Scombrotoxin Food Poisoning Outbreak among Frozen Seafood Factory Workers Samut Prakan Province, Thailand, July 2007
No Thumbnail Available
Date
2010-05-24
Journal Title
Journal ISSN
Volume Title
Publisher
Outbreak, Surveillance and Investigation Reports
Abstract
Background: Scombroid Food Poisoning or histamine food poisoning is caused by consumption of foods that contain high level of histamine such as spoiled fish of families Scombridae and Scomberesocidae. Most commonly found in the U.S., and New Zealand, however, never been reported in Thailand. On 24 July 2007, Bureau of Epidemiology received a notification from Samutprakarn Provincial Health Office that 28 cases of food poisoning cases, 3 hospitalized, occurs among employees in frozen seafood factory in Samutprakarn Province. We conducted investigation during 24-25 July 2007 to confirm outbreak, verify diagnosis, define etiologic agent and implement control and prevention measure. Methods: We reviewed medical records of cases and interviewed cases and factory staff during active case finding. An unmatched case-control study was conducted among factory employees. Cases were defined as employees who worked at frozen seafood factory on 21 July 2007 with two major symptoms or one major symptom plus two minor symptoms. Major symptoms included nausea, vomiting, flushing, diarrhea, abdominal cramps, oral numbness, extremity numbness, dry mouth, rash, itching and swelling. Minor symptoms included headache, diplopia, fever and fatigue. Controls were selected by systematic sampling of employees listed in factory records. Left-over fermented tunas were sent for bacterial culture and histamine assay. Results: Overall attack rate was 8.4% (89/1,054). The mean age of cases was 31.2 years (SD=7.3). Common symptoms included headache (71.9%), dry mouth (59.6%), fatigue (59.6%), nausea (58.4%), and diarrhea (53.9%). The median incubation period was 120 minutes (Interquartile range: 60-180 minutes). Most cases were recovered within 8-12 hours. Eating fried fermented tuna was identified as a strong risk factor of food poisoning (OR=59.5, 95%CI=9.8-2409.1). Dose-response relationship between getting illness and consuming fried fermented tuna was identified (p
Description
Keywords
Citation
Outbreak, Surveillance and Investigation Reports; Issue 1, Vol 2, 2009; 5-8