A food poisoning outbreak in Al-Khazir U2 camp of internally displaced persons - Iraq, summer 2017

K Fathallah; Kamal Kadhim; A Jaafar; A Hamad; S Saadoon; Z Awad F Lami

doi:10.21767/2572-5483-C1-003

A food poisoning outbreak in Al-Khazir U2 camp of internally displaced persons - Iraq, summer 2017

9^th Edition of International Conference on Preventive Medicine & Public Health
July 16-17, 2018 London, UK

K Fathallah, Kamal Kadhim, A Jaafar, A Hamad, S Saadoon and Z Awad F Lami

University of Baghdad, Iraq

Posters & Accepted Abstracts: J Prev Med

DOI: 10.21767/2572-5483-C1-003

Abstract

Background: Globally, about 600 million fall ill and 420,000 die every year after eating contaminated food. On June 12, 2017, Iraq CDC informed about a food poisoning outbreak among internally displaced persons (IDPs) in Al-Khazir camp, Northern Iraq after consuming iftar (Ramadan breakfast) provided by an NGO. Iftar was composed of rice, white bean broth, chicken, yogurt, date and bread. We conducted this study to describe the outbreak, identify the causative agent and recommend preventive measures. Methods: A team of field epidemiology training program (FETP) residents dispatched to investigate the outbreak. The case patient was defined as any person in the camp who ate iftar and developed nausea/vomiting or diarrhea or abdominal pain. A retrospective cohort study was initiated. Results: The total number of IDPs in the camp was 6,425; 1,470 (22.9%) were in sections C, D and E who got iftar and all were directly interviewed. The mean age of patients was 19 (±15years), and the female, male ratio was 1.1:1. The attack rate was 91%. The most frequent symptoms were nausea and vomiting (86.6%), abdominal pain (68.4%) and diarrhea (59%). The range of incubation period was 15 minutes-16 hours; 62.2% had symptoms after three hours. About 72% of patients treated in the nearby primary health care (PHCs) and 28% transferred to the ER. None of the patients was hospitalized or died. The implicated food items were: rice (RR=1.4; 95% CI: 1.2-1.6) and chicken (RR=1.2; 95% CI: 1.1-1.3). Laboratory results of examined leftover food samples revealed Staphylococcus aureus growth. All meals were prepared by one restaurant, not kept in refrigerators and served after 10 hrs. For legal causes, the team was not allowed to assess the restaurant or examine the workers. Conclusions: The large number of ordered meals from a single restaurant led to suboptimal food preparation and storage. We recommended rigorous implementation of food handing instructions and health education of the food handlers.