be urgently addressed and continuous monitoring should be carried out in the future. In addition, students and staff should be educated and trained to improve their personal hygiene.
Abstract
Objectives: This study was performed in order to report the epidemiological features of a food poisoning outbreak caused by multiple pathogens in a high school in Chungcheongnam-do Province, Korea in April 2019 and to suggest measures to prevent a similar incidence. Methods: A total of 39 patients with diarrhea were examined. Environmental samples were obtained from 6 food handlers, 4 food utensils, 72 preserved foods served during the food poisoning outbreak, 9 door handles, 10 drinking water samples from water dispensers, and 6 ground water samples from water taps. These analyzed to detect viruses and bacteria. Results: Among the 39 patients, 21 cases (53.8%) of enteroaggregative E. coli (EAEC), 7 cases of Staphylococcus aureus (17.9%), and 17 cases of norovirus (43.6%) were positive, and in 16 of the cases a co-infection with at least one other pathogen were observed. EAEC was assumed to be transmitted from contaminated drinking water because it was also detected in the water sample from a water dispenser in the dormitory. Staphylococcus aureus was isolated only in the fecal samples of patients, meaning it was not possible to trace its origin. The genotype of norovirus detected in the drinking water and ground water was consistent with that isolated from patients, and it was determined that the norovirus infection originated from the school's water environment. Conclusions: These findings indicate that a lack of environmental hygiene management related to school meals caused the food poisoning incident. In particular, a lack of management of drinking water, water supply, and personal hygiene should be pointed out. This should be urgently addressed and continuous monitoring should be carried out in the future. In addition, students and staff should be educated and trained to improve their personal hygiene.
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