Multipathogen Outbreak of Bacillus cereus and Clostridium perfringens Among Hospital Workers in Alaska, August 2021.

IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Reports Pub Date : 2024-03-01 Epub Date: 2023-05-13 DOI:10.1177/00333549231170220
Katherine Newell, Kathryn Helfrich, Heidi Isernhagen, Martin Jones, Gabriela Stickel, Haley McKeel, Louisa Castrodale, Joseph McLaughlin
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Abstract

Objective: Clostridium perfringens and Bacillus cereus are common causes of reported foodborne illness. On August 6, 2021, the Alaska Division of Public Health identified a multipathogen gastrointestinal outbreak among hospital staff in Homer, Alaska. The objectives of this study were to identify the outbreak source and prevent future illness.

Methods: We conducted a retrospective cohort study of hospital staff who participated in luncheon events during August 5-7, 2021, and used an online survey to identify hospital staff with gastrointestinal illness. We defined case patients as people who reported new-onset gastrointestinal illness (diarrhea or abdominal cramping) after food consumption during the luncheon events. We calculated adjusted odds ratios of gastrointestinal illness associated with reported food exposures. We tested available food samples for C perfringens and B cereus and tested case patient stool specimens for C perfringens. We conducted an environmental investigation at the implicated vendor site.

Results: Of 202 survey responses, 66 (32.7%) people reported acute gastrointestinal illness: 64 (97.0%) reported diarrhea, 62 (94.9%) reported abdominal cramps, and none were hospitalized. Of 79 people who consumed ham and pulled pork sandwiches, 64 (81.0%) met the case definition; this food item was significantly associated with increased odds of gastrointestinal illness (adjusted odds ratio = 296.4; 95% CI, 76.7-2019.1). C perfringens and B cereus were isolated at confirmatory levels from sandwich samples. C perfringens enterotoxin was detected in all 5 stool specimens tested. Environmental investigators observed other food items at the sandwich vendor that were refrigerated outside the required temperature range (>41 °F); no clear handling deficiencies for the implicated food were identified.

Conclusion: Quick notification and effective collaboration can help detect an outbreak, identify the responsible food vehicle, and mitigate further risk.

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2021 年 8 月,阿拉斯加州医院工人中爆发蜡样芽孢杆菌和产气荚膜梭状芽孢杆菌的多病原体疫情。
目的:产气荚膜梭菌和蜡样芽孢杆菌是报告的食源性疾病的常见病因。2021 年 8 月 6 日,阿拉斯加公共卫生部发现阿拉斯加霍默市的医院员工中爆发了多病原体肠胃疾病。本研究的目的是确定疫情来源并预防未来的疾病:我们对 2021 年 8 月 5-7 日期间参加午餐会活动的医院员工进行了回顾性队列研究,并通过在线调查确定了患有肠胃疾病的医院员工。我们将病例患者定义为在午餐会期间进食后报告新发胃肠道疾病(腹泻或腹部绞痛)的人员。我们计算了与报告的食物接触相关的胃肠道疾病调整后几率比。我们对现有的食物样本进行了产气荚膜杆菌和蜡样芽孢杆菌检测,并对病例患者的粪便样本进行了产气荚膜杆菌检测。我们在涉事供应商所在地进行了环境调查:在202份调查回复中,66人(32.7%)报告了急性胃肠道疾病:64人(97.0%)报告了腹泻,62人(94.9%)报告了腹部绞痛,没有人住院治疗。在食用火腿和拉猪肉三明治的 79 人中,有 64 人(81.0%)符合病例定义;这种食品与胃肠道疾病几率的增加有显著相关性(调整后的几率比 = 296.4;95% CI,76.7-2019.1)。从三明治样本中分离出的产气荚膜杆菌和蜡样芽孢杆菌达到了确证水平。在检测的 5 份粪便样本中都检测到了 C perfringens 肠毒素。环境调查人员观察到三明治供应商冷藏的其他食品超出了规定的温度范围(>41 °F);未发现涉事食品有明显的处理缺陷:快速通知和有效合作有助于发现疫情、确定食品运输工具并降低进一步的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Public Health Reports
Public Health Reports 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.00
自引率
6.10%
发文量
164
审稿时长
6-12 weeks
期刊介绍: Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.
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