Outbreak of seafood‐related food poisoning from undetectable Vibrio parahaemolyticus‐like pathogen, Chiang Mai Province, Thailand, December 2020

Abstract

Objective: On 1 December 2020, the Department of Disease Control of Thailand was notified of a cluster of food poisoning cases among participants at a church festival in Mae Ai district, Chiang Mai province. We conducted an outbreak investigation to confirm diagnosis, describe the epidemiological characteristics of the outbreak, identify possible sources of the outbreak and provide appropriate control measures. Methods:We reviewed medical records of the food poisoning cases from the health care centres. Active case finding was conducted among participants who had consumed food and water at the festival. An environmental survey was done in the village where the festival was held. A case-control study was conducted to identify the source of the outbreak. Samples for laboratory analysis included rectal swabs and fresh stool specimens from the cases and food handlers, surface swabs of cooking equipment, food, water and ice samples.Results: Among 436 participants surveyed, 368 (84.4%) cases of food poisoning were identified. The most common clinical manifestation was abdominal pain (89.7%), followed by watery diarrhoea (45.7%), nausea (43.5%), vomiting (38.9%), fever (18.5%) and bloody diarrhoea (4.6%). None died in this outbreak. The case-control study showed that mixed spicy seafood salad served in the festival was significantly associated with the disease by both univariable and multivariable analyses. However, the causative agent could not be identified. The environmental investigation suggested this seafood might have been undercooked. Conclusion:Clinical manifestations of the cases, incubation period and the suspected seafood salad suggested seafood-related food poisoning. Grimontia hollisae, the organism causing illness similar to Vibrio parahaemolyticus and commonly undetectable in the laboratory with routine testing, might be the pathogen that caused this outbreak.G. hollisae should be in differential diagnosis and identified in seafood-associated outbreaks.

An Overview of the Public Health Challenges in Diagnosing and Controlling Human Foodborne Pathogens

“…Many studies and reports [28][29][30][31][32] have found that intestinal cramping, diarrhea, vomiting, anxiety, chills and breathing difficulties are common signs of foodborne illnesses. These signs are caused either by consumed microorganisms, or toxic infections, such as Clostridium perfringens [33,34], or by microbial toxins produced by the microorganisms [35,36].…”

Meta-Analysis and Systematic Review of Phenotypic and Genotypic Antimicrobial Resistance and Virulence Factors in Vibrio parahaemolyticus Isolated from Shrimp

“…Historically linked to seafood, such as shrimp, oysters, clams, and cockles, V. parahaemolyticus received recognition for its pathogenic potential in humans in 1950 following a major outbreak in Japan in which contaminated sardine with the bacterium led to 20 fatalities and 270 hospitalizations [7]. Subsequently, outbreaks stemming from the consumption of raw or undercooked seafood tainted with V. parahaemolyticus have been documented in various countries, including the USA, Thailand, Vietnam, China, Spain, and Chile [8][9][10][11][12][13]. The disease pathogenesis of V. parahaemolyticus infections is caused by virulence factors such as thermostable direct hemolysin (TDH) or TDH-related hemolysin (TRH), encoded by tdh and trh genes, respectively.…”

Research progress on detection techniques for point-of-care testing of foodborne pathogens

“…Viruses commonly reported are Norovirus and Hepatitis A, while examples of parasites involved are Cryptosporidium spp, Giardia lamblia , Trichinella spiralis , Cyclospora spp, Toxoplasma canis, and Entamoeba histolytica ( Stryinski et al, 2020 ; Bozkurt et al, 2021 ; Lee and Yoon, 2021 ; Segeritz et al, 2021 ; Patel et al, 2022 ). Typical symptoms of foodborne illness include abdominal pain, diarrhea, vomiting, nausea, fever, difficulty breathing, and even death in severe cases ( Abebe et al, 2020 ; Aik et al, 2020 ; Myintzaw et al, 2021 ; Sun et al, 2021 ; Janekrongtham et al, 2022 ). These symptoms are caused by ingested pathogens, such as foodborne infections ( Salmonellosis , Listeriosis , etc.)…”