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Year : 2021  |  Volume : 65  |  Issue : 5  |  Page : 10-13

Foodborne Disease outbreak associated with eating Gaajar Halwa at a Wedding – Palghar District, Maharashtra, India, 2018

1 Epidemic Intelligence Service Officer, National Centre for Disease Control, New Delhi, India
2 Coordinator, Epidemic Intelligence Service Programme, National Centre for Disease Control, New Delhi, India
3 Public Health Specialist, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, New Delhi, India
4 District Epidemiologist, Health Department, Zilla Parishad (District Council), Palghar, Maharashtra, India
5 State Surveillance Officer, Office of Joint Director of Health Services, Maharashtra, India

Correspondence Address:
Vaishali Vardhan
National Centre for Disease Control, 22 Shamnath Marg, New Delhi - 110 054
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijph.IJPH_1099_20

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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.

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