Outbreak Investigation Of Food Poisoning At SDN Cibuk Lor and SDN Margoluwih, In Sleman District

Baground: On break time around at 09.00 WIB, a dozen students from the State Elementary School (SDN) Cibuk Lor, Sleman allegedly experienced dizziness, nausea and vomiting after eating fried squid snacks sold in around the school area, counted 19 children experienced symptoms of poisoning. The aimed was investigation was carried out on the occurrence of food poisoning, in order to ensure the correctness of the information and determine the risk factors that influence the incidence of food poisoning. Method: Analytical descriptive study using a case control design. With a ratio of 1:2 subjects as many as 108 children. The cases were those who experienced the main symptoms, namely nausea, vomiting and dizziness as 36 children. Data analysis using SPSS 16.0 software and laboratory testing for food samples has been carried out. Results: The average incubation period was 15 minutes, the dominant clinical symptoms were nausea (100%) accompanied by vomiting (16.6%) and dizziness (25%). There are also 2 students who only smell the food but the students also feel dizzy. Fried squid attack rate (66.7%) and no died in this outbreak. The results of laboratory tests showed of Rhodamin and borax in fried squid. Conclusions: Food poisoning occurs due to the use of food mixtures containing hazardous chemicals (rhodamine and borax) and suspected to be contaminated in the food processing. the school and the health center cooperate in tackling the incident by controlling every pitchman comes around the school. Keywords: Outbreak , case control, sleman Pendahuluan: Pada saat jam istirahat sekitar pukul 09.00 WIB, belasan siswa Sekolah Dasar Negeri (SDN) Cibuk Lor, Seyegan, Sleman diduga mengalami pusing, mual dan muntah seusai menyantap jajanan cumi goreng yang dijual di sekitar area sekolah, terhitung 19 anak mengalami gejala keracunan. Tujuan penelitian ini untuk untuk menyelidiki adanya kejadian keracunan makanan, guna memastikan kebenaran informasi dan faktor risiko yang mempengaruhi kejadian keracunan makanan. Metode: Studi deskriptif analitik dilakukan menggunakan desain case control dengan perbandingan 1:2 jumlah subyek sebanyak 108 anak. kasus adalah mereka yang mengalami gejala utama yaitu mual, muntah dan pusing sebanyak 36 anak. analisis data menggunakan software SPSS 16.0 dan untuk sampel makanan telah dilakukan pengujian laboratorium. Hasil: Masa inkubasi rata-rata adalah 15 menit sementara itu gejala klinis yang dominan adalah mual (100%) disertai muntah (16,6%) dan pusing (25%). adapula 2 siswa yang hanya mencium bau makanan akan tetapi siswa tersebut juga merasakan pusing. Attack rate cumi goreng (66,7%) dan tidak ada yang meninggal pada KLB ini. hasil uji laboratorium menunjukkan adanya kandungan Rhodamin dan boraks pada cumi goreng. Kesimpulan: Keracunan makanan terjadi akibat pemakaian bahan campuran makanan yang mengandung bahan kimia berbahaya (rhodamin dan boraks) dan diduga terkontaminasi pada proses pengolahan makanan. Kata kunci: Kejadian luar biasa, case control, sleman

High impact of molecular surveillance on hepatitis A outbreak case detection in Sweden: a retrospective study, 2009 to 2018

BackgroundSwedish hepatitis A surveillance includes sequence-based typing, but its contribution to outbreak detection in relation to epidemiological investigations has not been fully evaluated.AimTo evaluate the role of sequence-based typing in hepatitis A outbreak detection and to describe the hepatitis A epidemiology in Sweden to improve surveillance.MethodsWe retrospectively investigated hepatitis A virus sequences of 447 cases notified in Sweden 2009–18. We performed a phylogenetic analysis of evolutionary distances to identify cases with similar virus sequences (≥ 459/460 identical nt in the VP1/P2A junction). Unique sequences, dyads and sequence-based clusters (SBCs) were identified. We linked non-sequenced cases by epidemiological information and retrospectively assessed the value of typing for outbreak identification.ResultsFifty-five percent (n = 542/990) of the notified hepatitis A cases were referred to the Public Health Agency of Sweden for typing and 447 (45%) were sequenced successfully. Subgenotypes included IA (42.5%, n = 190), IB (42.7%, n = 191) and IIIA (14.8%, n = 66). Phylogenetic analysis identified 154 unique sequences, 33 dyads (66 cases) and 34 SBCs (227 cases). The combination of molecular and epidemiological data revealed 23 potential outbreaks comprising 201 cases. Cases were linked by sequence (59%, n = 118), epidemiological data (11%, n = 23) or both (30%, n = 60). Typing was needed to identify 15 of 23 potential outbreak signals.ConclusionSequence-based typing contributed substantially to detecting clustering cases and identifying outbreaks in Sweden. The results show routine sequence-based typing detects outbreaks, promotes timely outbreak investigations and facilitates international collaboration.

Use of Power Transform Mixing Ratios as Hydrometeor Control Variables for Direct Assimilation of Radar Reflectivity in GSI En3DVar and Tests with Five Convective Storms Cases

When directly assimilating radar data within a variational framework using hydrometeor mixing ratios (q) as control variables (CVq), the gradient of the cost function becomes extremely large when background mixing ratio is close to zero. This significantly slows down minimization convergence and makes the assimilation of radial velocity and other observations ineffective because of the dominance of reflectivity observation term in the cost function gradient. Using logarithmic hydrometeor mixing ratios as control variables (CVlogq) can alleviate the problem but the high nonlinearity of logarithmic transformation can introduce spurious analysis increments into mixing ratios.In this study, power transform of hydrometeors is proposed to form new control variables (CVpq) where the nonlinearity of transformation can be adjusted by tuning exponent or power parameter p. The performance of assimilating radar data using CVpq is compared with those using CVq and CVlogq for the analyses and forecasts of five convective storm cases from spring of 2017. Results show that CVpq with p = 0.4 (CVpq0.4) gives the best reflectivity forecasts in terms of root mean square error and equitable threat score. Furthermore, CVpq0.4 has faster convergence of cost function minimization than CVq and produces less spurious analysis increment than CVlogq. Compared to CVq and CVlogq, CVpq0.4 have better skills of 0-3h composite reflectivity forecasts, and the updraft helicity tracks for the 16 May 2017 Texas and Oklahoma tornado outbreak case are more consistent with observations when using CVpq0.4.

COVID-19 Workplace Outbreaks by Industry Sector and their Associated Household Transmission, Ontario, Canada, January – June, 2020

IntroductionWorkplaces requiring in-person attendance of employees for ongoing operations may be susceptible to SARS-CoV-2 outbreaks that impact workers as well as their close contacts. To understand industry sectors impacted by workplace outbreaks in the first wave of the pandemic, and the additional burden of illness through household transmission, we analyzed public health declared workplace outbreaks between January 21 to June 30, 2020, and their associated cases from January 21 to July 28.MethodsNumber, size and duration of outbreaks were described by sector, and outbreak cases were compared to sporadic cases in the same time frame. Address matching identified household cases with onset ≥2 days before, ≥2 days after, or within 1 day of the workplace outbreak case.ResultsThere were 199 outbreaks with 1245 cases, and 68% of outbreaks and 80% of cases belonged to i) Manufacturing, ii) Agriculture, Forestry, Fishing, Hunting, iii) Transportation and Warehousing. Median size of outbreaks was 3 cases (range: 1-140), and lasted median 7days (range: 0-119). Outbreak cases were significantly more likely to be male, younger, healthier, and have better outcomes. There were 608 household cases associated with 339 (31%) outbreak cases with valid addresses, increasing the burden of illness by 56%. The majority of household cases (368, 60%) occurred after the outbreak case.ConclusionsWorkplace outbreaks primarily occurred in three sectors. COVID-19 prevention measures should target industry sectors at risk by preventing introduction from exposed employees, spread in the workplace, and spread outside of the workplace.What is already known about this topic?COVID-19 outbreaks occur within workplaces and can spread to the communityWhat is added by this report?From January 21 – June 30, 2020, there were 199 workplace outbreaks in Ontario, Canada; 68% of outbreaks and 80% of outbreak-associated COVID-19 case were in three industry sectors: Manufacturing, Agriculture/Forestry/Fishing/Hunting, and Transportation/Warehousing. Household transmission occurred among 31% of outbreak cases, resulting in a 56% increase in workplace outbreak-associated cases when burden of household transmission is considered.What are the implications for public health practice?Workplace outbreak prevention measures should be targeted to industry sectors at risk by preventing introduction from exposed employees, spread in the workplace, and transmission to the greater community.