Abstract
BACKGROUND: Salmonella species is one of the bacteria under laboratory-based surveillance system in Malaysia since 2002. On 7th October 2018, notifications received on two deaths from different family were related with history of consumption of Laksa Kebok, bought at Kupang, Baling Kedah on 4th October 2018. The symptoms were described as fever, diarrhoea, vomiting, abdominal pain after consumptions. The assessment team were mobilized aims to verify the outbreak, describe the epidemiological characteristics of the outbreak, to identify the source and infection and implement control measures. METHODS: Active case detection was performed looking for cases who had symptoms of diarrhoea, vomiting and abdominal pain or fever and who had consumed Laksa Kebok, Kupang Baling on 4th October 2018 onwards. We evaluated the status of hygiene and sanitation, food and water supply used. All clinical and environmental samples were sent for chemical and microbiological test. DNA fingerprinting was performed by Pulsed Field Gel Electrophoresis (PFGE) at National Public Health Laboratory. RESULTS: Total attack rate was 93.2% (83/89). Women were higher compared with men, mean age of cases 31 years old. Major clinical manifestation was diarrhoea (86.7%), fever (65.1%), vomiting (53.0%), abdominal pain (50.6%) and others. About 8.4% required admission. Case fatality rate 2.4%. Of 20 isolates from clinical samples, 16 isolates were identified as Salmonella Weltevreden. The PFGE results showed >99% genetic similarity and were grouped as one cluster. CONCLUSION: Cross contamination with S. Weltevreden due to improper storage of dough Laksa, in adequate cooking temperature and insufficient time boiling of Laksa noodles possibility causing the outbreak.
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@proceedings{APCPH-2019-34,
title = {An Outbreak of Salmonella Enterica Serovar Weltevreden; Cases from Kedah, Perak and Selangor After Consumption of Laksa Kebok, Kupang Baling Kedah, Malaysia on 4th October 2018},
author = {Sunita AR and Asiah A and Faridah A and Natrah MS and Wan Noraini WY and Noriah I and Mohd HZ and Zainatul E and Azhar AA and Yusoff H and Hani MH and Norhayati R},
year = {2019},
date = {2019-07-22},
urldate = {2019-07-22},
journal = {6th Asia-Pacific Conference on Public Health 2019 Proceedings},
issue = {6},
abstract = {BACKGROUND: Salmonella species is one of the bacteria under laboratory-based surveillance system in Malaysia since 2002. On 7th October 2018, notifications received on two deaths from different family were related with history of consumption of Laksa Kebok, bought at Kupang, Baling Kedah on 4th October 2018. The symptoms were described as fever, diarrhoea, vomiting, abdominal pain after consumptions. The assessment team were mobilized aims to verify the outbreak, describe the epidemiological characteristics of the outbreak, to identify the source and infection and implement control measures. METHODS: Active case detection was performed looking for cases who had symptoms of diarrhoea, vomiting and abdominal pain or fever and who had consumed Laksa Kebok, Kupang Baling on 4th October 2018 onwards. We evaluated the status of hygiene and sanitation, food and water supply used. All clinical and environmental samples were sent for chemical and microbiological test. DNA fingerprinting was performed by Pulsed Field Gel Electrophoresis (PFGE) at National Public Health Laboratory. RESULTS: Total attack rate was 93.2% (83/89). Women were higher compared with men, mean age of cases 31 years old. Major clinical manifestation was diarrhoea (86.7%), fever (65.1%), vomiting (53.0%), abdominal pain (50.6%) and others. About 8.4% required admission. Case fatality rate 2.4%. Of 20 isolates from clinical samples, 16 isolates were identified as Salmonella Weltevreden. The PFGE results showed \>99% genetic similarity and were grouped as one cluster. CONCLUSION: Cross contamination with S. Weltevreden due to improper storage of dough Laksa, in adequate cooking temperature and insufficient time boiling of Laksa noodles possibility causing the outbreak.},
note = {Type: ORAL PRESENTATION; Organisation: 1Surveillance/Communicable Disease Unit, Kedah State Health Department, 2Perak State Health Department, 3National Public Health Laboratory, Sg Buluh, 4Baling District Health Office, 5Selangor State Health Department, 6Communicable Disease Division, Malaysia Ministry of Health, 7Food Safety and Quality, Kedah State Health Department},
keywords = {apcph2019, food poisoning, laksa kebok, salmonella weltevreden},
pubstate = {published},
tppubtype = {proceedings}
}