Multiple Outbreaks of Gastroenteritis That Were Associated with 16 Funerals and a Unique Caterer and Spanned 6 Days, 2011, Québec, Canada

2013 ◽  
Vol 76 (9) ◽  
pp. 1582-1589 ◽  
Author(s):  
COLETTE GAULIN ◽  
SOULYVANE NGUON ◽  
MARIE-ANDREE LEBLANC ◽  
DANIELLE RAMSAY ◽  
SOPHIE ROY
Keyword(s):  
Public Health ◽  
Food Samples ◽  
Viral Gastroenteritis ◽  
Epidemiological Investigation ◽  
Food Handlers ◽  
Duration Of Symptoms ◽  
Causative Agents ◽  
Stool Samples ◽  
The Mean ◽  
Over Time

In January 2011, multiple acute gastroenteritis outbreaks that spanned many days and were related to attendance at funerals were reported to public health units in Quebec. An epidemiological investigation was initiated to identify the source of the contamination and to explain the extent of the contamination over time. Thirty-one cohorts of individuals attended different funerals held between 14 and 19 January. All attendees were served a cold buffet made by the same caterer. Of these 31 cohorts, 16 (with a total of about 800 people) contained individuals who reported being ill after the funeral. Symptoms were mainly diarrhea (89 to 94% of individuals), vomiting (63 to 90%,) and fever (26 to 39%), with a median incubation period of 29 to 33 h and a median duration of symptoms of 24 to 33 h, suggesting norovirus-like infection. Among the 16 cohorts, 3 were selected for cohort studies. Among those three cohorts, the mean illness rate was 68%. Associations were found between those who fell ill and those who had consumed pasta salad (relative risk [RR] = 2.4; P = 0.0022) and ham sandwiches (RR = 1.8; P = 0.0096). No food handlers reported being sick. No stool samples were provided by individuals who became ill. Environmental and food samples were all negative for causative agents. Although the causative agent was not clearly identified, this investigation raised many concerns about the importance of preventing foodborne transmission of viral gastroenteritis and generated some recommendations for management of similar outbreaks.

scholarly journals Molecular characterization of hookworm spp. isolated from food handlers, Khartoum, Sudan: A cross-sectional study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 662
Author(s):  
Tarig A. Gamar ◽  
Hassan H. Musa ◽  
Hisham N. Altayb ◽  
Mohamed H. Mohamed ◽  
Adam D. Abakar
Keyword(s):  
Public Health ◽  
Molecular Characterization ◽  
Molecular Probe ◽  
Hookworm Infection ◽  
Food Handlers ◽  
The Public ◽  
Necator Americanus ◽  
Link Type ◽  
Stool Samples

Background: Hookworms infect the intestines, cause an itchy rash, respiratory and gastrointestinal problems, and eventually iron deficiency (anaemia) due to the ongoing loss of blood. The objectives of this study were to assess the prevalence and molecular characterization of hookworms isolated from food handlers attending the Public Health Laboratories in Khartoum state, Sudan, for annual check-ups, and to assess the efficiency of PCR as molecular probe for hookworm infection. Methods: A total of 350 foods handlers’ participant's stool samples who were not suspected to be infected with hookworms were studied. Conventional methods were applied to make an early diagnosis. Stool samples were collected from public health laboratories (the public health lab in the Medical Commission) of Khartoum State; Omdurman locality, Khartoum North locality and Khartoum locality between October 2016 and April 2017. Specific identification was made by PCR on specimens identified as positive by Baermann’s technique, which were then sequence and genotyped Results: The prevalence of hookworms in the stool samples of food-handlers was 1.43%. One larval specimen recovered by Baermann’s technique was confirmed to be Necator americanus by PCR. PCR also confirmed that Necator americanus was the common species isolated from four further specimens. The results of DNA sequencing for Necator americanus were deposited in NCBI GenBank under the following accession numbers: sample 91, MH035824; sample 92, MH035825; sample 294, MH035826; and sample 319 MH035827. Conclusion: PCR was found to be effective for confirmation of the diagnosis of hookworm infection and can aid the clinician in initiating prompt and appropriate antiparasite therapy.

scholarly journals Burden of Enteropathogens Associated Diarrheal Diseases in Children Hospital, Nepal

1970 ◽  
Vol 7 (7) ◽  
pp. 71-75 ◽  
Author(s):  
Jeevan B Sherchand ◽  
Michiyo Yokoo ◽  
Ojaswee Sherchand ◽  
Arun R Pant ◽  
Osamu Nakogomi
Keyword(s):  
Public Health ◽  
Pathogenic Bacteria ◽  
Diarrheal Disease ◽  
Intestinal Parasites ◽  
Significant Proportion ◽  
Culture Method ◽  
Institute Of Medicine ◽  
Shigella Species ◽  
Causative Agents ◽  
Stool Samples

Diarrheal disease caused by bacteria, parasites or viruses continues to be an important cause of morbidity and mortality among young children in developing countries. Methods currently used in public health laboratories do not allow for the identification of rotavirus, Cyclospora and pathogenic E.coli infection though they represent as an etiology in large proportion of patients with diarrhea, the possibility exists that a portion of the undiagnosed illness may be attributable to one or more of the above enteropathogens. In a view to determine the causative agents of diarrhoea, the current study described the various enteropathogens associated with diarrhoea in hospitalized children. Stool samples were collected from children under 11 years of age who developed diarrhoea and were admitted to Kanti Children's Hospital between May to October 2007 and investigated in Tribhuvan University, Institute of Medicine, Health Research Laboratory; by using both the combination of microbiological and immunological tools ( EIA for rotavirus detection, standard parasitological procedure for Cyclospora and other intestinal parasites, and selective culture method and serotyping were used to differentiate the species of bacteria). A total of 440 diarrhoeal stool samples were collected and 285 (64.8%) enteropathogens were identified. The highest infection was due to intestinal parasites 104/285 (36.5%) followed by rotavirus 92/285 (32.3%); pathogenic bacteria 57/285 (20%) and Cyclospora 32/285 (11.2%). Among the pathogenic bacteria (20%) isolated, the predominant bacteria were Shigella species (36.8%); Vibrio species (26.3%); Escherichia coli (22.8%) and Salmonella species (14.03%) respectively. Various enteropthogens responsible for diarrhoea especially rotavirus, different pathogenic bacteria and Cyclospora infection, which are not examined routinely in public health laboratories, were found in significant proportion as a cause of diarrhoeal illness in children. The infection was peak in children under 2 years of age and was highest in rainy season. Key words: Burden; Diarrhea; Enteropathogens; Children; Nepal. DOI: 10.3126/sw.v7i7.3830Scientific World Vol.7(7) 2009 pp.71-75

scholarly journals A large common-source outbreak of norovirus gastroenteritis in a hotel in Singapore, 2012

2016 ◽  
Vol 145 (3) ◽  
pp. 535-544 ◽  
Author(s):  
P. RAJ ◽  
J. TAY ◽  
L. W. ANG ◽  
W. S. TIEN ◽  
M. THU ◽  
...  
Keyword(s):  
Food Samples ◽  
Common Source ◽  
Food Handlers ◽  
Case Control Studies ◽  
Modes Of Transmission ◽  
Norovirus Gastroenteritis ◽  
Contaminated Food ◽  
Plate Counts ◽  
Microbial Analysis ◽  
Stool Samples

SUMMARYAn outbreak of gastroenteritis affected 453 attendees (attack rate 28·5%) of six separate events held at a hotel in Singapore. Active case detection, case-control studies, hygiene inspections and microbial analysis of food, environmental and stool samples were conducted to determine the aetiology of the outbreak and the modes of transmission. The only commonality was the food, crockery and cutlery provided and/or handled by the hotel's Chinese banquet kitchen. Stool specimens from 34 cases and 15 food handlers were positive for norovirus genogroup II. The putative index case was one of eight norovirus-positive food handlers who had worked while they were symptomatic. Several food samples and remnants tested positive for Escherichia coli or high faecal coliforms, aerobic plate counts and/or total coliforms, indicating poor food hygiene. This large common-source outbreak of norovirus gastroenteritis was caused by the consumption of contaminated food and/or contact with contaminated crockery or cutlery provided or handled by the hotel's Chinese banquet kitchen.

scholarly journals Cross-border investigation of a Shigella sonnei outbreak in a group of Norwegian tourists after a trip to Russia

2007 ◽  
Vol 12 (4) ◽  
pp. 9-10 ◽  
Author(s):  
B Schimmer ◽  
H Meldal ◽  
N G Perederij ◽  
L Vold ◽  
M A Petukhova ◽  
...  
Keyword(s):  
Public Health ◽  
Gastrointestinal Symptoms ◽  
Food Samples ◽  
Shigella Sonnei ◽  
Epidemiological Surveillance ◽  
Cross Border ◽  
Cured Meat ◽  
Food And Beverage ◽  
Stool Samples ◽  
E Mail

In early September 2006, the Norwegian Institute of Public Health was alerted to an outbreak of Shigella sonnei infections (shigellosis) among 23 Norwegian passengers who had taken a bus tour from Kirkenes, Norway to Murmansk, Russia. The trip lasted from 27 to 31 August, and the group stayed in various hotels and visited several restaurants in both Kirkenes and Murmansk during this period. Stool samples from three ill passengers yielded S. sonnei; an additional 10 passengers had gastrointestinal symptoms with diarrhoea or loose stools with abdominal pain. An investigation was initiated in collaboration with the department of epidemiological surveillance in Murmansk. We sent a questionnaire to the work e-mail addresses of all passengers asking about symptoms and exposures. Two restaurants and a hotel visited by the Norwegian tourists in Murmansk were inspected and sampled. Of all the food and beverage items mentioned in the questionnaire, only cured meat consumed in restaurant A in Murmansk on 28 August was associated with the risk of developing illness. Inspections of the restaurants in Murmansk identified some hygienic shortcomings and inadequate routines. However, S. sonnei could not be isolated from food samples or the personnel. Improved routines were implemented.

scholarly journals Emergence of blaTEM Type Extended-Spectrum β-Lactamase Producing Salmonella spp. in the Urban Area of Bangladesh

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Dilruba Ahmed ◽  
Abu Iftiaf Md. Salah Ud-Din ◽  
Syeda Umme Habiba Wahid ◽  
Razib Mazumder ◽  
Kamrun Nahar ◽  
...  
Keyword(s):  
Public Health ◽  
Nalidixic Acid ◽  
Health Concern ◽  
Enteric Infection ◽  
Esbl Production ◽  
Public Health Concern ◽  
Salmonella Spp ◽  
Paratyphi B ◽  
Stool Samples ◽  
Over Time

Salmonellosis, an acute invasive enteric infection, is endemic in Bangladesh. We analyzed 128,312 stool samples of diarrheal patients to identify Salmonella spp. during 2005–2013. A total of 2120 (1.7%) Salmonella spp. were isolated and the prevalence of Salmonella spp. decreased significantly over time (2→1%, P<0.001). Among the typhoidal Salmonella (TS) serogroups, S. Typhi was predominant (404, [65.1%]) followed by S. Paratyphi B (139, [22.4%]) and S. Paratyphi A (78, [12.6%]). Of the nontyphoidal Salmonella (NTS) isolates, the serogroup C1 (560, [37%]) was predominant followed by B (379, [25%]), C2 (203, [14%]), E (127, [9%]), and D (94, [6%]). Most of the resistance was found towards nalidixic acid (40%), ampicillin (36%), cotrimoxazole (20%), chloramphenicol (13%), ciprofloxacin (4%), and ceftriaxone (4%). Interestingly, 32% of the isolates showed reduced susceptibility to Cip. Multiantibiotic resistance (MAR, ≥3 drugs) was more common among TS than NTS strains (P<0.001). Among the representative ceftriaxone-resistant isolates, blaTEM gene was detected among 88% (7/8) of the strains, whereas only one strain of S. Typhi was positive for both blaTEM and blaCTX-M genes. The study reflects higher prevalence of MAR Salmonella spp. and is the first to report the blaTEM gene mediated ESBL production among Salmonellae in Bangladesh. Emergence of MAR Salmonella spp. in particular ESBL strains should be considered a public health concern.

scholarly journals The Financial Burden of Public Health Responses to Hepatitis A Cases Among Food Handlers, 2012-2014

2017 ◽  
Vol 132 (4) ◽  
pp. 443-447 ◽  
Author(s):  
Rebecca J. Morey ◽  
Melissa G. Collier ◽  
Noele P. Nelson
Keyword(s):  
Public Health ◽  
Hepatitis A ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Food Handlers ◽  
The Mean ◽  
State And Local ◽  
Mean Cost

When food handlers become ill with hepatitis A virus (HAV) infection, state and local health departments must assess the risk of HAV transmission through prepared food and recommend or provide postexposure prophylaxis (PEP) for those at risk for HAV infection. Providing PEP (eg, hepatitis A [HepA] vaccine or immunoglobulin), however, is costly. To describe the burden of these responses on state and local health departments, we determined the number of public health responses to HAV infections among food handlers by reviewing public internet sources of media articles. We then contacted each health department to collect data on whether PEP was recommended to food handlers or restaurant patrons, the number of PEP doses given, the number of HepA vaccine or immunoglobulin doses given as PEP, and the mean number of health department person-hours required for the response. Of 32 public health responses identified from Twitter, HealthMap, and Google alerts from January 1, 2012, to December 31, 2014, a total of 27 (84%) recommended PEP for other food handlers or restaurant patrons or both. Per public health response, the mean cost per dose of the HepA vaccine or immunoglobulin was $34 139; the mean personnel cost per response was $7329; and the total mean cost of each response was $41 468. PEP is expensive. Less aggressive approaches to PEP, such as limiting PEP to fellow food handlers in nonoutbreak situations, should be considered in the postvaccination era. HepA vaccine for PEP provides long-term immunity and can be used when immunoglobulin is unavailable or cannot be administered within 14 days of exposure to HAV.

scholarly journals Normalisation of SARS-CoV-2 concentrations in wastewater: the use of flow, conductivity and CrAssphages

2021 ◽  
Author(s):  
Jeroen Langeveld ◽  
Remy Schilperoort ◽  
Leo Heijnen ◽  
goffe elsinga ◽  
claudia schapendonk ◽  
...  
Keyword(s):  
Public Health ◽  
Domestic Wastewater ◽  
Normalization Method ◽  
Short Term ◽  
Flow Monitoring ◽  
Virus Rna ◽  
Normalization Methods ◽  
Stool Samples ◽  
Quality Check ◽  
Over Time

Over the course of the COVID-19 pandemic in 2020-2021, monitoring of SARS-CoV-2 RNA in wastewater has rapidly evolved into a supplementary surveillance instrument for public health. Short term trends (2 weeks) are used as a basis for policy and decision making on measures for dealing with the pandemic. Normalization is required to account for the varying dilution rates of the domestic wastewater, that contains the shedded virus RNA. The dilution rate varies due to runoff, industrial discharges and extraneous waters. Three normalization methods using flow, conductivity and CrAssphage, have been investigated on 9 monitoring locations between Sep 2020 and Aug 2021, rendering 1071 24-hour flow-proportional samples. In addition, 221 stool samples have been analyzed to determine the daily CrAssphage load per person. Results show that flow normalization supported by a quality check using conductivity monitoring is the advocated normalization method in case flow monitoring is or can be made available. Although Crassphage shedding rates per person vary greatly, the CrAssphage loads were very consistent over time and space and direct CrAssphage based normalization can be applied reliably for populations of 5600 and above.

scholarly journals Public Health Implication of Intestinal Parasites Recovered from Stool Samples of Food Handlers and Vendors in Calabar Municipality

2019 ◽  
Vol 8 (01) ◽  
pp. 1480-1485
Author(s):  
I. Usang Akedor ◽  
A. Bassey Omeh ◽  
E. Efeffiong Emem ◽  
O. Ikpan Ogbe ◽  
Edima Duke ◽  
...  
Keyword(s):  
Public Health ◽  
Intestinal Parasites ◽  
Food Handlers ◽  
Public Health Implication ◽  
Health Implication ◽  
Stool Samples

Molecular Detection of Group A Rotavirus in under Five Years Old Children with Acute Diarrhoea Admitted to Yangon Children’s Hospital

2019 ◽  
Vol 31 (1) ◽  
pp. 87-92
Keyword(s):  
Acute Diarrhoea ◽  
Enzyme Linked Immunosorbent Assay ◽  
Viral Gastroenteritis ◽  
Cross Sectional ◽  
Under Five ◽  
Group A Rotavirus ◽  
Rotavirus Vaccination ◽  
Group A ◽  
Stool Samples ◽  
Considerable Morbidity

Rotaviruses are regarded as the most common cause of viral gastroenteritis and are responsible for considerable morbidity and mortality among children especially under five years of age worldwide. In developing countries like Myanmar, where diarrhoea is in the priority childhood disease, rotavirus surveillance and detection of rotavirus genotypes are utmost important. A hospital-based, cross-sectional descriptive study was conducted at Yangon Children‟s Hospital among under five children admitted for acute diarrhoea from January to October 2016. This study includes detection of Group A rotavirus antigen by commercial enzyme-linked immunosorbent assay (ELISA) and genotyping by multiplex RT-PCR. From a total of 488 collected samples, rotavirus antigen was detected in 219 samples (45%). Rotavirus diarrhoea was most common among the age of 6-11 months (38.8%) followed by 12-23 months (37.9%). The results showed that boys were more commonly affected than girls. Detection of rotavirus positivity was peak in February (57.6 %). Out of 219 stool samples with positive ELISA result, 40 stool samples with high optical density value were proceeded for further determination of G and P genotypes. Regarding distribution of G genotypes, the most common G genotype was G9 which comprised 45%, and that of P genotype was P[8] which comprised 92.5%. Regarding combination of G and P genotypes, the most frequent combination is G9P[8], and it constituted 42.5%. Untypable genotypes were seen in 30% of G and 2.5% of P typing. As rotavirus infection can be prevented by vaccine, WHO recommended that rotavirus vaccination should be included in national immunization program especially in countries where prevalence of rotavirus is high. The distribution of G and P genotypes is important in consideration of appropriate vaccine in pre-vaccination and evaluation of effectiveness of vaccine in post-vaccination period. Therefore, the information on currently circulating genotypes of rotavirus in this study will serve as valuable data for vaccination programme.

scholarly journals Incomplete Kawasaki disease - a diagnostic and therapeutic challenge

2014 ◽  
Vol 9 (4) ◽  
pp. 30-35
Author(s):  
S Datta ◽  
S Maiti ◽  
G Das ◽  
A Chatterjee ◽  
P Ghosh
Keyword(s):  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Incomplete Kawasaki Disease ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Echocardiographic Finding ◽  
2D Echocardiography ◽  
Acquired Heart Disease ◽  
The Mean ◽  
One Year

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234

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