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Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015

Year 2018, Volume: 75 Issue: 4, 399 - 408, 01.12.2018

Abstract

Amaç: Aynı yemek firmasında 25 Mayıs 2015’te hazırlanan öğle yemeğinden yeyen 7 ilçeden 872 öğrenci hastanelere bavurmuştur. Hastaneye başvuranların 406’sında bulantı, kusma, baş dönmesi ve titreme şikayetleri olduğu belirlenmiştir. Bu inceleme, hastalığın kaynağının ve bulaş yolunun tespit edilmesi ve kontrol önlemlerinin alınması amacıyla yapılmıştır. Yöntem: Bu retrospektif kohort çalışmasında olası vaka tanımı; etkilenen okullarda; 25 Mayıs 2015 tarihinde; “Karın ağrısı ve bulantı ve kusma şikâyetleri olan kişiler” olarak belirlenmiştir. 2.713 öğrenci, 137 öğretmen, 22 okul çalışanı ile yüz yüze görüşülmüştür. Etkeni tespit etmek için okullardan ve yemek firmasından su ve gıda örnekleri, hastalardan ve yemek firması çalışanlarından 37 tane gaita numunesi alınmıştır. Aynı zamanda gıda firması çalışanlarından burun ve boğaz sürüntü örnekleri alınmıştır. Bulgular: Öğle yemeği yiyen kişiler arasında atak hızı %52’dir 457/872 . Vaka sayısı 25 Mayıs 2015 tarihinde pik yapmıştır ve salgın eğrisi salgının tek kaynaklı bir salgın olduğunu düşündürmektedir. İnkübasyon süresi ortalama 3,3±1,5 saattir. Vakalarda başlıca görülen semptomlar karın ağrısı %84 , bulantı %83 , kusma %59 , ateş %30 ve ishaldir %29 . Salçalı makarna yiyen olası vakaların yemeyenlere göre hastalanma riski yaklaşık altı kattır RR: 5,6 %95 GA: 3,2-9,8 . Okullardan alınan salçalı makarna örneklerinde Staphylococcus aureus enterotoksini ve Bacillus cereus, yemek firmasından alınan salçalı makarnada Staphylococcus aureus enterotoksini üremiştir. Gıda işleyicilerinden alınan burun, boğaz ve gaita numunelerinde ve hastalardan alınan gaita numunelerinde Staphylococcus aureus tespit edilmemiştir. Sonuç: Bu salgın kontamine salçalı makarnadan kaynaklanmaktadır. İncelemede kontaminasyon kaynağı bulunamamıştır. Gıda firmasına kontrol ve önleme tedbirleri ve iyi hijyen uygulamalarının yerine getirilmesi önerilmiştir.

References

  • 1. Le Loir Y, Baron F, Gautier M, et al. Staphylococcus aureus and food poisoning. Genet Mol Res, 2003;2(1):63–76.
  • 2. Kadariya J, Smith TC, Thapaliya D. Staphylococcus aureus and Staphylococcal food-borne disease: An ongoing challenge in public health. BioMed Res Int. 2014:e827965.
  • 3. FoodBorne Diseases Strategy [23 Şubat 2017]. https://www.food.gov.uk/sites/default/files/ multimedia/pdfs/fds2015.pdf.
  • 4. Dorman V, Aslan S, Ceylan A, Küçük SN, Günel A, Sarı H, vd. Aynı fabrikadan yemek alan iki inşaat firması işçilerinde meydana gelen toplu besin zehirlenmesi. Dicle Tıp Derg. 2010;37(3). http://dergipark. ulakbim.gov.tr/dicletip/article/view/5000104293.
  • 5. Erdogan H, Arslan H. Nasal and pharyngeal carriage of Staphylococcus aureus among hotel staff and risk assessment. Klimik 2011;24(2):90–3.
  • 6. Zealand AN. agents of foodborn illness. [kaynak 07 Şubat 2017]; https://pdfs.semanticscholar.org/ d9db/bbaadff43e041e790e3fa540afb94d4cb5d9. pdf.
  • 7. Larsen HD, Jørgensen K. The occurrence of Bacillus cereus in Danish pasteurized milk. Int J Food Microbiol. 1997;34(2):179–86.
  • 8. Altaf, Musvı, S, Iqbal,Asıf, Ahmad, Manzoor, Hussaın,Syed Arshıd, Ahmad, Rayaz. Study of enterotoxigenicity of B. cereus emetic strain by skin vasopermeability reaction in rabbits and poultry. 2012 [kaynak 07 Şubat 2017]; http:// ijpbs.net/vol-3/issue-2/bio/18.pdf.
  • 9. Labbé RG, García S. Guide to Foodborne Pathogens. John Wiley & Sons; 2001. 398 s.
  • 10. Holmberg SD, Blake PA. Staphylococcal food poisoning in the United States. New facts and old misconceptions. JAMA, 1984;251(4):487–9.
  • 11. Doyle M. Foodborne Bacterial Pathogens. CRC Press; 1989. 818 s.
  • 12. Clayton D, Griffith C, Price P, Peters A. Food handlers’ beliefs and self-reported practices. Int J Environ Health Res, 2002;12(1):25–39.
  • 13. NSW Food Authority. Health and hygiene for food handlers. 2012, 16 Şubat 2017. http:// www.foodauthority.nsw.gov.au/_Documents/ retailfactsheets/health_hygiene_of_food_ handlers.pdf.
  • 14. Çakıcı N, Demirel Zorba NN, Akçalı A. Food industry employees and staphylococcal food poisoning. Turk Bull Hyg Exp Biol, 2015;72(4):337–50.
  • 15. Mossel D a. A, Netten P van. Staphylococcus aureus and related staphylococci in foods: ecology, proliferation, toxinogenesis, control and monitoring. J Appl Bacteriol, 1990;69:123S–145S.
  • 16. Todd EC. Epidemiology of foodborne diseases: a worldwide review. World Health Stat Q Rapp Trimest Stat Sanit Mond, 1997;50(1–2):30–50.
  • 17. Ageing AGD of H and. An outbreak of Clostridium perfringens and the enforcement of food safety standards. Australian Government Department of Health and Ageing; [07 Şubat 2017]. http:// www.health.gov.au/internet/main/publishing.nsf/ Content/cda-cdi3204j.htm.
  • 18. Mikroorganizma Dunyasindan. [23 Şubat 2017]. http://www.kalitesistem.com/ebulten/ ocak2012/Mikroorganizma_Dunyasindan.htm.
  • 19. Guide to confirming an etiology in foodborne disease outbreak | Foodborne Outbreaks | Food Safety | CDC. [20 Şubat 2017]. https://www. cdc.gov/foodsafety/outbreaks/investigatingoutbreaks/confirming_diagnosis.html.

Food-borne outbreak associated with Staphylococcal enterotoxin and Bacillus cereus in districts schools—Aksaray, Nevsehir and Nigde provinces, 2015

Year 2018, Volume: 75 Issue: 4, 399 - 408, 01.12.2018

Abstract

Objective: On 25th May 2015, 872 students of seven districts who had lunch prepared in the same food factory, applied to hospitals. It was found that 406 of them applied with nausea, vomiting, dizziness and chills. This investigation was conducted to identify the cause and mode of transmission, and to implement control measures. Methods: It was defined a probable case in this retrospective cohort study as “a person with nausea, vomiting and abdominal pain in schools affected by outbreak onset on 25th May 2015’’. It was conducted face-to-face interviews of 2713 students, 137 teachers and 22 school workers. In order to identify the agent, it was taken water and food samples from schools and food factory, 37 stool samples from patients and food handlers. It was also collected nasal and throat swabs of food-handlers at the food factory. Results: The attack rate among people who ate lunch was 52% 457/872 . Number of cases peaked on 25th May 2015 and epidemic curve revealed a singlesource outbreak. The mean incubation period was 3.3±1.5 hours. Main symptoms of cases were abdominal pain 84% , nausea 83% , vomiting 59% , fever 30% and diarrhea 29% . Probable cases who ate pasta with sauce developed illness 6 times more than non-exposed. Staphylococcus aureus enterotoxin and Bacillus cereus was identified at pasta with sauce samples taken from schools and Staphylococcus aureus enterotoxin was identified at pasta with sauce samples taken from food factory. Staphylococcus aureus wasn’t identified from the nose, throat and stool samples of food-handlers and stool samples of patients. Conclusion: This outbreak was likely due to contaminated pasta with sauce. It wasn’t found the contamination source the result of investigations couldn’t reveal the contamination source. We recommended the food factory to implement control and prevention measures and good hygiene practices.

References

  • 1. Le Loir Y, Baron F, Gautier M, et al. Staphylococcus aureus and food poisoning. Genet Mol Res, 2003;2(1):63–76.
  • 2. Kadariya J, Smith TC, Thapaliya D. Staphylococcus aureus and Staphylococcal food-borne disease: An ongoing challenge in public health. BioMed Res Int. 2014:e827965.
  • 3. FoodBorne Diseases Strategy [23 Şubat 2017]. https://www.food.gov.uk/sites/default/files/ multimedia/pdfs/fds2015.pdf.
  • 4. Dorman V, Aslan S, Ceylan A, Küçük SN, Günel A, Sarı H, vd. Aynı fabrikadan yemek alan iki inşaat firması işçilerinde meydana gelen toplu besin zehirlenmesi. Dicle Tıp Derg. 2010;37(3). http://dergipark. ulakbim.gov.tr/dicletip/article/view/5000104293.
  • 5. Erdogan H, Arslan H. Nasal and pharyngeal carriage of Staphylococcus aureus among hotel staff and risk assessment. Klimik 2011;24(2):90–3.
  • 6. Zealand AN. agents of foodborn illness. [kaynak 07 Şubat 2017]; https://pdfs.semanticscholar.org/ d9db/bbaadff43e041e790e3fa540afb94d4cb5d9. pdf.
  • 7. Larsen HD, Jørgensen K. The occurrence of Bacillus cereus in Danish pasteurized milk. Int J Food Microbiol. 1997;34(2):179–86.
  • 8. Altaf, Musvı, S, Iqbal,Asıf, Ahmad, Manzoor, Hussaın,Syed Arshıd, Ahmad, Rayaz. Study of enterotoxigenicity of B. cereus emetic strain by skin vasopermeability reaction in rabbits and poultry. 2012 [kaynak 07 Şubat 2017]; http:// ijpbs.net/vol-3/issue-2/bio/18.pdf.
  • 9. Labbé RG, García S. Guide to Foodborne Pathogens. John Wiley & Sons; 2001. 398 s.
  • 10. Holmberg SD, Blake PA. Staphylococcal food poisoning in the United States. New facts and old misconceptions. JAMA, 1984;251(4):487–9.
  • 11. Doyle M. Foodborne Bacterial Pathogens. CRC Press; 1989. 818 s.
  • 12. Clayton D, Griffith C, Price P, Peters A. Food handlers’ beliefs and self-reported practices. Int J Environ Health Res, 2002;12(1):25–39.
  • 13. NSW Food Authority. Health and hygiene for food handlers. 2012, 16 Şubat 2017. http:// www.foodauthority.nsw.gov.au/_Documents/ retailfactsheets/health_hygiene_of_food_ handlers.pdf.
  • 14. Çakıcı N, Demirel Zorba NN, Akçalı A. Food industry employees and staphylococcal food poisoning. Turk Bull Hyg Exp Biol, 2015;72(4):337–50.
  • 15. Mossel D a. A, Netten P van. Staphylococcus aureus and related staphylococci in foods: ecology, proliferation, toxinogenesis, control and monitoring. J Appl Bacteriol, 1990;69:123S–145S.
  • 16. Todd EC. Epidemiology of foodborne diseases: a worldwide review. World Health Stat Q Rapp Trimest Stat Sanit Mond, 1997;50(1–2):30–50.
  • 17. Ageing AGD of H and. An outbreak of Clostridium perfringens and the enforcement of food safety standards. Australian Government Department of Health and Ageing; [07 Şubat 2017]. http:// www.health.gov.au/internet/main/publishing.nsf/ Content/cda-cdi3204j.htm.
  • 18. Mikroorganizma Dunyasindan. [23 Şubat 2017]. http://www.kalitesistem.com/ebulten/ ocak2012/Mikroorganizma_Dunyasindan.htm.
  • 19. Guide to confirming an etiology in foodborne disease outbreak | Foodborne Outbreaks | Food Safety | CDC. [20 Şubat 2017]. https://www. cdc.gov/foodsafety/outbreaks/investigatingoutbreaks/confirming_diagnosis.html.
There are 19 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Fatma Özarslan This is me

Publication Date December 1, 2018
Published in Issue Year 2018 Volume: 75 Issue: 4

Cite

APA Özarslan, F. (2018). Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015. Türk Hijyen Ve Deneysel Biyoloji Dergisi, 75(4), 399-408.
AMA Özarslan F. Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015. Turk Hij Den Biyol Derg. December 2018;75(4):399-408.
Chicago Özarslan, Fatma. “Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin Ve Bacillus Cereus İlişkili Gıda Kaynaklı Salgın, 2015”. Türk Hijyen Ve Deneysel Biyoloji Dergisi 75, no. 4 (December 2018): 399-408.
EndNote Özarslan F (December 1, 2018) Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015. Türk Hijyen ve Deneysel Biyoloji Dergisi 75 4 399–408.
IEEE F. Özarslan, “Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015”, Turk Hij Den Biyol Derg, vol. 75, no. 4, pp. 399–408, 2018.
ISNAD Özarslan, Fatma. “Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin Ve Bacillus Cereus İlişkili Gıda Kaynaklı Salgın, 2015”. Türk Hijyen ve Deneysel Biyoloji Dergisi 75/4 (December 2018), 399-408.
JAMA Özarslan F. Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015. Turk Hij Den Biyol Derg. 2018;75:399–408.
MLA Özarslan, Fatma. “Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin Ve Bacillus Cereus İlişkili Gıda Kaynaklı Salgın, 2015”. Türk Hijyen Ve Deneysel Biyoloji Dergisi, vol. 75, no. 4, 2018, pp. 399-08.
Vancouver Özarslan F. Aksaray, Nevşehir, Niğde İllerindeki İlçe Okullarında Stafilokokal Enterotoksin ve Bacillus cereus İlişkili Gıda Kaynaklı Salgın, 2015. Turk Hij Den Biyol Derg. 2018;75(4):399-408.