Background:
A foodborne disease outbreak among wedding attendees from Makunsar village, Palghar district, Maharashtra state, India, was reported on February 18, 2018.
Objectives:
The outbreak investigation was conducted to find out the epidemiology of the outbreak and to identify the etiologic agent and risk factors.
Methods:
A case–control study was carried out, where cases (patients), controls, and food handlers were interviewed and leftover foods were collected for culture. A case was defined as a person having vomiting or diarrhea (i.e., ≥3 loose stools within 24 h) who attended the wedding ceremony at Makunsar village, Palghar district, Maharashtra, on February 18, 2018. Attack rate and odds ratio (OR) were calculated with 95% confidence intervals (CIs).
Results:
Out of 75 cases, 63% were female. Altogether, forty-two (56%) cases were hospitalized, and later on, all of them were discharged from hospital without any mortality. About 93%, 68%, 43%, and 41% of the cases reported with vomiting, nausea, abdominal pain, and diarrhea, respectively. The median incubation period was found to be 4 h (range: 2–8 h). Eating
gaajar halwa
(carrot pudding) was significantly associated with illness (OR: 12.8; 95% CI: 3.5–46).
Gaajar halwa
is prepared with
khoa
, a perishable milk product. The
gaajar halwa
culture yielded no growth.
Conclusion:
The case-patients’ clinical presentation and incubation period were consistent with enterotoxin-producing
Staphylococcus aureus
as the probable etiologic agent. The epidemiologic investigation identified the probable etiologic agent and food source in a low-resource community setting. Community food handlers were educated on food preparation hygiene and safe storage measures to prevent future outbreaks.