Three students staying in the same house developed symptoms of diarrhoea after a meal. Noe of the other family members who also had the meal had the symptoms. The list of food items the students took is given below.
Bitter GourD
Yes 3 100.0%
Total 3 100.0%
Chicken
Yes 3 100.0%
Total 3 100.0%
Fried fish
No 3 100.0%
Total 3 100.0%
Fried Mee Hoon
Yes 3 100.0%
Total 3 100.0%
Kangkong
Yes 1 33.3%
No 2 66.7%
Total 3 100.0%
Milo
Yes 1 33.3%
No 2 66.7%
Total 3 100.0%
Nasi Lemak
Yes 3 100.0%
Total 3 100.0%
Orange juice
Yes 3 100.0%
Total 3 100.0%
Papadam
Yes 1 33.3%
No 2 66.7%
Total 3 100.0%
Popia Gulung
Yes 3 100.0%
Total 3 100.0%
Rice
Yes 3 100.0%
Total 3 100.0%
Sambal
Yes 2 66.7%
No 1 33.3%
Total 3 100.0%
Tea
Yes 2 66.7%
No 1 33.3%
Total 3 100.0%
1) To continue with the investigations what questions needs to be asked to the family members who participated in the meal?
2) From this incubation period what is the suspect organism?
3) When investigating a diseases outbreak it is important to get the sequence of the onset of symptoms. Why is this?
4) Can you short list the suspect food items? What additional questions need to be asked about the food items in question? Why? What relation is there to incubation period?
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2 comments:
1) To continue with the investigations what questions needs to be asked to the family members who participated in the meal?
To continue with the investigations, one can further probe other family members whether have they had the similiar symptoms after eating the same food as the 3 infected persons.
2) From this incubation period what is the suspect organism?
Streptococcal infection
3) When investigating a diseases outbreak it is important to get the sequence of the onset of symptoms. Why is this?
It is important to know the sequence of the onset of the symptoms because it that way, one can find out the incubation period and the infective period. From here, we can judge whether the person is in a critical condition or the other way round
4) Can you short list the suspect food items? What additional questions need to be asked about the food items in question? Why? What relation is there to incubation period?
The suspected food items can be either Nasi Lemak or Popia Gulung. The additional questions which need to be asked is whether how was the food being prepared. This is because Streptococcal infection can be passed down when the food is still warm and later been cooled down (food such as the items which has coconut source, etc) before it is being consumed. The incubation period for streptocaccal infection normally takes about 6 to 12 hours.
Ans 2) Streptococcal food poisoning is incorrect.
Please see the following sites.
http://www.safete.com/safetyarticles/foodpoisoning/foodpoisoning.html
http://pathmicro.med.sc.edu/fox/strep-staph.htm
Ans 3) Incorrect. The sequence of onset of disease has to be obtained to describe the disease and its natural history. This will help confirm diagnosis clinically. The incubation period is obtained from time of consumption to time of first symptoms. It helps identify the organism. For Staph food poisoning 6-12 hrs.
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