Outbreak investigation of acute diarrhea in a school of Sao Hai District Saraburi Province

Abstract

An outbreak of acute diarrhea was notified at a school in Sao Hai District, Saraburi Province, from June 19 to 30, 2024. This study aimed to confirm the outbreak, describe the epidemiological characteristics of the patients, identify the causing pathogen and risk factors, and implement the control measures to prevent further spread. Data were collected from medical records of patients treated at Sao Hai Hospital, and a retrospective cohort study was conducted by interviewing teachers, students, and staff about their consumption of food, water, and ice at the school. Laboratory tests were performed on stool samples from patients and food handlers, as well as water and ice samples from the school. The results showed 74 affected individuals, with 38 diagnosed cases (attack rate: 51.35%). Six patients were hospitalized, but no fatalities occurred. Most cases had watery diarrhea (94.74%), vomiting (78.95%), and abdominal pain (73.68%). Laboratory tests identified rotavirus in patient samples, and both rotavirus and norovirus were found in water and ice samples. An analytical study revealed that drinking water from a dispenser near the first-grade classroom was a significant risk factor for developing the illness (Adjusted OR=5.2, 95% CI: 1.3-20.8). The outbreak is likely caused by viral contamination, particularly from the water dispenser. To prevent future outbreaks, it is recommended that the school regularly clean and disinfect the water dispensers.