An outbreak investigation of Acute diarrhea in a school, Sanpatong District, Chiangmai Province, Thailand, September 2020

Abstract

On 14 September 2020, thirteen acute diarrhea patients, all of them lived at one school in Sanpatong district, were notified to SRRT Sanpatong, Chiangmai province. We investigated this event to confirm a diagnosis, confirm the outbreak, describe the epidemiology of the outbreak, and implement control measures. We conducted a descriptive study by reviewing medical records, interviewing patients who had acute diarrhea at Sanpatong hospital, and conducted the active case finding. The analytic study was conducted by a questionnaire for searching foods that had risk to cause of acute diarrhea. An environmental study was conducted by surveying the canteen of school and interviewing cooks. A laboratory study was conducted by collecting rectal swabs for searching pathological organisms by stool culture and collecting samples for searching coliform bacteria by SI-2 testing. Results showed twenty-eight cases had acute diarrhea. Male was 39.29 percent and female 40.71 percent. The age average was 14.17-year-olds. The attack rate was 13.15%.  Clinical presentations of patients were loose stool, abdominal pain, liquid instead of a formed stool, fatigue, and nausea/vomiting. Food which had risk to cause of acute diarrhea was pork snack & fresh vegetable.  An environmental study showed the canteen had a good food sanitation standard. A laboratory study showed no pathological organism, Vibrio spp., Salmonella spp. และ Shigella spp., from stool culture, but we found coliform bacteria in kitchenware, food container, and cook’s hand. So that we confirmed an outbreak of acute diarrhea in a school, Sanpatong District, Chiangmai between 4-24 September 2020. The pathogen of this outbreak was coliform bacteria.