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A foodborne outbreak of gastroenteritis caused by Vibrio parahaemolyticus associated with cross-contamination from squid in Korea
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Sun-Wha Jung
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Epidemiol Health. 2018;40:e2018056. Published online November 13, 2018
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DOI: https://doi.org/10.4178/epih.e2018056
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Abstract
OBJECTIVES
Water-borne diseases caused by Vibrio parahemolyticus are often known to cause gastritis when raw or undercooked seafood is eaten. It is very rare that Vibrio gastritis caused by ingesting non-seafood products occurs on a large scale. On September 19, 2017, a large-scale Vibrio gastritis occurred after the city residents consumed food at a bazaar held in a welfare center in Jungnang-gu, Seoul.
METHODS The total number of visitors was approximately 299, and 237 (79.3%) of them showed symptoms. Among those who showed symptoms, 116 (48.9%) consulted the hospital, and 53 (45.6%) were hospitalized. Among the 299 exposed individuals, 174 (58.1%) responded to this survey: 163 (93.6%) with and 11 (6.4%) without symptoms. This study was retrospectively conducted by investigating the exposed individuals. To investigate the spread of infection, medical staff of hospitals in the epidemic area were interviewed, exposed individuals surveyed, microbiological testing conducted, and ingredient handling and cooking processes investigated.
RESULTS A total of 237 individuals, including 6 food handlers, were affected (prevalence, 79.2%). During the microbiological testing, V. parahemolyticus was found in 34 patients and 4 food handlers. In the consumption analysis, the relative risk of kimbap was 6.79 (confidence interval 1.10 to 41.69). In-depth investigation found that squid, an ingredient of Korean pancake, and egg sheets, an ingredient of kimbap, were prepared using the same cutting board and knife, which were thought to be the cause of cross-contamination that led to a large-scale outbreak of Vibrio gastritis.
CONCLUSIONS A recent large-scale outbreak of Vibrio gastritis occurred due to the cross-contamination with kimbap during the preparation process of squid rather than the actual consumption of seafood. Thus, a more stringent hygiene management is necessary during the processing and management of food to prevent infections associated with V. parahemolyticus.
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Summary
Korean summary
비브리오 장염은 흔히 날 것이나 덜 익힌 해산물을 섭취하였을 경우 잘 생기는 것으로 알려져 있다. 그러나 해산물을 처리하는 과정에서 생긴 교차 감염에 의해서도 비브리오 장염이 생길 수 있으며 이로 인하여 대규모의 유행이 발생할 수 있다. 이에 보다 철저한 위생관리와 교육이 필요하다
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Citations
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