epiH Search


Epidemiol Health > Accepted Articles
Epidemiology and Health 2019;e2019002.
DOI: https://doi.org/10.4178/epih.e2019002    [Accepted] Published online January 9, 2019.
A large outbreak of Salmonella enterica Serovar Thompson Infections associated with chocolate cake in Busan, Korea
Youngduck Eun1,4  , Hyunjin Son1,4  , Hyesun Jeong1,4  , Seungjin Kim1,4  , Wonseo Park1  , Byoungseon Ahn2,4  , Dongkeun Kim2,4  , Eunhee Kim2,4  , Eunhee Park3,4  , Sunhee Park3  , Inyeong Hwang3 
1Busan Center for infectious Disease Control and Prevention, Busan National University Hospital, Busan, Korea
2Division of Health Promotion, Busan Metropolitan City, Busan, Korea
3Division of Microbiology, Busan Institute of Health and Environment, Busan, Korea
4Epidemic investigation team of Busan Metropolitan City, Busan, Korea
Correspondence  Hyunjin Son ,Tel: +82-51-888-6934, Fax: +82-51-888-6939, Email: hjson78@gmail.com
Received: October 11, 2018  Accepted after revision: December 5, 2018
This study aimed to reveal the epidemiologic characteristics of the outbreak of gastroenteritis caused by Salmonella enterica serovar Thompson in Busan Metropolitan City and to identify points for improvement to prevent of food-borne disease outbreak.
This was a case-control study. The control group comprised asymptomatic students in the same classes of the cases. The presence or absence of symptoms, ingestion of each food provided by school meal service, and commonly ingested foods in addition to those foods in meal service were investigated. Moreover, specimens collected from rectal swab, preserved foods, and environmental surface were tested.
Of the 6,092 subjects, 1,111 (1,083 students, 22 school personnel, and 6 foodservice employees) were included in the case group; this corresponded to an 18.4% attack rate. Symptoms included diarrhea (n=1,051 subjects, 94.6%), abdominal pain (n=931 subjects, 83.8%), febrile sensation (n=502 subjects, 45.2%), and vomiting (n=275 subjects, 24.8%). The epidemic curves of each 10 schools were unimodal. Investigation of food intake showed a significantly high odds ratio for chocolate cake in 5 out of the 10 schools. Laboratory test detected Salmonella enterica serovar Thompson both in rectal swab specimens of 9 schools and in collected preserved chocolate cakes of 9 schools. Pulsed-field gel electrophoresis test result showed that Salmonella enterica seorvar Thompson isolated from human and foods were the same.
The source of infection for the Salmonella enterica serovar Thompson outbreak in the 10 schools of Busan Metropolitan City is chocolate cake. Traceback investigation for origin of contaminated food in food-borne disease outbreak and safety control during food production should be more enhanced.
Keywords: Food borne disease; Salmonella infections; Outbreak; Busan


Browse all articles >

Editorial Office
Graduate School of Cancer Science and Policy, National Cancer Center
323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea
TEL: +82-2-745-0662   FAX: +82-2-764-8328    E-mail: enh0662@gmail.com

Copyright © 2019 by Korean Society of Epidemiology. All rights reserved.

Developed in M2community

Close layer
prev next