Outbreak Investigation of Escherichia coli Diarrhea among Military Academy School Students in Prachaup Kiri Khan

Abstract

          On May 22th, 2015, Prachaup Kiri Khan Provincial Health Office received a notification from the Pranburi district Surveillance and Rapid Response Team (SRRT) about abdominal pain, nausea and watery diarrhea but were not severely among Military academy school students since May 12th, 2015. The SRRT conducted a investigation in the area, identify risk factors of diarrhea and provide preventing and controlling measures during May 22th-25th, 2015.
          A descriptive study was carried-out to identify suspected water/food items in Military academy school. A diarrhea case was defined as a students and staffs who had watery diarrhea during May 1st - June 9th, 2015. Data were collected by questionnaire. A rectal swab and environmental inspection such as tap water, drinking water samples were collected for bacterial culture. The data were analyzed using descriptive statistics for study of the distribution and determinants of disease including frequency, percentage and median.
          The study revealed that of 55 diarrhea cases among 1,330 students and staffs surveyed (4.14 %), median of age was 19.5 years. Most common symptoms were fever and liquefied diarrhea (100 %), abdominal pain (61.82 %), vomiting (34.55 %), nausea (27.27 %), fatigue (14.55 %) and watery diarrhea (6.4 %). Of 6 rectal swabs were cultured negative. MPN Coliforms was 5 cultured positive more than 23/100 ml. and Escherichia coli was 3 cultured positive identified from drinking water samples.
          This was a confirmed outbreak of Escherichia coli diarrhea. The investigation suggested that contaminated drinking water was a source of the outbreak because of tap water producing processes and drinking water transportation. To prevent future outbreaks, education programs for drillmasters and students in Military academy school. Recommendation for developing tap water quality and drinking water should be concerned.