Rapid-onset Gastrointestinal Illness Following a Funeral Ceremony in Northern Thailand: A Staphylococcal Food Poisoning Outbreak Investigation, June 2025
DOI:
https://doi.org/10.59096/osir.v19i3.280369Keywords:
Staphylococcus aureus, staphylococcal food poisoning, foodborne outbreak, outbreak investigationAbstract
Objectives: On 15 Jun 2025, a cluster of acute gastrointestinal illness cases was reported among attendees of a funeral ceremony in Phayao Province, Thailand. We conducted an investigation to identify the etiology and describe the epidemiological characteristics of the outbreak, determine associated risk factors, and recommend prevention and control measures.
Methods: A suspected case was defined as any person who attended the funeral or consumed food served at the event and developed at least one gastrointestinal symptom during 15–17 Jun 2025. An active case finding together with interviews, medical record reviews, environmental assessments and laboratory testing of clinical, food handler, and food specimens were conducted. A retrospective cohort study was conducted. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs).
Results: Among 311 participants, 188 cases were identified (60.5%). Common symptoms were nausea (89.9%), vomiting (83.5%), abdominal pain (71.3%), and diarrhea (53.2%). The shortest incubation period was one hour, and the median was four hours (interquartile range 3–5 hours). All cases reported consumption of red pork with rice, with no illness among unexposed participants. In multivariable analysis, rice (AOR 21.34; 95% CI 3.19–142.75) and boiled eggs (AOR 3.10; 95% CI 1.08–8.92) were associated with illness. Methicillin-susceptible Staphylococcus aureus was isolated from vomitus, food samples, and a food handler’s hand swab. Environmental assessment identified prolonged storage of food at room temperature, inadequate hand hygiene practices, reuse of ice, and low residual free chlorine levels.
Public Health Recommendations: Findings supported staphylococcal food poisoning associated with contaminated food. Proper hand hygiene, prevention of cross-contamination, safe food storage, temperature control, strengthened food safety training, and improved catering supervision are recommended.
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