論文ID: JJID.2014.460
In June 2013, a diarrheal outbreak occurred among high school students in Incheon, South Korea. We investigated the outbreak to identify the pathogen and the mode of transmission. A case-control study was conducted using self-administered questionnaire by local authorities and the Korean Centers for Disease Control and Prevention. Bacterial cultivation was performed on stool, environmental samples, and samples of preserved food items. PCR and serotyping were used for the identification of bacteria. Pulsed-field gel electrophoresis (PFGE) was performed on the outbreak-related pathogens. We identified 54 cases of gastroenteritis, with symptoms including diarrhea, abdominal pain, and nausea. None of the food items served were significantly associated with illness, although the odds ratio for kippered trotters mixed with vegetables was elevated (odds ratio: 2.92, 95% confidence interval: 0.62–13.69). Enteroaggregative E. coli (EAEC) was isolated from kippered trotters mixed with vegetables and stool samples from 22 cases and 4 asymptomatic food handlers. The PFGE patterns of EAEC isolated from cases, food handlers, and the food were indistinguishable. This outbreak was caused by EAEC, and kippered trotters mixed with vegetables were linked to the outbreak, which might have been contaminated by asymptomatic food handlers. This case highlights the importance of safe food preparation.
